Down Syndrome Abstract
of the Month:
Sept 2008
Relative rather than absolute macroglossia in patients with Down syndrome: implications for treatment of obstructive sleep apnea
Guimaraes CV, Donnelly LF, Shott SR, Amin RS, Kalra M.
Pediatr Radiol. 2008 Aug 7
Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Abstract:
BACKGROUND: Children with Down syndrome are described as having macroglossia as well as midface hypoplasia. We reviewed anatomic parameters on MRI to determine whether adolescents with Down syndrome have true macroglossia or relatively large tongues compared to the small size of their oral cavity. This has implications for the treatment of obstructive sleep apnea, which occurs at a relatively high rate among patients with Down syndrome. OBJECTIVE: To determine whether adolescents with Down syndrome have relative rather than true macroglossia. MATERIALS AND METHODS: On sagittal and axial MR images, parameters for tongue size (area in sagittal midline), the bony craniofacial confines of the retroglossal pharynx (distance between the mandibular rami and distance between the posterior aspect of the mental mandible and the anterior aspect of the spine), and the size of the tongue relative to the craniofacial bony parameters [tongue area/(transverse diameter x anterior-to-posterior diameter)] were compared between 16 patients with Down syndrome and 16 age- and gender-matched controls. RESULTS: The tongue area was significantly smaller in patients with Down syndrome than in the control patients. The craniofacial bony parameters were also smaller in patients with Down syndrome than in the controls. However, the size of the tongue relative to the craniofacial parameters was larger in the patients with Down syndrome than in the controls. CONCLUSION: Children with Down syndrome do not have true macroglossia but have relatively large tongues compared to the bony confines of the oral cavity.
My comments:
This is quite a straight-forward article, and the abstract pretty much sums everything up. It's important to note that all the subjects in this study were adolescents, but a similar on younger children in 2001 found the same results. For children with DS who have persistent obstructive sleep apnea after removal of tonsils and adenoids, evaluation of the tongue is necessary to determine if it is the cause of the apnea. However, as this study shows, efforts may be needed to enlarge the oral cavity size rather than reduce the tongue.Home Page | List of Past Abstracts | Contact Me