Patterns of Pharyngeal Obstruction and Collapse in Obese and Nonobese Children on Drug‐Induced Sleep Endoscopy
Bibliographic record
Abstract
Abstract Objective (1) Compare proportions of collapse, obstruction, or mixed instances on drug‐induced sleep endoscopy findings of obese and nonobese children with obstructive sleep disordered breathing. (2) Determine the frequency of collapse in general between both groups. Study Design Retrospective case‐control study. Setting Tertiary pediatric center. Methods Obese (body mass index >95 percentile) children presenting with obstructive sleep disordered breathing (>33 on the pediatric sleep questionnaire) were identified from a prospectively kept surgical database. Only those who had undergone drug‐induced sleep endoscopy were eligible. Age and sex pair‐matched nonobese children were identified. Only nonsyndromic, neurologically normal, surgically naïve patients were included. The frequency of obstructive, collapse, and mixed pharyngeal patterns was documented in both groups. A comparison of proportions was then undertaken ( χ 2 test). Results Over a 5‐year period, 73 consecutive children with obesity were identified (40 males; mean of 8.5 ± 3.0 years, 2.8‐13.1). They were matched with 73 nonobese children (8.4 ± 3.0 years, 2.6‐14.1). The obese group exhibited significantly more pharyngeal collapses (62:47) ( p = .0021 odds ratio [OR] 3.358, 95% confidence interval [CI] 1.52‐7.42). The proportion of pharyngeal findings on drug‐induced sleep endoscopy was significantly different ( p = .000129) between the 2 groups; obese (61 mixed: 3 obstruction: 9 collapse) and nonobese (48 mixed: 22 obstruction: 4 collapse). Conclusion The predominance of hypopharyngeal collapse in children with obesity may explain the likelihood of failure of surgery directed at obstructive findings. This may also strengthen the case for drug‐induced sleep endoscopy in this group at the initial surgery to guide it rather than after the failure of adenotonsillectomy.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| 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) | 0.000 | 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 teacher head, 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".