OBJECTIVE: The aim of the study was to examine the prevalence of sleep-disordered breathing (SDB) in children and adolescents with large overjet due to mandibular retrognathia compared to a control group.
METHODS: In this case-control study children with large overjet ≥ 6 mm due to mandibular retrognathia (study group) were compared to a group with neutral occlusion (controls). All participants underwent respiratory polygraphy (PG) and questionnaires regarding sleepiness and snoring. Differences across groups were tested by: Chi-square, general linear model adjusted for age, sex, and body mass index (BMI), and Mann-Whitney test. Differences in results of PG were also tested by general linear model adjusted for age, sex, and BMI according to severity of mandibular retrognathia.
RESULTS: Thirty-seven (19 male;18 female, median age 12.3 years) participants were included in the study group and 32 (16 male;16 female, median age 12.2 years) in the control group. No significant difference in SDB assessed by PG or questionnaires between the groups was found even though the snore index was higher in the study group (p=0.051). The snore index was higher than the parent-reported snoring. Respiration rate was significantly reduced in the study group (p=0.043), and estimated sleep time efficiency was significantly reduced in males compared to females (p<0.001).
CONCLUSIONS: No significant differences in SDB were found between the groups even though the snore index was higher in the study group. The snore index of the PG was higher than the parent-reported snoring. Estimated sleep time efficiency was reduced in males. The study improves the understanding of risk of SDB in non-obese children with large overjet due to mandibular retrognathia and may contribute to an interdisciplinary approach of risk assessment of SDB in children with malocclusion.
BACKGROUND: NCT04964830.

BACKGROUND: Sleep-disordered breathing (SDB) during childhood is common and includes a range of breathing abnormalities that range from primary snoring (PS) to obstructive sleep apnea syndrome (OSAS).Studies have shown that not only OSAS, but also PS, which is originally considered harmless, could cause cardiovascular, cognitive, behavioral, and psychosocial problems. Many researches are focused on the relation of OSA and serum lipid levels. However, little studies are focused on PS and serum lipid levels in children.We evaluated whether serum lipid (total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C),low-density lipoprotein cholesterol (LDL-C)) concentrations were associated with specific components of SDB, including indices of oxygen reduction index, lowest oxygen saturation, mean oxygen saturation. And we explored whether serum lipid levels were associated with different degree sleep disordered (PS and OSA group) and obese.
METHODS: This was a cross-sectional study. Children who were complained by their guardians with habitual snoring and(or) mouth breathing were collected in the SDB group. Normal children without sleep problem were matched in the control group. Subjects in the SDB group underwent polysomnography. The serum lipid profiles of all the children included TC, TG, HDL-C and LDL-C concentrations were measured by appropriate enzymatic assays.
RESULTS: A total of 241 with Apnea/Hypopnea Index ≥ 5 (AHI) were assigned to the OSAS group and the remaining 155 with normal AHI were assigned to the PS group. The values of TC, TG, LDL-C and LDL/HDL were significantly higher in the OSAS group than in the PS group, and the values in the PS group were significantly higher than the control group. Multiple regression analysis revealed serum TG only correlated negatively with lowest oxygen saturation. Body mass index-z score has a positive effect on TG in all the 1310 children (P = 0.031) and in SDB 396 children(P = 0.012). The level of serum TG in obese group was significantly higher than that in non-obese group.
CONCLUSIONS: SDB had a very obvious effect on blood lipids, whereas PS without apnea and hypoxia. Obese only affects the aggregation of TG.
BACKGROUND: ChiCTR1900026807(2019.10.23).

Sleep is a major concern in Down syndrome children. Obstructive sleep apnea, delayed sleep onset, night-time and early awakenings have been reported contributing to the cognitive and behavioral outcomes. The aim is to evaluate sleep related difficulties in Down syndrome young children. A questionnaire of sleep related difficulties was translated and validated into Arabic language then was filled in by caregivers of 45 Down syndrome and 48 normal children. The questionnaire consisted of sections related to snoring, breathing difficulties, mouth breathing, upper respiratory tract infections, sleep position, restless sleep and frequent awakening, and daytime behavior. The results show highly significant differences between the total and subtotal questionnaire scores with higher scores in the control group. The questionnaire has a good reliability. Test-retest reliability of the questionnaire revealed a significant positive correlation in the total questionnaire and all the subitems except for the 7th subitem of the daytime behavior which showed no significant correlation. The questionnaire showed 100% sensitivity and 70.8% Specificity with at cut-off value of 8.5. The sleep related difficulties questionnaire has good psychometric properties and could detect significant sleep problems in Down syndrome children.
UNASSIGNED: The online version contains supplementary material available at 10.1007/s12070-023-04090-9.

BACKGROUND: Obstructive sleep apnea complicates 10% to 32% or greater of pregnancies, however, reports on long-term effects on the children of pregnancies affected by obstructive sleep apnea are limited.
OBJECTIVE: We sought to test the hypothesis that the children of pregnant people with symptoms of obstructive sleep apnea during pregnancy have an increased incidence of autism spectrum disorder.
METHODS: This was a case-control study comparing the pregnancies of people whose children were later diagnosed with autism spectrum disorder without a known associated genetic condition to those whose children were diagnosed with autism spectrum disorder with a known associated genetic condition.
RESULTS: Of the 51 total parents who were eligible and consented to participate, 4 had a child with autism associated with a known genetic condition, and 47 had a child with autism with no known genetic condition. The prevalence of any snoring (50.0% and 36.2%, respectively) and daytime tiredness (75.0% and 89.4%, respectively) were similar between both groups.
CONCLUSIONS: In this study, the prevalence of any snoring and falling asleep while driving during pregnancy was higher in the sampled population than typically reported in pregnant people. While the sample size for this study was small, our preliminary results suggest that parents of children with autism have a high prevalence of sleep-related concerns during their pregnancies, which indicates the need for further investigation - especially for obstructive sleep apnea. Future studies exploring the neurodevelopmental outcomes of children of a cohort of pregnant people with known presence or absence of obstructive sleep apnea during pregnancy is warranted.

BACKGROUND: The aim of this study was to analyze the relationship between breastfeeding duration and adenoid size, snoring and acute otitis media (AOM).
METHODS: We analyzed the medical history of children admitted to the ENT outpatient clinic in 2022 and 2023, reported symptoms, ear, nose and throat (ENT) examination, and flexible nasopharyngoscopy examination of 145 children aged 3-5 years.
RESULTS: Breastfeeding duration of 3 and 6 months or more had a significant effect on the reduction of snoring (p = 0.021; p = 0.039). However, it had no effect on the adenoid size, mucus coverage and sleeping with an open mouth. Snoring was correlated with open mouth sleeping (p < 0.001), adenoid size with a 75% A/C ratio or more (p < 0.001), and adenoid mucus coverage in the Mucus of Adenoid Scale by Nasopharyngoscopy Assessment-MASNA scale (p = 0.009). Children who were breastfed for less than 3 months had more than a four-fold greater risk of snoring. There was a statistically significant correlation between AOM and gender (p = 0.033), breastfeeding duration in groups fed 1, 3 or 6 months or more (p = 0.018; p = 0.004; p = 0.004) and those fed with mother\'s breast milk 3 or 6 months or more (p = 0.009; p = 0.010). Moreover, a correlation was found between adenoid size and mucus coverage, tympanogram, and open-mouth sleeping (p < 0.001). Independent factors of snoring in 3- to 5-year-old children were breastfeeding duration of less than 3 months (p = 0.032), adenoid size with an A/C ratio of 75% or more (p = 0.023) and open mouth sleeping (p = 0.001).
CONCLUSIONS: Children breastfed for 3 and 6 months or more exhibited reduced rates of snoring. There was no effect of breastfeeding duration on adenoid size in children aged 3 to 5 years, suggesting that the link between breastfeeding duration and snoring is primarily associated with craniofacial development and muscle tone stimulation. A breastfeeding duration of 1 month or more plays a key role in reducing the rate of AOM. The mother\'s milk plays a protective role against AOM. The presence of mucus might be responsible for snoring in preschool children. A medical history of breastfeeding should be taken into consideration when snoring children are suspected of adenoid hypertrophy.

OBJECTIVE: To assess the role of laryngo-tracheo-bronchoscopy in children with obstructive sleep apnoea by identifying airway abnormalities at surgery, that occur separately or in addition to adenotonsillar hypertrophy, and examining the correlation with respiratory parameters.
METHODS: A retrospective study was conducted of children with obstructive sleep apnoea who underwent laryngo-tracheo-bronchoscopy intra-operatively, performed by a single ENT surgeon from February 2016 to July 2019. Pre- and post-operative minimum oxygen saturation, apnoea-hypopnoea index, and oxygen desaturation index were recorded.
RESULTS: Sixty-five children were identified; 34 were aged less than three years and 31 were aged three years or more. 77 per cent and 13 per cent respectively had an airway abnormality; the t-test showed a significantly higher mean oxygen desaturation index and lower mean minimum oxygen saturation pre-operatively compared to children without an airway abnormality.
CONCLUSIONS: An update of the surgical pathway for children aged less than three years with obstructive sleep apnoea is required to include laryngo-tracheo-bronchoscopy intra-operatively. A t-test analysis of the pre-operative respiratory parameters suggests that airway abnormalities contribute to obstructive sleep apnoea severity.

Obstructive Sleep Apnea (OSA) is one of the most common sleep disorders. A mandibular advancement device (MAD) can be used to manage primary snoring and OSA cases. It is mostly indicated in cases with mild to moderate OSA. This case reports shows the successful management of severe OSA using MAD. A 34-year-old male presented to the orthodontic clinic with a diagnosis of severe OSA, apnea-hypopnea index (AHI) of 71 events per hour with symptoms of loud snoring, witnessed gasping, morning headache, and excessive daytime sleepiness. The case was managed using MAD to position the lower jaw in a forward position during sleep with 7 mm advancement. Progress sleep study results showed that the AHI reached normal levels, with only two hypopnea events per hour and a complete resolution of apnea episodes. The patient\'s symptoms subsided after using MADs. This case report documents that severe OSA can be managed with MAD in suitable cases.

Normal airways are a key factor during the craniofacial growth of the young. Therefore, sleep-disordered breathing (SDB) without treatment can have harmful consequences for development and health.
This study aimed to evaluate the cephalometric characteristics in non-snoring individuals and snoring subjects, and investigate differences in the pharyngeal airway space between the 2 groups.
This case-control study included 70 patients aged over 18 years, selected from a radiology center. The patients were divided into 2 groups: case (35 patients with a history of habitual snoring); and control (35 healthy patients). The Berlin sleep questionnaire was administered to the parents of the patients. The nasopharyngeal airway was measured according to the analysis of Linder-Aronson (1970), and 4 indices were measured and analyzed in each of the lateral cephalometric radiographs.
No statistically significant differences were observed in the pharyngeal measurements between the 2 groups, although all means in the control group were higher than in the experimental group. However, there was a significant relationship between gender and the Ba-S-PNS and PNS-AD2 indices.
Although the patients with nocturnal snoring had smaller airway dimensions, their pharyngeal measurements were not significantly different from the control group.

UNASSIGNED: Head and neck is the second most common region for lymphomas. Extranodal lymphomas of the larynx are rare in the pediatric population. Non Hodgkin Lymphoma (NHL) of the larynx is common in the supraglottic region as its rich in lymphoid tissue. They may present with dysphagia, dysphonia, snoring and progressive respiratory distress. Early visualization of the larynx is essential in such cases for appropriate diagnosis to improve the survival rates.
UNASSIGNED: We present a case of 9 year old boy who presented with a change in voice, snoring and feeding difficulties for one year. Video laryngoscopy revealed globular mass arising from the epiglottis. He underwent excision biopsy and by immunohistochemistry was diagnosed to have diffuse large B cell lymphoma. He was treated with chemotherapy and the child is clinically well in the follow-up, 1 year after the completion of therapy.
UNASSIGNED: Although primary lymphomas of the larynx in children are rare, a high index of clinical suspicion is warranted to avoid diagnostic delays to initiate appropriate management to have better outcomes.

本文报道了1例以睡眠打鼾为主要表现的第二鳃裂囊肿（second branchial cleft cyst，SBCC）。患儿男，9岁5月，因“打鼾3年余，加重2个月，发现鼻咽部肿物1周”就诊。术前MR示右侧咽旁间隙延伸至鼻咽腔囊状肿物影，考虑第二鳃裂囊肿可能。在全身麻醉下行内窥镜下鳃裂囊肿切除术，肿物内含囊液，术后病理诊断为第二鳃裂囊肿。术后半年复查MR未见原囊性占位。随访1年，未见囊肿复发，预后良好。.