{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,19]],"date-time":"2026-09-19T19:43:39Z","timestamp":1789847019552,"version":"4.0.1"},"reference-count":14,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[1998,4,1]],"date-time":"1998-04-01T00:00:00Z","timestamp":891388800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[1998,4,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Collapsibility of the active pharynx, where active contraction of the upper airway muscles is evident, was previously reported to be higher in children with obstructive sleep apnea (OSA) than in those with primary snoring during sleep. Contribution of neuromuscular and anatomic factors to the increased collapsibility, however, was not estimated. We therefore evaluated collapsibility of the passive pharynx, in which upper airway muscle activities were eliminated. Our aim in the present study was to test the hypothesis that children with sleep-disordered breathing (SDB) have a structurally narrowed and a more collapsible pharynx compared with normal children. The static pressure\/area relationship of the passive pharynx was endoscopically quantified in 14 children with SDB and in 13 normal children under general anesthesia with complete paralysis. The majority of children with SDB primarily closed their airways at levels of enlarged adenoids and tonsils with positive closing pressure (Pclose) (3.5 \u00b1 4.3 cm H2O), whereas half of the normal children closed their airways at the soft palate edges and the other half at the tongue bases with subatmospheric Pclose ( \u2212 7.4 \u00b1 4.9 cm H2O). Cross-sectional area of the narrowest segment was significantly smaller in SDB children than in normal children. Interestingly, collapsibility of the retropalatal and retroglossal segments significantly increased in SDB children, compared with the normal subjects. We conclude that anatomic factors play a significant role in the pathogenesis of pediatric OSA and that predisposing structural abnormalities of the entire pharynx are likely to contribute to manifestation of OSA in addition to enlarged adenoids and tonsils.<\/jats:p>","DOI":"10.1164\/ajrccm.157.4.9702042","type":"journal-article","created":{"date-parts":[[2013,4,4]],"date-time":"2013-04-04T13:35:05Z","timestamp":1365082505000},"page":"1204-1212","source":"Crossref","is-referenced-by-count":160,"title":["Comparison of Static Mechanical Properties of the Passive Pharynx between Normal Children and Children with Sleep-disordered Breathing"],"prefix":"10.1093","volume":"157","author":[{"given":"SHIROH","family":"ISONO","sequence":"first","affiliation":[{"name":"Departments of Anesthesiology and Otolaryngology, Chiba University School of Medicine, Chiba; and Departments of Anesthesiology and Otolaryngology, Kaihin Chiba City Hospital, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AKIKO","family":"SHIMADA","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology and Otolaryngology, Chiba University School of Medicine, Chiba; and Departments of Anesthesiology and Otolaryngology, Kaihin Chiba City Hospital, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"MAKOTO","family":"UTSUGI","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology and Otolaryngology, Chiba University School of Medicine, Chiba; and Departments of Anesthesiology and Otolaryngology, Kaihin Chiba City Hospital, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"AKIYOSHI","family":"KONNO","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology and Otolaryngology, Chiba University School of Medicine, Chiba; and Departments of Anesthesiology and Otolaryngology, Kaihin Chiba City Hospital, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"TAKASHI","family":"NISHINO","sequence":"additional","affiliation":[{"name":"Departments of Anesthesiology and Otolaryngology, Chiba University School of Medicine, Chiba; and Departments of Anesthesiology and Otolaryngology, Kaihin Chiba City Hospital, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[1998,4,1]]},"reference":[{"key":"2026032709142640400_B1","doi-asserted-by":"crossref","first-page":"594","DOI":"10.1055\/s-2007-1012757","article-title":"Disorders of breathing during sleep in pediatric population.","volume":"9","author":"Brouillette","year":"1988","journal-title":"Semin. Respir. Med."},{"key":"2026032709142640400_B2","doi-asserted-by":"crossref","first-page":"38","DOI":"10.3109\/00016489209136806","article-title":"Sleep apnea syndrome in children: secondary to adenotonsillar hypertrophy?","volume":"492","author":"Laurikainen","year":"1992","journal-title":"Acta Oto-Laryngol. Suppl."},{"key":"2026032709142640400_B3"},{"key":"2026032709142640400_B4","doi-asserted-by":"crossref","first-page":"918","DOI":"10.1152\/jappl.1994.77.2.918","article-title":"Upper airway collapsibility in children with obstructive sleep apnea syndrome.","volume":"77","author":"Marcus","year":"1994","journal-title":"J. Appl. Physiol."},{"key":"2026032709142640400_B5","doi-asserted-by":"crossref","first-page":"1319","DOI":"10.1152\/jappl.1997.82.4.1319","article-title":"Anatomy of pharynx in patients with obstructive sleep apnea and in normal subjects.","volume":"82","author":"Isono","year":"1997","journal-title":"J. Appl. Physiol."},{"key":"2026032709142640400_B6","doi-asserted-by":"crossref","first-page":"2132","DOI":"10.1152\/jappl.1995.79.6.2132","article-title":"Advancement of the mandible improves velopharyngeal airway patency.","volume":"79","author":"Isono","year":"1995","journal-title":"J. Appl. Physiol."},{"key":"2026032709142640400_B7"},{"key":"2026032709142640400_B8","doi-asserted-by":"crossref","first-page":"148","DOI":"10.1152\/jappl.1993.75.1.148","article-title":"Static mechanics of the velopharynx of patients with obstructive sleep apnea.","volume":"75","author":"Isono","year":"1993","journal-title":"J. Appl. Physiol."},{"key":"2026032709142640400_B9"},{"key":"2026032709142640400_B10","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1164\/arrd.1984.130.2.175","article-title":"Lung volume dependence of pharyngeal cross-sectional area in patients with obstructive sleep apnea.","volume":"130","author":"Hoffstein","year":"1984","journal-title":"Am. Rev. Respir. Dis."},{"key":"2026032709142640400_B11","doi-asserted-by":"crossref","first-page":"2159","DOI":"10.1152\/jappl.1990.68.5.2159","article-title":"Influence of passive changes of lung volume on upper airways.","volume":"68","author":"Series","year":"1990","journal-title":"J. Appl. Physiol."},{"key":"2026032709142640400_B12","doi-asserted-by":"crossref","first-page":"500","DOI":"10.1152\/jappl.1980.48.3.500","article-title":"Upper airway patency in the human infant: influence of airway pressure and posture.","volume":"48","author":"Wilson","year":"1980","journal-title":"J. Appl. Physiol."},{"key":"2026032709142640400_B13","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1093\/geronj\/36.4.420","article-title":"Respiration during sleep in the aged human.","volume":"36","author":"Carskadon","year":"1981","journal-title":"J. Gerontol."},{"key":"2026032709142640400_B14","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1164\/ajrccm\/147.1.182","article-title":"Site of pharyngeal narrowing predicts outcome of surgery for obstructive sleep apnea.","volume":"147","author":"Launois","year":"1993","journal-title":"Am. Rev. Respir. Dis."}],"container-title":["American Journal of Respiratory and Critical Care Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/157\/4\/1204\/67447636\/ajrccm_157_4_1204.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ajrccm\/article-pdf\/157\/4\/1204\/67447636\/ajrccm_157_4_1204.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,27]],"date-time":"2026-03-27T13:14:33Z","timestamp":1774617273000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ajrccm\/article\/157\/4\/1204\/8531193"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1998,4,1]]},"references-count":14,"journal-issue":{"issue":"4","published-online":{"date-parts":[[1998,4,1]]},"published-print":{"date-parts":[[1998,4,1]]}},"URL":"https:\/\/doi.org\/10.1164\/ajrccm.157.4.9702042","relation":{},"ISSN":["1073-449X","1535-4970"],"issn-type":[{"value":"1073-449X","type":"print"},{"value":"1535-4970","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[1998,4]]},"published":{"date-parts":[[1998,4,1]]}}}