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Original Research

Open Access

Mallampati and Brodsky Classification and Children’s Risk for Sleep Related Breathing Disorder

  • Bret Lesavoy1,*,
  • Christie Lumsden2
  • Eli Grunstein3
  • Richard Yoon4

1Columbia University Medical Center, New York, NY 10032 USA

2Section of Oral, Diagnostic, and Rehabilitation Sciences at the College of Dental Medicine, Columbia University Medical Center, New York, NY 10032 USA

3Division of Pediatric Otolaryngology at the College of Physicians and Surgeons, Columbia University Medical Center, New York, NY 10032 USA

4Section of Growth and Development at the College of Dental Medicine, Columbia University Medical Center, New York, NY 10032 USA

DOI: 10.22514/1053-4625-46.4.4 Vol.46,Issue 4,July 2022 pp.280-286

Published: 01 July 2022

*Corresponding Author(s): Bret Lesavoy E-mail: bretlesavoy@gmail.com

Abstract

Objective: To evaluate associations between Mallampati and Brodsky classification and children’s risk for sleep related breathing disorder (SRBD). Study Design: This study recruited well-children 2-11 years old and legal guardians over 18 years from a community dental clinic. Modified Mallampati classification (I-IV) and Brodsky grade (0-4) were classified by a single dentist. Guardians completed the validated 22-item pediatric sleep questionnaire (PSQ) to identify children at risk of SRBD. Associations between Mallampati and Brodsky classifications with risk for SRBD as defined by PSQ were determined by Chi-square, Kruskal-Wallis, and simple logistic regression models. Results: Of 150 children included (M=5.9 years), 76 (51%) female, 108 (72%) Latino/Hispanic, 82 (55%) were classified as Mallampati class I or II, 68 (45%) class III or IV, 119 (79%) were identified as Brodsky grade 0, 1, or 2, and 31 (21%) grade 3 or 4. Children with Mallampati class III and IV and Brodsky grade 3 and 4 collectively had a 5.24-fold and 2.8-fold increase in SRBD risk per PSQ compared to children with class I and II and grade 1 and 2, respectively. Conclusion: Mallampati classification may be a quick, non-invasive screening tool to improve identification and timely intervention for children at risk of SRBD.


Keywords

Sleep apnea syndromes; Oropharynx; Snoring


Cite and Share

Bret Lesavoy,Christie Lumsden,Eli Grunstein,Richard Yoon. Mallampati and Brodsky Classification and Children’s Risk for Sleep Related Breathing Disorder. Journal of Clinical Pediatric Dentistry. 2022. 46(4);280-286.

References

1. Bixler E. Sleep and society: an epidemiological perspective. Sleep Med, 2009;10(1):3-6.

2. Biggs SN, Walter LM, Jackman AR, Nisbet LC, Weichard AJ, Hollis SL, Davey MJ, Anderson V, Nixon GM, Horne RS. Long-Term Cognitive and Behavioral Outcomes following Resolution of Sleep Disordered Breathing in Preschool Children. PLoS One, 2015;10(9):1-15.

3. Alexander N, Boota A, Hooks K, White J. Rapid Maxillary Expansion and Adenotonsillectomy in 9-Year-Old Twins with Pediatric Obstructive Sleep Apnea Syndrome: An Interdisciplinary Effort. J Osteopath Med, 2019;119(2):126-34.

4. Marcus CL, Brooks LJ, Draper KA, Gozal D, Halbower AC, Jones J, Schechter MS, Sheldon HC, Psruyt K, Ward SD, Lehmann C, Shiffman RN. Diagnosis and management of childhood obstructive sleep apnea syndrome. Pediatrics, 2012;130(3):714-55.

5. American Academy of Sleep Medicine. International Classification of Sleep Disorders. 3rd ed. Darien, Ill., USA, 2014: 63-8.

6. Katz ES, D’Ambrosio CM. Pediatric obstructive sleep apnea syndrome. Clin Chest Med, 2010; 31(2):221-34.

7. Trosman I, Trosman SJ. Cognitive and Behavioral Consequences of Sleep Disordered Breathing in Children. Med Sci (Basel), 2017;5(4):30.

8. Chervin RD, Hedger K, Dillon JE, Pituch KJ. Pediatric sleep questionnaire (PSQ): validity and reliability of scales for sleep-disordered breathing, snoring, sleepiness, and behavioral problems. Sleep Med, 2000;1(1):21-32.

9. Chervin RD, Weatherly RA, Garetz SL, Ruzicka DL, Giordani BJ, Hodges EK, Dillon JE, Guire KE. Pediatric sleep questionnaire: prediction of sleep apnea and outcomes. Arch Otolaryngol Head Neck Surg, 2007;133(3):216-22.

10. Ryan C, Bradley D. Pathogenesis of obstructive sleep apnea. J Appl Physiol, 2005; 99:2440-50.

11. Mallampati SR, Gatt SP, Gugino LD, Desai SP, Waraksa B, Freiberger D, Liu PL. A clinical sign to predict difficult tracheal intubation: A prospective study. Can Anaesth Soc J, 1985;32:429-34.

12. Greenfeld M, Tauman R, DeRowe A, Sivan Y. Obstructive sleep apnea syndrome due to adenotonsillar hypertrophy in infants. Int J Pediatr Otorhinolaryngol, 2003;67(10):1055-60.

13. Samsoon GL, Young JR. Difficult tracheal intubation: a retrospective study. Anaesthesia, 1987;42(5):487-90.

14. Kuczmarski RJ, Ogden CL, Grummer-Strawn LM, Flegal KM, Guo SS, Wei R, Mei Z, Curtin LR, Roche AF, Johnson CL. CDC growth charts: United States. Adv Data, 2000;8(314):1-27.

15. Dayyat E, Kheirandish-Gozal L, Sans Capdevila O, Maarafeya MMA, Gozal D. Obstructive sleep apnea in children: relative contributions of body mass index and adenotonsillar hypertrophy. Chest, 2009;136(1):137-44.

16. Kumar H, Schroeder JW, Gang Z, Sheldon S. Mallampati Score and Pediatric Obstructive Sleep Apnea. J Clin Sleep Med, 2014;10(9):985-90.

17. Kljajic Z, Glumac S, Deutsch JA, Lupi-Ferandin S, Dogas Z, Roje Z. Feasibility study of determining a risk assessment model for obstructive sleep apnea in children based on local findings and clinical indicators. Int J Pediatr Otorhinolaryngol, 2020; 135:110081.

18. Nuckton TJ, Glidden DV, Browner WS, Claman DM. Physical examination: Mallampati score as an independent predictor of obstructive sleep apnea. Sleep, 2006; 29(7):903-8.

19. Yagi H, Nakata S, Tsuge H, Yasuma F, Noda A, Morinaga M, Tagaya M, Nakashima T. Morphological examination of upper airway in obstructive sleep apnea. Auris Nasus Larynx, 2009; 36:444-9.

20. Hiremath AS, Hillman DR, James AL, Noffsinger WJ, Platt PR, Singer SL. Relationship between difficult tracheal intubation and obstructive sleep apnoea. Br J Anaesth, 1998; 80(5):606-11.

21. Hukins C. Mallampati class is not useful in the clinical assessment of sleep clinic patients. J Clin Sleep Med, 2010; 6(6):545-9, 2010.

22. Guilleminault C, Huang YS, Glamann C, Li K, Chan A. Adenotonsillectomy and obstructive sleep apnea in children: a prospective survey. Otolaryngol Head Neck Surg, 2007; 136(2):169-75.

23. Aroucha Lyra MC, Aguiar D, Paiva M, Arnaud M, Filho, A. Prevalence of sleep-disordered breathing and associations with malocclusion in children. J Clin Speed Med, 2020; 16(7):1007-12.


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