0885 OROFACIAL MORPHOLOGY AND DYSFUNCTIONS IN CHILDREN WITH PERSISTANT SLEEP DISORDERED BREATHING LONG-TERM AFTER ADENOID AND/OR TONSILS REMOVAL
Bibliographic record
Abstract
The main etiology for pediatric sleep-disordered-breathing (SDB) is the hypertrophy of adenoids and tonsills, and their surgical removal (T&A) is the first line treatment. Nevertheless, incomplete resolution of SDB after T&A, or a relapse with time are a common finding. Our aim was to screen persistant SDB patients and evaluate the prevalence of craniofacial-orthodontic abnormalities, oral dysfunctions or obesity in this population. A 6 questions validated pediatric questionnaire, the Hierarchic Severity Clinical Scale (HSCS) was sent to parents of 2068 children operated between 2002 and 2015 in a tertiary hospital. Patients reporting SDB, and without craniofacial syndrome were invited to complete a clinical examination and an ambulatory sleep study. 735 parents returned the questionnaire (56.2% males, time from surgery 4.1 ± 3.4 years). Resolution of SDB was found in 512 patients (69.7 %; 369 patients HSCS=0 and143 patients 0 2.72 suggesting persistent obstructive sleep apnea. Mean HSCS were 0,83 ± 1.0 for non-syndromic versus 1,44 ± 1.1 for syndromic children (p<0,01). Among those 223 children with persistant SBD symptoms, 34 were syndromic; 54 non syndromic children were examined (mean HSCS 2.18 ± 1.0) showing convex profiles (38/54), malocclusions (posterior crossbite 11/54, class II malocclusions 18/54), oral dysfunctions (52/54 low tongue posture, 22/54 short lingual frenum, 23/54 oral hypotonia) and nasal cartilage hypotonia (n=8 only Caucasian). Moreover, only 7/54 children were overweight or obese, resulting in 2 phenotypes: a moderate severity group associated with obesity (mean AHI 2,59 ± 1,79), and a mild severity group that combined malocclusions/oral dysfunctions (mean AHI 1,48 ± 1,7). Persistant SDB after T&A in non-syndromic children seems to be associated with multiple anatomical and functionnal factors. This study was supported by the SickKids Foundation, Toronto, Canada.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".