Adenotonsillar tissue size in prematurely-born children with snoring: An MRI study

<b>Introduction:</b> Premature birth is a risk factor for sleep-disordered breathing (SDB) in childhood but the pathogenetic mechanisms are unknown. We hypothesized that linear and cross-sectional area (CSA) dimensions of adenoid and tonsils are larger in young children (&lt;6 y.o.) without or with SDB born prematurely (&lt;37 wks gestational age) than in full term-born participants. <b>Methods:</b> Measurements were performed in head MRI scans of consecutive subjects. SDB was defined as snoring ≥1 night/wk. General linear models were applied to assess the association of prematurity and SDB with pharyngeal lymphoid tissue and airway dimensions. <b>Results:</b> MRI data were analyzed in 85 full term-born children (0.01-5.6 y.o.; 45.9% with SDB) and in 35 prematurely-born children (0,02-4.6 y.o.; 60% with SDB). Prematurity and SDB were associated significantly with:% adenoid oblique width/mental spine–clivus length (AOW/MSCL), adenoid CSA, % bilateral tonsillar width/intermandibular length (TW/IML), bilaterar tonsillar CSA and oropharynx CSA (P&lt;0.05) but not with nasopharynx CSA (P&gt;0.05). Prematurely-born children without SDB had smaller AOW/MSCL, adenoid CSA, bilateral TW/IML and bilateral tonsillar CSA than full term-born subjects without SDB (10%±4% vs. 13%±4%;91.1±60.2 vs. 161±83 mm²;31%±6% vs. 36.5%±8.8%;114.4±55.6 vs. 206.6±101.1 mm², respectively;P&lt;0.05). Prematurely-born and full term-born subjects with SDB did not differ significantly regarding MRI measurements. <b>Conclusions:</b> Although prematurely-born young children without SDB have adenotonsillar tissue of smaller dimensions than those in full term-born children, adenoid and tonsils are enlarged in children with SDB irrespective of history of prematurity.