Woo Young Kim1, Seung-No Hong2, Seung Koo Yang2, Kuk Jin Nam3, Kang Hyeon Lim3, Sun Jin Hwang3, Min Young Seo3, Seung Hoon Lee4. 1. Department of Internal Medicine, Westchester Medical Center and New York Medical College, Valhalla, NY, USA. 2. Department of Otorhinolaryngology, Boramae Medical Center, Seoul National University College of Medicine, Seoul, Republic of Korea. 3. Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Korea University of Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, 15355, South Korea. 4. Department of Otorhinolaryngology-Head and Neck Surgery, Korea University College of Medicine, Korea University of Ansan Hospital, 123, Jeokgeum-ro, Danwon-gu, Ansan-si, Gyeonggi-do, 15355, South Korea. shleeent@korea.ac.kr.
Abstract
PURPOSE: Positional change during sleep influences upper airway patency. However, few studies have used imaging techniques to demonstrate the change. This study aims to determine the effect of positional change on the upper airway space. METHODS: A total of 118 subjects with sleep breathing disorders were analyzed. Participants underwent upper airway CT scans in the supine and lateral decubitus positions (right and left). They were divided into non-obstructive sleep apnea (n = 28) and obstructive sleep apnea (n = 90) groups. We measured the minimal cross-sectional area of the retropalatal/retroglossal spaces and compared the differences of those two spaces in the supine and lateral positions. CT was performed while patients were awake. RESULTS: The minimal cross-sectional area in the OSA group was significantly smaller than non-OSA group in both supine (median[interquartile range], 8.3[0.0-25.1] vs 22.2[1.0-39.6]; P = 0.018) and lateral decubitus positions (5.2[0.0-16.9] vs 21.3[6.1-38.4]; P = 0.002). As the body position of OSA patients shifted from supine to lateral, the retroglossal space increased significantly (67.3[25.1-116.3] vs 93.3[43.4-160.1]; P < 0.001). However, there was no significant difference in the retropalatal space between the supine and lateral decubitus positions. CONCLUSIONS: Positional change from the supine to lateral decubitus position expands the upper airway lumen, especially the retroglossal space. Positional OSA may be related to anatomical change of the upper airway lumen based on body position.
PURPOSE: Positional change during sleep influences upper airway patency. However, few studies have used imaging techniques to demonstrate the change. This study aims to determine the effect of positional change on the upper airway space. METHODS: A total of 118 subjects with sleep breathing disorders were analyzed. Participants underwent upper airway CT scans in the supine and lateral decubitus positions (right and left). They were divided into non-obstructive sleep apnea (n = 28) and obstructive sleep apnea (n = 90) groups. We measured the minimal cross-sectional area of the retropalatal/retroglossal spaces and compared the differences of those two spaces in the supine and lateral positions. CT was performed while patients were awake. RESULTS: The minimal cross-sectional area in the OSA group was significantly smaller than non-OSA group in both supine (median[interquartile range], 8.3[0.0-25.1] vs 22.2[1.0-39.6]; P = 0.018) and lateral decubitus positions (5.2[0.0-16.9] vs 21.3[6.1-38.4]; P = 0.002). As the body position of OSA patients shifted from supine to lateral, the retroglossal space increased significantly (67.3[25.1-116.3] vs 93.3[43.4-160.1]; P < 0.001). However, there was no significant difference in the retropalatal space between the supine and lateral decubitus positions. CONCLUSIONS: Positional change from the supine to lateral decubitus position expands the upper airway lumen, especially the retroglossal space. Positional OSA may be related to anatomical change of the upper airway lumen based on body position.
Entities:
Keywords:
Airway; Body position; Computed tomography; Obstructive sleep apnea; Sleep
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