Evaluation of the Relationship between Childhood Adenoid Tissue and Subcutaneous Fat Tissue Using MRI

Abstract

Purpose: In this study, it was aimed to evaluate the relationship between subcutaneous fat tissue thickness in the neck region and nasopharyngeal air passage in pediatric patients with magnetic resonance imaging (MRI).

Materials and Methods: In our study, medical imaging records of 93 children (46 male and 47 female) aged between 4-6 years, who underwent brain magnetic resonance imaging (MRI) for any reason between June 2018 and December 2018, were retrospec-tively examined on the purpose of evaluation of adenoid tissue thickness and occipital subcutaneous fat tissue thickness. Single plane (sagittal plane) rapid sequence MRI images taken from the patients within the last one year were used for this purpose.

Results: A total of 93 cases, 46(49.5%) male and 47(50.5%) female, were included in the study. No statistically significant differ-ence was observed in nasopharyngeal adenoid tissue thickness and occipital region subcutaneous fat tissue thicknesses according to gender. While the mean adenoid tissue thickness was 9.8±2.13 mm in men, it was measured as 9.25±1.74 mm in women (p=0.178). The mean subcutaneous fat tissue thickness obtained from the occipital region was 5.65±1.26 mm in male, whereas it was found to be 5.84±1.28 mm in women (p=0.465). However, a significant moderate positive correlation was found between the occipital subcutaneous fat tissue thickness, adenoid tissue thickness (Rho=0.488 p=0.000) and the percentage of nasopharyngeal air passage stenosis (Rho=0.482 p=0.000).

Conclusion: The nasopharyngeal air passage was observed to be significantly narrowed as occipital subcutaneous fat tissue thickness and adenoid tissue thickness increased.

Keywords

• Adenoid
• MRI
• Obesity
• Pediatric
• Sleep apnea

Çocukluk Çağı Adenoid Dokusu ve Deri Altı Yağ Dokusu İlişkisinin MRG Kullanılarak Değerlendirilmesi

Abstract

Amaç: Bu çalışmada, çocuk hastalarda boyun bölgesindeki deri altı yağ dokusu kalınlığı ile nazofaringeal hava geçişi arasındaki ilişkinin manyetik rezonans görüntülemede (MRG) ile değerlendirilmesi amaçlanmıştır.

Araçlar ve Yöntem: Çalışmamızda Haziran 2018 ile Aralık 2018 tarihleri arasında herhangi bir nedenle beyin manyetik rezonans görüntüleme (MRG) yapılan 4-6 yaş arası 93 çocuğun (46 erkek ve 47 kadın) tıbbi görüntüleme kayıtları adenoid doku kalınlığı ve oksipital deri altı yağ dokusu kalınlığının değerlendirilmesi amacıyla geriye dönük olarak incelendi. Bu amaçla hastalardan son bir yıl içinde alınan tek düzlemli (sagital düzlem) hızlı sıralı MRG görüntüleri kullanıldı.

Bulgular: Çalışmaya 46(%49.5) erkek ve 47(%50.5) kadın olmak üzere toplam 93 olgu dahil edildi. Cinsiyete göre nazofaringeal adenoid doku kalınlıkları ile oksipital bölge subkutan yağ doku kalınlıkları arasında istatistiksel olarak anlamlı bir fark gözlen-medi. Ortalama adenoid doku kalınlığı erkeklerde 9.8±2.13 mm iken kadınlarda 9.25±1.74 mm olarak ölçüldü (p=0.178). Oksipi-tal bölgeden elde edilen ortalama deri altı yağ dokusu kalınlığı erkeklerde 5.65±1.26 mm, kadınlarda ise 5.84±1.28 mm olarak bulundu (p=0.465). Ancak, oksipital deri altı yağ dokusu kalınlığı, adenoid doku kalınlığı (Rho=0.488 p=0.000) ve nazofaringeal hava yolu darlığı yüzdesi (Rho=0.482 p=0.000) arasında orta derecede pozitif korelasyon bulundu.

Sonuç: Oksipital subkutan yağ dokusu kalınlığı ve adenoid doku kalınlığı arttıkça nazofaringeal hava yolunun önemli ölçüde daraldığı gözlendi.

Keywords

• Adenoid
• MRG
• Obezite
• Pediatri
• Uyku apnesi

References

1. 1. Wetmore RF. Tonsils and Adenoids. In: Nelson Textbook of Pediatrics; Kliegman RM, Stanton BF, St Geme JW, Schor NF, 20th ed., Philadelphia, Elsevier, 2015;2023-2026.
2. 2. Ishida T, Manabe A, Yang SS, Yoon HS, Kanda E, Ono T. Patterns of adenoid and tonsil growth in Japanese children and adolescents: A longitudinal study. Sci Rep. 2018;8(1):1-7.
3. 3. Major MP, Saltaji H, El-Hakim H, Witmans M, Major P, Flores-Mir C. The accuracy of diagnostic tests for adenoid hypertrophy: a systematic review. J Am Dent Assoc. 2014;145(3):247-254.
4. 4. Bar A, Tarasiuk A, Segev Y, Phillip M, Tal A. The effect of adenotonsillectomy on serum insulin-like growth factor-I and growth in children with obstructive sleep apnea syndrome. J Pediatr. 1999;135(1):76-80.
5. 5. Gozal D. Sleep-disordered breathing and school performance in children. Pediatrics. 1998;102(3):616-620.
6. 6. Shen L, Lin Z, Lin X, Yang Z. Risk factors associated with obstructive sleep apnea-hypopnea syndrome in Chinese children: A single center retrospective case control study. PLoS One. 2018;13(9):e0203695.
7. 7. Daar G, Sarı K, Gencer ZK, Ede H, Aydın R, Saydam L. The relation between childhood obesity and adenotonsillar hypertrophy. Eur Arch Otorhinolaryngol. 2016;273(2):505-509.
8. 8. Kang KT, Chou CH, Weng WC, Lee PL, Hsu WC. Associations between adenotonsillar hypertrophy, age, and obesity in children with obstructive sleep apnea. PLoS One. 2013;8(10):e78666.

9. 9. Kang KT, Lee PL, Weng WC, Hsu WC. Body weight status and obstructive sleep apnea in children. Int J Obes (Lond). 2012;36(7):920-924.
10. 10. Bitar MA, Birjawi G, Youssef M, Fuleihan N. How frequent is adenoid obstruction? Impact on the diagnostic approach. Pediatr Int. 2009;51(4):478-483.
11. 11. Duan H, Xia L, He W, Lin Y, Lu Z, Lan Q. Accuracy of lateral cephalogram for diagnosis of adenoid hypertrophy and posterior upper airway obstruction: A metaanalysis. Int J Pediatr Otorhinolaryngol. 2019; 119:1-9.
12. 12. Faul F, Erdfelder E, Lang A-G, Buchner A. G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39(2):175-191.
13. 13. Wang Y, Jiao H, Mi C, Yang G, Han T. Evaluation of Adenoid Hypertrophy with Ultrasonography. Indian J Pediatr. 2020;87(11):910-915.
14. 14. Niedzielska G, Kotowski M, Niedzielski A. Assessment of pulmonary function and nasal flow in children with adenoid hypertrophy. Int J Pediatr Otorhinolaryngol. 2008;72(3):333-335.
15. 15. Pruzansky S. Roentgencephalometric studies of tonsils and adenoids in normal and pathologic states. Ann Otol Rhinol Laryngol. 1975;84(2):55-62.
16. 16. Wang DY, Bernheim N, Kaufman L, Clement P. Assessment of adenoid size in children by fibreoptic examination. Clin Otolaryngol Allied Sci. 1997;22(2): 172-177.
17. 17. Amaddeo A, de Sanctis L, Olmo Arroyo J, Giordanella JP, Monteyrol PJ, Fauroux B. Obésité et SAOS de l’enfant. Obesity and obstructive sleep apnea in children. Arch Pediatr. 2017;24(1):34-38.
18. 18. Major MP, Flores-Mir C, Major PW. Assessment of lateral cephalometric diagnosis of adenoid hypertrophy and posterior upper airway obstruction: a systematic review. Am J Orthod Dentofacial Orthop. 2006;130(6):700-708.
19. 19. Fujioka M, Young LW, Girdany BR. Radiographic evaluation of adenoidal size in children: adenoidal-nasopharyngeal ratio. AJR Am J Roentgenol. 1979;133 (3):401-404.