Analysis of the dynamic changes in the soft palate and uvula in obstructive sleep apnea-hypopnea using ultrafast magnetic resonance imaging

Abstract

ABSTRACT. Apnea and the respiratory cycle are dynamic processes in obstructive sleep apnea-hypopnea (OSAH), which occur only during sleep. Our study aimed to observe the dynamic changes in the soft palate and the uvula during wakefulness and sleep using ultrafast magnetic resonance imaging (UMRI) to provide reference data for the pathogenesis and treatment of OSAH. The dynamic changes in the soft palate and uvular tip of 15 male patients (average age: 50.43 ± 9.82 years) with OSAH were evaluated using UMRI of the upper 8597 Pathogenesis of obstructive sleep apnea-hypopnea ©FUNPEC-RP www.funpecrp.com.br Genetics and Molecular Research 13 (4): 8596-8608 (2014) airway while asleep and awake after 1 night of sleep deprivation. A series of midline sagittal images of the upper airway were obtained. The distance from the center of the soft palate to the x-axis (an extended line from the anterior nasal spine to the posterior nasal spine), from the uvular tip to the x-axis, from the center of the soft palate to the y-axis (a perpendicular line from the center of the pituitary to the x-axis), and from the uvular tip to the y-axis (designated as PX, UX, PY, and UY, respectively) were measured during sleep and wakefulness. The minimum PX, PY, UX, and UY were shorter during sleep than during wakefulness, whereas the maxima were longer during sleep (P < 0.01), the differences between the maximum and minimum PX, PY, UX, and UY were larger during sleep (P < 0.01). The upward, downward, forward, and backward ranges of movement of the soft palate and the uvular tip were larger during sleep in OSAH patients. This increased compliance may trigger each airway obstructive event.

Obstructive sleep apnea and rhonchopathy are associated with downregulation of trefoil factor family peptide 3 (TFF3)—Implications of changes in oral mucus composition

“…Besides structural changes in the uvula and soft palate [ 13 ], the influence of the upper airway lining liquid on surface tension is a factor contributing to upper airway collapsibility [ 4 , 14 , 15 ].…”

Value Of Cephalometric And Volumetric Measurements Performed By Multi-Level Three-Dimensional Computed Tomography In Patients With Obstructive Sleep Apnea Syndrome

“…Morphologic and functional differences of upper respiratory tract have been reported between the normal population and OSAS patients, as well as the sleep and wake periods of OSAS patients 2,12,13 . CT provides a 3-D image and can be achieved in the supine body position which is important because of changes in body posture that affect the size of the upper airways during respiration.…”

Salivary trefoil factor family peptide 3 (TFF3) and flow rate in persons with and without obstructive sleep apnea: A preliminary study

“…Intraorally, OSA is associated with structural changes in the uvula and soft palate (Paulsen et al, 2002), the influence of the upper airway lining liquid on surface tension is a factor contributing to upper airway collapsibility (Kirkness et al, 1985(Kirkness et al, , 2005Paulsen et al, 2002;Wang et al, 2014) due to increased airway resistance (Lévy et al, 2015). Previous studies reported trefoil factor family (TFF) peptides: TFF1, TFF2, and TFF3 have lectin activities and are predominantly co-secreted together with mucins from mucous epithelia (Hoffmann, 2020;Hoffmann et al, 2001).…”