THE RELATIONSHIP BETWEEN THE ANATOMY FEATURES OF THE STRUCTURES OF THE PHARYNX AND THE DEVELOPMENT OF OBSTRUCTIVE SLEEP APNOEA SYNDROME IN ADULTS.

Abstract

The aim. To assess the correlation between subjective measurements and objective volume of palatine tonsils in adults, and to test the effect of oropharyngeal anatomy, body mass index, age, and OSA severity on actual tonsil volume. In addition, we evaluated the effect of tonsil size on the development of OSA in adults. Materials and methods. A prospective study of 130 patients with rhonchopathy and obstructive sleep apnea syndrome was conducted. Patients underwent a physical examination, nocturnal polysomnography, Epworth Sleepiness Scale, body mass index (BMI, kg/m²), and a subjective assessment of snoring on an analog scale from 1 (not important) to 10 (worst possible). Results: pharyngeal tissues are also found to be proportional to body size in both patients with rhonchopathy and patients with OSA, which indicates a secondary role of anatomy in the pathogenesis of OSA development. Tonsil volume (p = 0.053) tended to correlate with the degree of severity OSA There were no significant differences in the mean apnea-hypopnea index (AHI) between patients with grade I (30.5), II (29.6), or III (38.2) tonsil hypertrophy. Patients with grade IV tonsil hypertrophy had a higher AHI (mean 103.2) than patients with grade I (p = 0.01), II (p = 0.01) or III (p = 0.03) hypertrophy. Conclusions: In adult patients with rhonchopathy and OSA, there is a reliable correlation between the clinical degree of tonsil hypertrophy and the objective volume of the tonsils. Possible changes in pharyngeal geometry associated with OSA do not affect the clinical ability to determine tonsil volume. Although tonsil volume correlates with AHI, clinically only grade IV tonsils are predictive of severe OSA. Pharyngeal tissue volume likely reflects body mass index rather than OSA.