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Pediatrics
Diagnosis
Airway
Obstructive Sleep Apnea
Glossoptosis
Glossoptosis
Mantosh S. Rattan, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Abnormal posterior motion of tongue during sleep leading to obstructive sleep apnea (OSA)
            • Typically associated with underlying hypotonia, macroglossia, or micrognathia
            • Glossoptosis almost unheard of in otherwise healthy children

          IMAGING

          • General Features

            • Radiographic Findings

              • MR Findings

                • Imaging Recommendations

                  DIFFERENTIAL DIAGNOSIS

                    PATHOLOGY

                    • General Features

                      • Gross Pathologic & Surgical Features

                        CLINICAL ISSUES

                        • Presentation

                          • Demographics

                            • Treatment

                              DIAGNOSTIC CHECKLIST

                              • Image Interpretation Pearls

                                Selected References

                                1. Ehsan Z et al: The effects of Anesthesia and opioids on the upper airway: A systematic review. Laryngoscope. 126(1):270-84, 2016
                                2. Donnelly LF: Magnetic resonance sleep studies in the evaluation of children with obstructive sleep apnea. Semin Ultrasound CT MR. 31(2):107-15, 2010
                                3. Schaaf WE Jr et al: Findings on MR sleep studies as biomarkers to predict outcome of genioglossus advancement in the treatment of obstructive sleep apnea in children and young adults. AJR Am J Roentgenol. 194(5):1204-9, 2010
                                4. Mahmoud M et al: A comparison of dexmedetomidine with propofol for magnetic resonance imaging sleep studies in children. Anesth Analg. 109(3):745-53, 2009
                                5. Guimaraes CV et al: Relative rather than absolute macroglossia in patients with Down syndrome: implications for treatment of obstructive sleep apnea. Pediatr Radiol. 38(10):1062-7, 2008
                                6. Mihaescu M et al: Computational fluid dynamics analysis of upper airway reconstructed from magnetic resonance imaging data. Ann Otol Rhinol Laryngol. 117(4):303-9, 2008
                                7. Fricke BL et al: Comparison of lingual tonsil size as depicted on MR imaging between children with obstructive sleep apnea despite previous tonsillectomy and adenoidectomy and normal controls. Pediatr Radiol. 36(6):518-23, 2006
                                8. Donnelly LF: Obstructive sleep apnea in pediatric patients: evaluation with cine MR sleep studies. Radiology. 236(3):768-78, 2005
                                9. Donnelly LF et al: Causes of persistent obstructive sleep apnea despite previous tonsillectomy and adenoidectomy in children with down syndrome as depicted on static and dynamic cine MRI. AJR Am J Roentgenol. 183(1):175-81, 2004
                                10. Nour SG et al: Percutaneous MR imaging-guided radiofrequency interstitial thermal ablation of tongue base in porcine models: implications for obstructive sleep apnea syndrome. Radiology. 230(2):359-68, 2004
                                11. Rosen CL: Obstructive sleep apnea syndrome in children: controversies in diagnosis and treatment. Pediatr Clin North Am. 51(1):153-67, vii, 2004
                                12. de Miguel-Diez J et al: Prevalence of sleep-disordered breathing in children with Down syndrome: polygraphic findings in 108 children. Sleep. 26(8):1006-9, 2003
                                13. Donnelly LF et al: Upper airway motion depicted at cine MR imaging performed during sleep: comparison between young Patients with and those without obstructive sleep apnea. Radiology. 227(1):239-45, 2003
                                14. Donnelly LF et al: Glossoptosis (posterior displacement of the tongue) during sleep: a frequent cause of sleep apnea in pediatric patients referred for dynamic sleep fluoroscopy. AJR Am J Roentgenol. 175(6):1557-60, 2000
                                15. Donnelly LF et al: Imaging of pediatric tongue abnormalities. AJR Am J Roentgenol. 175(2):489-93, 2000
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                KEY FACTS

                                • Terminology

                                  • Imaging

                                    • Pathology

                                      • Clinical Issues

                                        TERMINOLOGY

                                        • Definitions

                                          • Abnormal posterior motion of tongue during sleep leading to obstructive sleep apnea (OSA)
                                          • Typically associated with underlying hypotonia, macroglossia, or micrognathia
                                          • Glossoptosis almost unheard of in otherwise healthy children

                                        IMAGING

                                        • General Features

                                          • Radiographic Findings

                                            • MR Findings

                                              • Imaging Recommendations

                                                DIFFERENTIAL DIAGNOSIS

                                                  PATHOLOGY

                                                  • General Features

                                                    • Gross Pathologic & Surgical Features

                                                      CLINICAL ISSUES

                                                      • Presentation

                                                        • Demographics

                                                          • Treatment

                                                            DIAGNOSTIC CHECKLIST

                                                            • Image Interpretation Pearls

                                                              Selected References

                                                              1. Ehsan Z et al: The effects of Anesthesia and opioids on the upper airway: A systematic review. Laryngoscope. 126(1):270-84, 2016
                                                              2. Donnelly LF: Magnetic resonance sleep studies in the evaluation of children with obstructive sleep apnea. Semin Ultrasound CT MR. 31(2):107-15, 2010
                                                              3. Schaaf WE Jr et al: Findings on MR sleep studies as biomarkers to predict outcome of genioglossus advancement in the treatment of obstructive sleep apnea in children and young adults. AJR Am J Roentgenol. 194(5):1204-9, 2010
                                                              4. Mahmoud M et al: A comparison of dexmedetomidine with propofol for magnetic resonance imaging sleep studies in children. Anesth Analg. 109(3):745-53, 2009
                                                              5. Guimaraes CV et al: Relative rather than absolute macroglossia in patients with Down syndrome: implications for treatment of obstructive sleep apnea. Pediatr Radiol. 38(10):1062-7, 2008
                                                              6. Mihaescu M et al: Computational fluid dynamics analysis of upper airway reconstructed from magnetic resonance imaging data. Ann Otol Rhinol Laryngol. 117(4):303-9, 2008
                                                              7. Fricke BL et al: Comparison of lingual tonsil size as depicted on MR imaging between children with obstructive sleep apnea despite previous tonsillectomy and adenoidectomy and normal controls. Pediatr Radiol. 36(6):518-23, 2006
                                                              8. Donnelly LF: Obstructive sleep apnea in pediatric patients: evaluation with cine MR sleep studies. Radiology. 236(3):768-78, 2005
                                                              9. Donnelly LF et al: Causes of persistent obstructive sleep apnea despite previous tonsillectomy and adenoidectomy in children with down syndrome as depicted on static and dynamic cine MRI. AJR Am J Roentgenol. 183(1):175-81, 2004
                                                              10. Nour SG et al: Percutaneous MR imaging-guided radiofrequency interstitial thermal ablation of tongue base in porcine models: implications for obstructive sleep apnea syndrome. Radiology. 230(2):359-68, 2004
                                                              11. Rosen CL: Obstructive sleep apnea syndrome in children: controversies in diagnosis and treatment. Pediatr Clin North Am. 51(1):153-67, vii, 2004
                                                              12. de Miguel-Diez J et al: Prevalence of sleep-disordered breathing in children with Down syndrome: polygraphic findings in 108 children. Sleep. 26(8):1006-9, 2003
                                                              13. Donnelly LF et al: Upper airway motion depicted at cine MR imaging performed during sleep: comparison between young Patients with and those without obstructive sleep apnea. Radiology. 227(1):239-45, 2003
                                                              14. Donnelly LF et al: Glossoptosis (posterior displacement of the tongue) during sleep: a frequent cause of sleep apnea in pediatric patients referred for dynamic sleep fluoroscopy. AJR Am J Roentgenol. 175(6):1557-60, 2000
                                                              15. Donnelly LF et al: Imaging of pediatric tongue abnormalities. AJR Am J Roentgenol. 175(2):489-93, 2000