{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T16:55:29Z","timestamp":1780332929519,"version":"3.54.1"},"reference-count":31,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2017,11,7]],"date-time":"2017-11-07T00:00:00Z","timestamp":1510012800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine whether neck:height ratio combined with adenoid and tonsillar size is a good predictive tool for obstructive sleep apnea in obese youth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Cross\u2010sectional study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Sleep clinics at the Hospital for Sick Children, Toronto, Canada.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Consented obese individuals aged 8 to 18 years were recruited between 2013 and 2015. Anthropometric measures were obtained by a trained research coordinator in a standardized manner. Otolaryngologists evaluated adenoid and tonsil sizes. Obstructive sleep apnea was diagnosed with an overnight polysomnogram as an obstructive apnea\u2010hypopnea index \u22652. Multivariable logistic regressions investigated the relationship between potential predictors and obstructive sleep apnea. The C\u2010statistic measured the predictive ability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Of the 53 subjects (median age, 13 years; 55% males), 28 (53%) were diagnosed with obstructive sleep apnea, with a median index of 10.6 per hour. In a logistic regression controlling for adenoid size, enlarged tonsils were significantly associated with the presence of obstructive sleep apnea (<jats:italic>P<\/jats:italic> &lt;. 01). Adding neck:height ratio into the model improved the model predictive ability (C\u2010index increased from 0.73 to 0.84). Controlling for tonsil and adenoid sizes, an increase in neck:height ratio was significantly associated with the presence of obstructive sleep apnea (<jats:italic>P<\/jats:italic> =. 01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our study suggests that neck:height ratio combined with tonsillar hypertrophy may have a strong predictive ability for obstructive sleep apnea and may be useful in an ambulatory setting to screen obese youth at high risk. These findings should be confirmed in a larger study.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599817740349","type":"journal-article","created":{"date-parts":[[2017,12,31]],"date-time":"2017-12-31T06:24:01Z","timestamp":1514701441000},"page":"745-751","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":18,"title":["Utility of Neck, Height, and Tonsillar Size to Screen for Obstructive Sleep Apnea among Obese Youth"],"prefix":"10.1002","volume":"158","author":[{"given":"Indra","family":"Narang","sequence":"first","affiliation":[{"name":"Division of Respiratory Medicine Hospital for Sick Children Toronto Canada"},{"name":"University of Toronto Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Suhail","family":"Al\u2010Saleh","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine Hospital for Sick Children Toronto Canada"},{"name":"University of Toronto Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reshma","family":"Amin","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine Hospital for Sick Children Toronto Canada"},{"name":"University of Toronto Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evan J.","family":"Propst","sequence":"additional","affiliation":[{"name":"University of Toronto Toronto Canada"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Hospital for Sick Children Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saadoun","family":"Bin\u2010Hasan","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine Hospital for Sick Children Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paolo","family":"Campisi","sequence":"additional","affiliation":[{"name":"University of Toronto Toronto Canada"},{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Hospital for Sick Children Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clodagh","family":"Ryan","sequence":"additional","affiliation":[{"name":"University of Toronto Toronto Canada"},{"name":"Division of Respirology Toronto General Hospital University Health Network Toronto Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tetyana","family":"Kendzerska","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences Toronto Canada"},{"name":"The Ottawa Hospital Research Institute University of Ottawa Ottawa Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,11,7]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(08)61622-0"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201510-1942OC"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1155\/2012\/134202"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.smrv.2007.11.002"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012-1671"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1093\/pch\/19.7.367"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1215881"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00431-015-2613-6"},{"key":"e_1_2_8_10_1","first-page":"211","article-title":"Sleeping too close together: obesity and obstructive sleep apnea in childhood and adolescence","volume":"15","author":"Mathew JL","year":"2013","journal-title":"Paediatr Respir Rev"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1093\/sleep\/33.12.1641"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.5572"},{"key":"e_1_2_8_13_1","unstructured":"World Health Organization.The WHO child growth standards.http:\/\/www.who.int\/childgrowth\/en\/."},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1177\/15648265040251S105"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpediatrics.2012.126"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2010-0242"},{"key":"e_1_2_8_17_1","volume-title":"A Manual of Standardized Terminiology: Techniques and Scoring System for Sleep Stages","author":"Rechtschaffen A","year":"1968"},{"key":"e_1_2_8_18_1","volume-title":"The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications. 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