Expansion Sphincter Pharyngoplasty for Obstructive Sleep Apnea: Outcome Evaluated by Pre‐ and Postoperative Polysomnography

Abstract

Presentation schedule is subject to change. For the most up-to-date information, visit www.entannualmeeting.org. Methods:The subjects underwent a polysomnography study to determine the severity of OSA and DTI scans to detect fiber integrity. Fractional anisotropy (FA), a measure of fiber integrity, was derived from the diffusion tensor, resulting in a whole brain FA map. The FA maps were compared using voxel-based statistics to determine differences between severe OSA and control groups, with age and sex as a covariate. The correlation between FA value and clinical severity was performed.Results: Twenty patients with severe OSA (apnea/hypopnea index, AHI >30/h) and 14 sex-and age-matched healthy volunteers (AHI <5/h) were recruited. The exploratory groupwise comparison showed that severe OSA patients exhibited reduced FA values in several brain clusters, including the white matter underlying amygdala, superior temporal gyrus, inferior parietal lobule, precuneus, postcentral gyrus, anterior cingulate gyrus, claustrum, insula, basal ganglia, tapetum, and cerebral peduncle compared with controls. The FA values were negatively correlated with clinical disease severity.Conclusions: This study indicates that OSA patients have impaired white matter integrity in vulnerable regions, associated with increased disease severity. The findings likely represent the pathological process of the brain in OSA patients.