Three-Dimensional Computed Tomographic Analysis of Airway Anatomy in Patients With Obstructive Sleep Apnea

Abramson, Zachary; Susarla, Srinivas M.; August, Meredith; Troulis, Maria J.; Kaban, Leonard B.

doi:10.1016/j.joms.2009.09.087

Cited by 126 publications

(103 citation statements)

References 33 publications

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“…In the aetiology of OSA, some of the most important parameters are the airway volume, airway length and various anthropometric measurements [1,9,10,21,36]. According to the CT study performed by Enciso et al [10], men older than 57 years and individuals having narrow upper airway measurement have been identified as a high risk group for OSA.…”

Section: Discussionmentioning

confidence: 99%

What can anthropometric measurements tell us about obstructive sleep apnoea?

Yılmaz

Akcaalan

2017

Folia Morphol

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Section: Discussionmentioning

confidence: 99%

What can anthropometric measurements tell us about obstructive sleep apnoea?

Yılmaz

Akcaalan

2017

Folia Morphol

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“…These results are in line with studies showing that tongue dimensions and pharyngeal length also contribute to increase the risk of upper airway collapse during sleep. 4,7,[25][26][27] In addition, a lower positioned hyoid bone is the most commonly reported cephalometric abnormality among patients with OSA. Hyoid bone position also has a close relationship with OSA severity.…”

Section: Discussionmentioning

confidence: 99%

“…Multiple studies using computed tomography (CT) and magnetic resonance imaging have shown that patients with OSA have a smaller airway, larger soft-tissue volume, and an increased upper airway length than proper controls while awake. [4][5][6][7] Pharyngeal critical closing pressure (Pcrit) evaluates upper airway collapsibility during nonrapid eye movement (NREM) sleep and determines the anatomical contribution to OSA. Pcrit is associated with anatomic features such as pharyngeal length and tongue volume.…”

Section: Introductionmentioning

confidence: 99%

Upper Airway Collapsibility Assessed by Negative Expiratory Pressure while Awake is Associated with Upper Airway Anatomy

Hirata

Schorr

Kayamori

et al. 2016

Journal of Clinical Sleep Medicine

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Study Objectives:There is a growing interest to develop a simple method to characterize the mechanisms leading to upper airway collapse in order to guide treatment options in patients with obstructive sleep apnea (OSA). Critical closing pressure (Pcrit) during sleep is able to predict the anatomical component of OSA. However, Pcrit is a laborious method that is only used for research purposes. The application of negative expiratory pressure (NEP) is a simple method to assess upper airway collapsibility that can be easily performed during wakefulness. We hypothesized that NEP will be, similarly to Pcrit, associated with upper airway anatomy assessed by computed tomography (CT) scan. Methods: Patients under investigation for OSA underwent polysomnography, CT of the upper airway, NEP while awake, and Pcrit during sleep. NEP was performed with −5 cm H 2 O in supine position using a nasal mask. Pcrit was measured during sleep induced by low doses of midazolam. Results: Twenty-eight male subjects were studied (age 45 ± 13 y, body mass index 29.4 ± 4.9 kg/m 2 , apnea-hypopnea index (AHI) 30 ± 26, range 2 to 86 events/h). NEP and Pcrit were similarly associated with tongue area (r = 0.646 and r = 0.585), tongue volume (r = 0.565 and r = 0.613) and pharyngeal length (r = 0.580 and r = 0.611), respectively (p < 0.05 for all comparisons). NEP and Pcrit were also significantly correlated with AHI (r = 0.490 and r = 0.531). NEP and Pcrit were significantly higher in patients with severe OSA than the remaining population. Conclusions: NEP is a simple and promising method that is associated with the anatomical component of upper airway collapsibility. NEP may be valuable to select patients for noncontinuous positive airway pressure alternative therapies for OSA.

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“…Despite the cause or the effect, any airway problem has to be properly diagnosed and treated as soon as it is identified. Methods that are traditionally used to assess the www.intechopen.com airway include cephalometry, rhinoendoscopy, and tomography (Subtenley & Baker, 1965;Fujiki & Rossato, 1999;Filho et al, 2001;Abramson et al, 2010). Mandibular advancement device, tongue retraining device, and a continous positive airflow pressure appliance are the most common orthodontic therapeutic options for patients with breathing disorders.…”

Section: Cone Beam Computed Tomography and Airway Analysismentioning

confidence: 99%

“…Clinicians can more easily perform the volumetric measurements and also calculate the cross-sectional areas of the airway in 3 planes of space: coronal, sagittal, and axial. In addition, the option provided by some softwares for detecting and measuring the most constricted area in the airway provides essential diagnostic clinical information especially in obstructive sleep apnea patients (Ogawa et al, 2007;Aboudara et al, 2009;Abramson et al, 2010) (Figures 8 and 9). …”

Section: Cone Beam Computed Tomography and Airway Analysismentioning

confidence: 99%