Tongue Volume Influences Lowest Oxygen Saturation but Not Apnea-Hypopnea Index in Obstructive Sleep Apnea

被引:33
作者
Ahn, Sang Hyeon [1 ]
Kim, Jinna [2 ]
Min, Hyun Jin [3 ]
Chung, Hyo Jin [1 ]
Hong, Jae Min [1 ]
Lee, Jeung-Gweon [1 ]
Kim, Chang-Hoon [1 ,4 ]
Cho, Hyung-Ju [1 ,4 ]
机构
[1] Yonsei Univ, Coll Med, Severance Hosp, Dept Otorhinolaryngol, Seoul, South Korea
[2] Yonsei Univ, Coll Med, Severance Hosp, Dept Radiol, Seoul, South Korea
[3] Chung Ang Univ, Coll Med, Dept Otorhinolaryngol Head & Neck Surg, Seoul 156756, South Korea
[4] Yonsei Univ, Coll Med, Airway Mucus Inst, Seoul, South Korea
基金
新加坡国家研究基金会;
关键词
UPPER AIRWAY; CEPHALOMETRIC ANALYSIS; OBESE; FAT; HYPERTENSION; MORPHOLOGY; DISORDERS; NONOBESE; ADULTS; RATIO;
D O I
10.1371/journal.pone.0135796
中图分类号
O [数理科学和化学]; P [天文学、地球科学]; Q [生物科学]; N [自然科学总论];
学科分类号
07 ; 0710 ; 09 ;
摘要
Objectives The aim of this study was to identify correlations between sleep apnea severity and tongue volume or posterior airway space measured via three-dimensional reconstruction of volumetric computerized tomography (CT) images in patients with obstructive sleep apnea (OSA) for use in predicting OSA severity and in surgical treatment. We also assessed associations between tongue volume and Mallampati score. Methods Snoring/OSA male patients (n = 64) who underwent polysomnography, cephalometry, and CT scans were enrolled in this retrospective study. OSA was diagnosed when the apneahypopnea index (AHI) was greater than 5 (mild 5-14; moderate 15-29; severe>30). The patients were also categorized into the normal-mild group (n = 22) and the moderate-severe group (n = 42). Using volumetric CT images with the three-dimensional reconstruction technique, the volume of the tongue, posterior airway space volume, and intra-mandibular space were measured. The volumes, polysomnographic parameters, and physical examination findings were compared, and independent factors that are related to OSA were analysed. Results No associations between tongue volume or posterior airway space and the AHI were observed. However, multivariate linear analyses showed that tongue volume had significantly negative association with lowest O-2 saturation (r = 0.365, p = 0.027). High BMI was related to an increase in tongue volume. Modified Mallampati scores showed borderline significant positive correlations with absolute tongue volume (r = 0.251, p = 0.046) and standardized tongue volume (absolute tongue volume / intramandibular area; r = 0.266, p = 0.034). Between the normal-mild and moderate-severe groups, absolute tongue volumes were not different, although the standardized tongue volume in the moderate-severe group was significantly higher. Conclusion Absolute tongue volume showed stronger associations with lowest O-2 saturation during sleep than with the severity of AHI. We also found that high BMI was a relevant factor for an increase in absolute tongue volume and modified Mallampati grading was a useful physical examination to predict tongue size.
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页数:15
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