Characterization of upper airway obstruction by fiber-optic nasolaryngoscopy and MRI in preoperative OSAHS patients

ORL J Otorhinolaryngol Relat Spec. 2014;76(6):321-8. doi: 10.1159/000362245. Epub 2014 Dec 20.

Abstract

Objective: To investigate changes in the upper airway and its surrounding soft tissue and to characterize the extent and severity of upper airway obstruction in 136 obstructive sleep apnea/hypopnea syndrome (OSAHS) patients who were awake.

Methods: OSAHS patients and healthy controls were evaluated by fiber-optic nasolaryngoscopy and MRI. The cross-sectional area and pharyngeal wall thickness of the retropalatal, retroglossal and epiglottic region were determined.

Results: Ninety-five percent of the mild OSAHS subjects had single-plane obstruction (vs. severe OSAHS, p < 0.05), 5.0% of the mild OSAHS subjects had two-plane obstruction (p < 0.05) and none of them had three-plane obstruction (p < 0.05). The cross-sectional area of the retropalatal, retroglossal and epiglottic region progressively declined as the severity of OSAHS increased (severe OSAHS vs. controls, p < 0.05). The lateral pharyngeal wall was significantly thicker in OSAHS subjects than in healthy controls (p < 0.05). The cross-sectional area of the soft palate in moderate and severe OSAHS subjects was markedly larger than that of the healthy controls (p < 0.05) and positively correlated with the apnea/hypopnea index (p < 0.05).

Conclusion: Moderate and severe OSAHS patients exhibit multi-plane obstruction of the upper airway, particularly in the retropalatal and retroglossal region. The severity of OSAHS negatively correlates with the thickness, length and cross-sectional area size of the soft palate.

MeSH terms

  • Adult
  • Airway Obstruction / diagnosis*
  • Airway Obstruction / etiology*
  • Case-Control Studies
  • Female
  • Fiber Optic Technology*
  • Humans
  • Laryngoscopy / instrumentation*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Polysomnography
  • Risk Factors
  • Sleep Apnea, Obstructive / complications*