Background: The impact of body mass index (BMI) on pharyngeal fat pads has been well studied, yet no study has assessed its associations on laryngeal morphology.
Objectives: To study the associations of BMI differences on laryngeal morphology in adult males using computed tomography angiography (CTA) scans.
Methods: All adult male patients who underwent head and neck CTAs between 2011 and 2018 were initially included and categorized according to their BMI: (1) BMI < 20; (2) 20 ≤ BMI < 25; (3) 25 ≤ BMI < 30; (4) 30 ≤ BMI < 35; and (5) BMI ≥ 35. Anatomical measurements included pre-epiglottic and paraglottic fat-pad dimensions, airway width at the epiglottis tip and base, and epiglottis angle. For statistical analysis, BMI was regarded both as a categorical and continuous variable.
Results: One hundred and five scans were included. BMI ranged from 15.90 to 44.40 kg/m2. Significant differences were found in pre-epiglottic and paraglottic fat measurements between BMI subgroups 1-5 (Pre-epiglottic fat depth: 17.75, 17.74, 19.04, 20.73, and 21.09 mm, respectively, P = 0.005, correlation 0.343, and P < 0.001 in continuous measurement; Paraglottic space average width: 3.5, 5.4, 5.46, 6.85, and 7.38 mm, P < 0.001, correlation 0.532, and P < 0.001 in continuous measurement). As BMI increased, the epiglottis-hard-palate angle increased (56.4°, 55.3°, 65.2°, 64°, and 68.4°, P = 0.001, correlation 0.354, and P < 0.001 in continuous measurement). No significant difference was found in airway width between subgroups at the epiglottis tip or base. Yet, in continuous variables analysis, a significant negative correlation was found between BMI scores and the airway width at the epiglottis base (-0.226, P = 0.02).
Conclusions: In adult males, BMI is correlated with laryngeal fat-pad volume, affecting its morphology and airway width. Clinical implications regarding obstructive sleep apnea and voice quality should be further investigated.