Although adenotonsillectomy is considered the firstline
treatment in OSAS in obese children with adenotonsillar
hypertrophy, up to 50% may still have unresolved
OSAS after their surgery.9–11 This suggests that other
factors not ameliorated by adenotonsillectomy contribute
to OSAS in obese children. Factors to be considered
include low upper airway muscle tone, increased parapharyngeal
fat and upper airway tissue fat content,
altered chest-wall mechanics, which can all increase
upper airway collapsibility during sleep. In addition,
anatomical abnormalities of the nasal passages, such as
nasal septal deviation, nasal turbinate hypertrophy, and
allergic rhinitis, could increase upper airway nasal
resistance and perpetuate OSAS in these subjects.
The relationship between nasal resistance and OSAS is
not well defined.12 Several studies using a standardized
method known as active anterior rhinomanometry (AAR)
Although adenotonsillectomy is considered the firstlinetreatment in OSAS in obese children with adenotonsillarhypertrophy, up to 50% may still have unresolvedOSAS after their surgery.9–11 This suggests that otherfactors not ameliorated by adenotonsillectomy contributeto OSAS in obese children. Factors to be consideredinclude low upper airway muscle tone, increased parapharyngealfat and upper airway tissue fat content,altered chest-wall mechanics, which can all increaseupper airway collapsibility during sleep. In addition,anatomical abnormalities of the nasal passages, such asnasal septal deviation, nasal turbinate hypertrophy, andallergic rhinitis, could increase upper airway nasalresistance and perpetuate OSAS in these subjects.The relationship between nasal resistance and OSAS isnot well defined.12 Several studies using a standardizedmethod known as active anterior rhinomanometry (AAR)
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