Predicting OSA Using Radiographs of the Airway Anatomy.

IF 3 2区医学 Q2 CLINICAL NEUROLOGY Nature and Science of Sleep Pub Date : 2024-11-18 eCollection Date: 2024-01-01 DOI:10.2147/NSS.S486432

Mengya Du, Yuqin Gui, Yu Guo, Jie Liu, Wenmin Deng, Jingyan Huang, Tianrun Liu, Xiangmin Zhang, Feng Pang

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Abstract

Objective: This study aims to analyze the tongue body shape and upper airway anatomical parameters in patients with Obstructive Sleep Apnea (OSA) and to explore the anatomical causes of OSA.

Methods: A total of 345 subjects participated in this study. Lateral pharyngeal images of the upper respiratory tract were captured in both normal and mandibular advancement states using X-ray plain film. Measurements were taken for the following parameters: Tongue Length, Tongue Thickness, Distance from the Mandibular Plane to the Hyoid, Soft Palate Length, Posterior Oropharyngeal Depth, Palatal Airway Space, Tongue Depth Space, and Mental Posterior Space. The correlation between the Apnea-Hypopnea Index (AHI) and these upper airway anatomical factors was analyzed using both univariate and multivariate analyses to develop a predictive model for OSA.

Results: The anatomical structure of the upper airway in patients with OSA is narrower compared to non-OSA individuals, and these patients exhibit a longer and thicker tongue. During mandibular advancement, the pharyngeal airway widens; however, the tongue length decreases while its thickness increases. Univariate correlation analysis revealed that the severity of OSA was significantly associated with tongue length, the ratio of tongue length to tongue thickness, the distance from the mandibular plane to the hyoid, soft palate length, and body mass index (BMI) in both the normal position and during mandibular advancement (p < 0.001). Multivariate linear analysis indicated that the severity of OSA is linked with the mandibular plane to hyoid distance in the normal position (MPH(N)) and BMI. A nomogram was utilized to develop a predictive model for OSA, achieving an area under the receiver operating characteristic curve of 0.838.

Conclusion: The pathogenesis of OSA is related to pharyngeal anatomy and tongue length in the state of mandibular advancement, which can be predicted by the measurement indexes of normal and anterior mandibular displacement lateral pharyngeal radiograph. This may potentially aid in early screening and diagnosis of OSA.

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利用气道解剖的 X 光片预测 OSA。

研究目的本研究旨在分析阻塞性睡眠呼吸暂停（OSA）患者的舌体形状和上气道解剖学参数，并探讨 OSA 的解剖学原因：方法：共有 345 名受试者参与了这项研究。使用 X 光平片拍摄正常和下颌前突状态下的上呼吸道侧面咽部图像。对以下参数进行了测量：舌长、舌厚、下颌平面到舌骨的距离、软腭长度、口咽后深度、腭气道间隙、舌深间隙和舌后间隙。通过单变量和多变量分析，分析了呼吸暂停-高通气指数（AHI）与这些上气道解剖因素之间的相关性，从而建立了 OSA 的预测模型：结果：与非 OSA 患者相比，OSA 患者的上气道解剖结构更狭窄，而且这些患者的舌头更长、更厚。在下颌骨前移过程中，咽部气道变宽，但舌头长度减少，厚度增加。单变量相关分析表明，OSA 的严重程度与正常位置和下颌前突时的舌长、舌长与舌厚之比、下颌平面到舌骨的距离、软腭长度和体重指数（BMI）均有显著相关性（P < 0.001）。多变量线性分析表明，OSA的严重程度与正常体位时下颌平面到舌骨的距离（MPH(N)）和体重指数有关。利用提名图建立了一个 OSA 预测模型，其接收器操作特征曲线下面积为 0.838：OSA的发病机制与下颌前突状态下的咽部解剖结构和舌长度有关，可以通过正常和下颌前突侧位咽部X光片的测量指标进行预测。这可能有助于 OSA 的早期筛查和诊断。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Nature and Science of Sleep Neuroscience-Behavioral Neuroscience

CiteScore

5.70

自引率

5.90%

发文量

245

审稿时长

16 weeks

期刊介绍： Nature and Science of Sleep is an international, peer-reviewed, open access journal covering all aspects of sleep science and sleep medicine, including the neurophysiology and functions of sleep, the genetics of sleep, sleep and society, biological rhythms, dreaming, sleep disorders and therapy, and strategies to optimize healthy sleep. Specific topics covered in the journal include: The functions of sleep in humans and other animals Physiological and neurophysiological changes with sleep The genetics of sleep and sleep differences The neurotransmitters, receptors and pathways involved in controlling both sleep and wakefulness Behavioral and pharmacological interventions aimed at improving sleep, and improving wakefulness Sleep changes with development and with age Sleep and reproduction (e.g., changes across the menstrual cycle, with pregnancy and menopause) The science and nature of dreams Sleep disorders Impact of sleep and sleep disorders on health, daytime function and quality of life Sleep problems secondary to clinical disorders Interaction of society with sleep (e.g., consequences of shift work, occupational health, public health) The microbiome and sleep Chronotherapy Impact of circadian rhythms on sleep, physiology, cognition and health Mechanisms controlling circadian rhythms, centrally and peripherally Impact of circadian rhythm disruptions (including night shift work, jet lag and social jet lag) on sleep, physiology, cognition and health Behavioral and pharmacological interventions aimed at reducing adverse effects of circadian-related sleep disruption Assessment of technologies and biomarkers for measuring sleep and/or circadian rhythms Epigenetic markers of sleep or circadian disruption.