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Advisory Committee Chair

Nada M Souccar

Advisory Committee Members

Chung How Kau

Amjad Javed

Augusto Robles

Document Type

Thesis

Date of Award

2018

Degree Name by School

Master of Science in Dentistry (MScD) School of Dentistry

Abstract

Objectives: The purpose of this study is to investigate clinical assessments that may help to predict pediatric obstructive sleep apnea (OSA). These clinical tools include the Mallampati and Brodsky classifications, as well as the Epworth Sleepiness Scale for Children and Adolescents (ESS-CHAD). The specific aims of this study are to: 1.) Compare the Mallampati scores, Brodsky scores, and results of the ESS-CHAD of children versus adolescents in order to observe how these criteria change with age. 2.) Compare the Mallampati scores derived by a dental student, an orthodontic resident and a pediatric otorhinolaryngologist (ENT) to determine the accuracy of this assessment. 3.) Determine the relationships between these three clinical assessments. Methods: This is a cross-sectional study of 33 children (ages 6-12) and 36 adolescents (ages 13-18). A photo was taken of each participant in order to evaluate his or her Mallampati score, which was assigned individually by a dental student, an orthodontic resident, and a pediatric ENT. All participants likewise received a Brodsky score based on tonsillar size. The ESS-CHAD questionnaire was also completed by each participant. Mallampati scores were then measured for reproducibility using the kappa statistic, along with the corresponding p-values and 95% confidence intervals. Correlations between the various assessments were explored using Spearman correlation analysis (these results were compared separately for each age group). Finally, assessment outcomes were compared for the two age groups using the Wilcoxon rank-sum test. Statistical tests were two-sided and were performed using a significance level of 5%. Results/Conclusions: The results of this study indicate that: 1.) In general, adolescents have a higher Mallampati score than children. 2.) There are no statistically significant differences in Brodsky and ESS-CHAD scores between children and adolescents. 3.) The Mallampati score is a reproducible clinical assessment. 4.) A statistically significant inverse correlation exists between the Mallampati and Brodsky scores of adolescents. However, this relationship is not statistically significant in the child age group. 5.) There are no statistically significant correlations between the Mallampati and ESS-CHAD scores or the Brodsky and ESS-CHAD scores.

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