DO PEDIATRIC INDIVIDUALS WITH ADENOID HYPERTROPHY HAVE DEVELOPMENTAL DIFFERENCES IN BRAIN ANATOMICAL STRUCTURES? A RETROSPECTIVE MAGNETIC RESONANCE IMAGING STUDY

Öz

Objective: Adenoid hypertrophy (AH) can cause changes in the brain by causing sleep-disordered breathing and obstructive sleep apnea. However, it has not been investigated whether AH affects the brain anatomy as a single factor independent of these diseases. In this study, we investigated the effects of AH on brain development using the estimated brain age (EBA) method. Method: This retrospective study included 55 individuals (39 males) with AH, aged 1-12 years, and 55 individuals of similar age and sex without AH. We used the adenoid-nasopharyngeal ratio (ANR: ratio of adenoid thickness to nasopharynx width) to detect AH. We used volBrain's BrainStructureAges (BSA) pipeline for EBA on brain anatomical structures. We compared the data with SPSS (ver.28). Results: ANR were higher in AH group (0.66±0.06) than control group (0.40±0.09) (p<0.05). Since the mean ANO value was between 0.60 and 0.69, AH group had mild obstruction. The mean chronological age of children in this study's AH and control groups was 5.07±2.80 years. We did not detect any significant difference in the global brain mean EBA values between the AH group (6.85±3.18 years) and the control group (6.97±3.30 years) (p>0.05). Mean EBA values of cortical and subcortical anatomical regions ranged from 6.51 to 7.97 years in the AH group and from 6.56 to 8.22 years in the control group. There was no statistically significant difference in EBA values of brain regions between AH and control groups (p>0.05). Conclusion: This study showed that mild AH does not negatively affect children's brain development in terms of EBA. Although minor deviations in EBA were observed in selected cortical and subcortical regions, these variations remained within the normal range of developmental heterogeneity. These findings demonstrated that mild AH is not an independent risk factor for brain development in the pediatric population.

Anahtar Kelimeler

• Adenoid Hypertrophy
• Age Estimation
• Brain
• Pediatric
• Magnetic Resonance Imaging

ADENOİD HİPERTROFİSİ OLAN PEDİATRİK BİREYLERDE BEYİN ANATOMİK YAPILARINDA GELİŞİMSEL FARKLILIKLAR VAR MI? RETROSPEKTİF BİR MANYETİK REZONANS GÖRÜNTÜLEME ÇALIŞMASI

Öz

Amaç: Adenoid hipertrofisi (AH), uykuda solunum bozukluğu ve obstrüktif uyku apnesine neden olarak beyinde değişikliklere neden olabilir. Ancak, AH'nin bu hastalıklardan bağımsız olarak beyin anatomisini tek başına etkileyip etkilemediği araştırılmamıştır. Bu çalışmada AH'nin beyin gelişimi üzerindeki etkilerini tahmini beyin yaşı (TBY) yöntemi ile inceledik. Yöntem: Bu retrospektif çalışmaya 1-12 yaşları arasında AH'li 55 birey (39 erkek) ve benzer yaş ve cinsiyette AH'siz 55 birey katıldı. AH'yi saptamak için adenoid-nazofaringeal orandan (ANO: adenoid kalınlığının nazofarenks genişliğine oranı) yararlandık. Beyin anatomik yapıları üzerinde TBY için volBrain'in BrainStructureAges (BSA) veri hattını kullandık. Veriler SPSS (versiyon 28) ile karşılaştırıldı. Bulgular: ANO değerlerinin AH grubunda (0.66±0.06) kontrol grubuna (0.40±0.09) göre anlamlı derecede daha yüksek olduğunu gözlemledik (p<0.05). Ortalama ANO değeri 0.60-0.69 arasında olduğundan AH grubu hafif derecede obstrüksiyona sahipti. Bu çalışmada AH ve kontrol gruplarındaki çocukların ortalama kronolojik yaşı 5.07±2.80 yıl idi. AH grubu (6.85±3.18 yıl) ile kontrol grubu (6.97±3.30 yıl) arasında global beyin ortalama TBY'si açısından anlamlı bir fark tespit edilmedi (p>0.05). Kortikal ve subkortikal anatomik bölgelerin ortalama EBA değerleri AH grubunda 6.51 yıl ile 7.97 yıl arasında, kontrol grubunda ise 6.56 yıl ile 8.22 yıl arasındaydı. Beyin bölgelerinin EBA değerleri açısından AH ve kontrol gruplarının arasında istatistiksel olarak anlamlı bir fark yoktu (p>0.05). Sonuç: Bu çalışma, hafif AH'nin TBY açısından çocukların beyin gelişimini olumsuz etkilemediğini gösterdi. Seçilen kortikal ve subkortikal bölgelerde TBY’de küçük sapmalar gözlemlenmiş olsa da bu varyasyonlar normal gelişimsel heterojenlik aralığında kaldı. Bu bulgular, hafif AH'nin pediatrik popülasyonda beyin gelişimi için bağımsız bir risk faktörü olmadığını gösterdi.

Anahtar Kelimeler

• Adenoid Hipertrofisi
• Yaş Tahmini
• Beyin
• Pediatri
• Manyetik Rezonans Görüntüleme

Kaynakça

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