Objectives: Chronic rhinitis may contribute to a persistently decreased quality of life in patients undergoing surgical treatment for obstructive sleep apnea (OSA). This study aimed to characterize the role of OSA in pediatric patients with refractory chronic rhinitis after adenoidectomy. Methods: We reviewed the charts of patients <18 years of age with a history of OSA who underwent adenoidectomy at an academic medical center from October 2012 to December 2018 and that were seen in the clinic for follow-up. They were identified through the Current Procedural Terminology (CPT) codes 42830 and 42831 with the exclusion of CPT 42820 for tonsillectomy and adenoidectomy. Patients with a prior diagnosis of OSA who had refractory symptoms were compared with those who had symptoms resolution using chi-square analysis and t-tests. Results: Thirty-six (35.0%) patients with refractory symptoms following adenoidectomy and 52 (37.4%) patients without refractory symptoms had a history of OSA before surgery (p=0.80). In patients with refractory symptoms, the average age (3.8 years) and male sex (n=24, 66.7%) did not differ significantly from the age (4.42 years) and male sex (n=36, 69.2%) percentages of patients without refractory symptoms. The mean apnea/hypopnea-index (AHI) (p=0.91), completion of the sleep study (p=0.41), history of snoring (p=0.92), and tonsil size (p=0.42) did not differ significantly between the groups. However, patients with refractory symptoms had a significantly higher mean body mass index (BMI) (19.58) than those who did not (17.77, p=0.04) and completed a higher number of allergy evaluations (p=0.02). Conclusions While the history and severity of OSA did not differ significantly in patients with refractory nasal symptoms after adenoidectomy, these patients had a significantly higher BMI and completion of allergy evaluation.

BACKGROUND AND PURPOSE: Non-contrast brain computed tomography (NCCT) remains the most common imaging modality employed to select patients for thrombolytic therapy in acute ischemic stroke. The current study used the Alberta Stroke Program Early CT Score (ASPECTS) to identify early ischemic changes on brain NCCT imaging with the aim to investigate whether a relationship exists between time from symptoms onset to NCCT with the presence of early ischaemic change quantified by ASPECTS. METHODS: We studied 1,329 ischemic stroke patients who had NCCT within 8 hours of stroke onset. Patients were assessed to see if they had any ASPECTS lesion and if the rate of patients with a lesion increased with time using logistic regression. RESULTS: 30% patients had an ASPECTS < 10 within the first 3 hours from symptom onset. Within the first 3 hours, the odds for a CT change (ASPECTS < 10) per minute of time was 1.00 with 95% confidence interval (CI) (0.99 to 1.00) (P=0.266). After 3 hours, there was a significant increase in odds of ASPECTS < 10 with increasing time. The odds of being ASPECTS positive increased 1% (odds ratio=1.01) per 1 minute of time with 95% CI (1.00 to 1.01) (P=0.002). CONCLUSIONS: We have identified that prior to first 3 hours of stroke there was no effect of time on odds of CT ischemic change; after the first 3 hours of stroke the odds increased with increasing time to CT scan. The occurrence of early ischemic change may be a marker of time from stroke onset rather than severity.
Alberta ; Brain ; Humans ; Logistic Models ; Stroke* ; Thrombolytic Therapy ; Tomography, X-Ray Computed