Magnetic resonance imaging of the upper airway in children with down syndrome

Elizabeth C. Uong, Joseph M. McDonough, Catherine E. Tayag-Kier, Huaqing Zhao, John Haselgrove, Soroush Mahboubi, Richard J. Schwab, Allan I. Pack, Raanan Arens

Research output: Contribution to journalArticlepeer-review

98 Scopus citations


As compared with control subjects, children with Down syndrome have different size and shape relationships among tissues composing the upper airway, which may predispose them to obstructive sleep apnea (OSA). We hypothesized that Down syndrome children without OSA have similar subclinical differences. We used magnetic resonance imaging to study the upper airway in 11 Down syndrome children without OSA (age, 3.2 ± 1.4 yr) and in 14 control subjects (age, 3.3 ± 1.1 yr). Sequential T1- and T2-weighted spin-echo axial and sagittal images were obtained. We found a smaller airway volume in subjects with Down syndrome (1.4 ± 0.4 versus 2.3 ± 0.8 cm3 in controls, p < 0.005). Subjects with Down syndrome had a smaller mid- and lower face skeleton. They had a shorter mental spine-clivus distance (5.7 ± 0.6 versus 6.2 p 0.4 cm, p < 0.05), hard palate length (3.2 ± 0.4 versus 3.7 ± 0.2 cm, p < 0.005), and mandible volume (11.5 ± 3.7 versus 16.9 ± 2.9 cm3, p < 0.0005). Adenoid and tonsil volume was significantly smaller in the subjects with Down syndrome. However, the tongue, soft-palate, pterygoid, and parapharyngeal fat pads were similar to those of control subjects. This study shows that Down syndrome children without OSA do not have increased adenoid or tonsillar volume; reduced upper airway size is caused by soft tissue crowding within a smaller mid- and lower face skeleton.

Original languageEnglish (US)
Pages (from-to)731-736
Number of pages6
JournalAmerican journal of respiratory and critical care medicine
Issue number3 I
StatePublished - 2001
Externally publishedYes

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine


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