{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:49:58Z","timestamp":1792100998642,"version":"4.4.0"},"reference-count":48,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2013,5,10]],"date-time":"2013-05-10T00:00:00Z","timestamp":1368144000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>To determine if adenotonsillar hypertrophy is an isolated factor in pediatric obstructive sleep apnea (OSA), or if it is part of larger spectrum of cervical lymphoid hypertrophy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Prospective case control study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A total of 70 screened patients (mean age 7.47 years) underwent polysomnography to confirm OSA, and then underwent MRI of the upper airway. Seventy\u2010six matched controls (mean age 8.00 years) who already had an MRI underwent polysomnography. Volumetric analysis of lymphoid tissue volumes was carried out. Chi\u2010square analysis and Student's <jats:italic>t<\/jats:italic> test were used to compare demographic data and lymph node volumes between cohorts. Fisher's Exact test and Chi\u2010square analysis were used to compare sleep data.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Patients and controls demonstrated no significant difference in mean age (7.47 vs. 8.00 yrs), weight (44.87 vs. 38.71 kg), height (124.68 vs. 127.65 cm), or body\u2010mass index (23.63 vs. 20.87 kg\/m<jats:sup>2<\/jats:sup>). OSA patients demonstrated poorer sleep measures than controls (<jats:italic>P<\/jats:italic> &lt; 0.05) in all polysomnography categories (sleep efficiency, apnea index, apnea\u2010hypopnea index, baseline SpO<jats:sub>2<\/jats:sub>, SpO<jats:sub>2<\/jats:sub> nadir, baseline ETCO<jats:sub>2<\/jats:sub>, peak ETCO<jats:sub>2<\/jats:sub>, and arousal awakening index). Children with OSA had higher lymphoid tissue volumes than controls in the retropharyngeal region (3316 vs. 2403 mm<jats:sup>3<\/jats:sup>, <jats:italic>P<\/jats:italic> &lt; 0.001), upper jugular region (22202 vs. 16819 mm<jats:sup>3<\/jats:sup>, <jats:italic>P<\/jats:italic> &lt; 0.005), and adenotonsillar region (18994 vs. 12675 mm<jats:sup>3<\/jats:sup>, <jats:italic>P<\/jats:italic> &lt; 0.0001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Children with OSA have larger volumes of deep cervical lymph nodes and adenotonsillar tissue than controls. This finding suggests a new paradigm in the understanding of pediatric OSA, and has ramifications for future research and clinical care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>3b. Laryngoscope, 123:2043\u20132049, 2013<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.23748","type":"journal-article","created":{"date-parts":[[2013,5,10]],"date-time":"2013-05-10T20:07:19Z","timestamp":1368216439000},"page":"2043-2049","source":"Crossref","is-referenced-by-count":14,"title":["Deep cervical lymph node hypertrophy: A new paradigm in the understanding of pediatric obstructive sleep apnea"],"prefix":"10.1002","volume":"123","author":[{"given":"Sanjay R.","family":"Parikh","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Seattle Children's Hospital\u2013University of Washington School of Medicine Seattle Washington"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babak","family":"Sadoughi","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2013Head and Neck Surgery Children's Hospital at Montefiore\u2013Albert Einstein College of Medicine Bronx New York 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