Morphological Assessment of the Soft Palate in Habitual Snoring Using Image Analysis

Abstract

Habitual snorers have a long soft palate, a long wide uvula, and a narrowed oropharyngeal isthmus. LAUP shortens and tightens the elongated palate and causes a further reduction in the space between the posterior pillars.

The upper airway in sleep: physiology of the pharynx

“…As discussed previously, since the airway area depends on body posture, gender, lung volume, state of consciousness and body size it is dif®cult to attribute the differences in airway dimensions to snoring alone. Nevertheless, it has been reported that snorers have reduced airway area at the level of velopharynx [96], tongue base, hyoid bone, have reduced sagittal dimensions, longer soft palates and longer and wider uvulas than healthy volunteers [97]. There is also however the alternate hypothesis that the reduction in airway cross section is a result of snoring, due to in¯ammation of the mucosa and edema [98].…”

Comparison of cone-beam computed tomography incidental findings between patients with moderate/severe obstructive sleep apnea and mild obstructive sleep apnea/healthy patients

“…Structural upper airway narrowing is detectable with CT in awake patients with obstructive sleep apnea according to Haponik’s study 30 . Using a rigid endoscope, Reda et al 31 discovered habitual snorers statistically have a narrower oropharyngeal isthmus compared to the healthy volunteers. However, the high prevalence of airway narrowing in the control group can be explained in part by self-selection bias.…”

“…34,35 In this study, we found that 30% of the cases and 21% of the controls had soft palate/uvula elongated or posteriorly positioned. Using a rigid endoscope, Reda et al 36 discovered habitual snorers statistically have a longer soft palate and a longer wide uvula compared to the healthy volunteers. Shigeta et al .…”

Surgical procedures and non-surgical devices for the management of non-apnoeic snoring: a systematic review of clinical effects and associated treatment costs

“…Reason for exclusion Miller 1996 192 Mixed patient population; results not reported separately; PSG results at baseline not reported; no objective outcome measure Myatt 1996 193 Mixed patient population; results no reported separately; no objective outcome assessment Nordgard 2004 194 Outcomes not measured objectively O'Sullivan 1995 195 Mixed patient population (non-apnoeic snorers and OSAS); results not reported separately Powell 1998 196 Mixed patient population (non-apnoeic snorers, UARS, OSAS); results not reported separately Prichard 1994 197 Patients unclear, no baseline PSG or oximetry; outcomes not assessed objectively Reda 1998 198 Patient group unclear; unclear if PSG/oximetry undertaken at baseline Reda 1999 199 Study assesses the morphological changes in the soft palate before and after LAUP. The following abbreviations are used throughout Appendix 3: AI, apnoea index; AHI, apnoea/ hypopnoea index; BMI, body mass index; CCT, controlled clinical trial; DIS, difficulty inducing sleep; EDS, excessive daytime sleepiness; ESS, Epworth Sleepiness Scale; HI, hypopnoea index; LAUP, laserassisted uvulopalatoplasty; NA, not applicable; NR, not reported; ODI, oxygen desaturation index; OSAS, obstructive sleep apnoea/hypopnoea syndrome; PSG, polysomnography; RCT, randomised controlled trial; REM, rapid eye movement; RDI, respiratory disturbance index; SI, snoring index; SPL, sound pressure level; TST, total sleep time; UP3, uvulopalatopharyngoplasty; VAS, visual analogue scale.…”