Use of 3-dimensional computed tomography scan to evaluate upper airway patency for patients undergoing sleep-disordered breathing surgery

OBJECTIVE: Our goal was to investigate the correlation between upper airway 3-dimensional computed tomography (3-D CT) measurements and polysomnography data of patients with sleep-disordered breathing (SDB). STUDY DESIGN AND SETTING: The 3-D CT scan measurements of the retropalatal space (RP), lateral and anteroposterior diameters of RP, retroglossal space, uvular thickness, and volume of upper airway were taken prospectively from 194 consecutive SDB patients. These were correlated with patients' respective Respiratory Distress Index (RDI), snoring index, and lowest arterial oxygen saturation gathered from polysomnographic data. RESULTS: RP (r = -0.27, P = 0.0001) and lateral diameter (P = 0.0073) were significantly correlated with RDI. Multivariate regression model (R-2 = 0.286) demonstrates RP (P = 0.0036) and retroglossal space (P = 0.027) to be predictive of RDI. No 3-D CT parameters correlated with snoring index and lowest arterial oxygen saturation attained statistical significant. CONCLUSION. The 3-D CT scan measurements can be valuable in evaluating upper airway patency in patients with SDB. The RP was the most relevant upper airway anatomic structure identified in these patients. SIGNIFICANCE: Modification of palatal surgery to increase the lateral dimension of the RP may be a breakthrough in increasing its success rate.