Abstract

Objective: Breath-holding spells (BHS) are common paroxysmal events in earlychildhood with unknown pathophysiology. Hypoxia can be the cause or result of BHS and the damage caused by hypoxia is of paramount importance. Therefore, exposure to hypoxia should be minimized in children with BHS. The present study, for the first time in the literature, investigated the staging of palatinetonsil and soft palate hypertrophy in children with BHS and their relationship with BHS.

Material and Methods: The retrospective study included 45 children with BHS with no iron deficiency and no complaints of frequent infections and had been followed up for a minimum of one year over between 2012 and 2016. A control group of 45 age-matched subjects. BHS was diagnosed based on patient history, clinical observations, and video records. Duration of spell, spell type, and the staging of palatinetonsil and soft palate hypertrophy were compared among the patients and with the control subjects in terms of age groups and genders.

Results: Mean age was 28.9±12.9 (range, 8-56) months in the BHS group. In the same group, the patients had stage 1-2 palatinetonsil hypertrophy (total 81.8%) and stage 2-3 soft palate hypertrophy (78.9%) and a significant difference was found between the BHS and control groups (p=0.000). In patients with cyanotic BHS, tonsillar hypertrophy was grade 2-3 and a positive correlation was found between cyanotic BHS and tonsillar hypertrophy (r: 0.315, p=0.032). Mean duration of spell was 3.5±1.3 minand tonsillar hypertrophy established a stronger correlation with spell duration and soft palatinetonsil hypertrophy (r: 0.459, p=0.000;r: 0.734, p=0.000, respectively).

Conclusion: The results indicated that the BHS patients with no iron deficiency and no complaints of frequent infections had greater palatinetonsil hypertrophy and a higher stage of soft palate hypertrophy compared to control subjects. We suggest that the presence of a high-stage soft palate hypertrophy increases the risk of developing BHS and the duration of spell by 1.5 times and thus requires early intervention and clinical follow-up.

Keywords: Breath-holding spell duration, Palatinetonsil hypertrophy, Soft-palate stage

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1.
Dilber B, Ural A, Kamasak T, Cansu A. The Importance of Palatitonsillar Hypertrophy and Soft Palate Staging in Etiology of Breathe Holding Spells. Turk J Pediatr Dis [Internet]. 2021 Jul. 16 [cited 2025 May 24];15(4):306-11. Available from: https://turkjpediatrdis.org/article/view/775