Adenoids and Tonsils
A common cause of airway narrowing in children is enlarged adenoids and tonsils (see image above).
Ten percent of children snore on a regular basis. The enlarged adenoids and tonsils cause an airway narrowing and the air passing through the blocked airway results in the actual snoring sound.
If a child is overweight then this can compound the problem, I.e. fat deposits around the neck and throat area. This factor can also contribute to airway narrowing.
If a child snores loudly on a regular basis and has problems in school, shows episodes of witnessed apneas (choking and gasping for air while asleep), failure to thrive, moodiness, and/or increased frequency of throat infections, then it may be a good idea to evaluate their tonsils and adenoids. The Dentist or an Ear, Nose and Throat doctor can evaluate the T and A’s.
Surgical removal of T and A’s is considered the first line of treatment for children with OSA if they show symptoms of OSA and their T and A’ s are very large; however, T and A’s often shrink when the child reaches puberty.
If the following scenario exists:
1) Large T and A’s.
2) Mild OSA.
3) No problem with academics.
4) Child near puberty.
One may want to watch this patient instead of performing surgery…….as there are risks to surgery.
Special Children
Children with Down Syndrome and Cerebral Palsy have a higher risk of developing OSA. They have larger tongues and narrow pharyngeal airways (see blog “Sleep Apnea and the Upper Respiratory Tract” posted on April 14th 2014, to review the airway anatomy).
Conclusion
Treatment of a crowded airway in a child can be remedied by removing the obstruction that is present, however certain variables exist which determine whether or not treatment is even necessary.
In the next blog, we will look at the link between Obstructive Sleep Apnea and headaches…..until then
Dr. F. Keshavarz Dentistry, Brampton Dentist
