Abstract
Objectives
Determine the relationships between soft tissue oropharyngeal measurements and obstructive sleep apnea severity.
Methods
A prospective series of adult patients undergoing surgical theraphy for obstructive sleep apnea (OSA) was studied. Tonsil size (graded 0 to 4+) and median (palatal spineuvula tip) and lateral (posterior hard palate-free edge soft palate) dimensions of the soft palate were directly measured transorally at the time of surgery. From the preoperative polysomnographic and the medical record, respiratory disturbance index (RDI), lowest oxygen saturation (LSat) and body mass index (BMI) were determined. The relationships between both RDI and LSat and tonsil size and palatal dimensions was determined with multivariate linear regression adjusted for BMI.
Results
88 patients were enrolled. The mean (±)95% confidence interval values for the median and lateral soft palate lengths were 4.71 (±) 0.14 cm and 3.73 (±) 0.12 cm, respectively; the mean tonsil size was 1.8 (±) 0.3. The mean RDI and LSat were 44.0 (±) 5.6 events/hour and 84.7 (±) 2.4%, respectively. On multivariate regression, only BMI significantly predicted RDI (p=0.003); median (p=0.210) and lateral (p=0.507) palate lengths and tonsil size (p=0.860) did not. For the LSat, both BMI and tonsil size were significant predictors (p<0.001 and p=0.017, respectively); median and lateral lengths were not (p=0.251 and p=.376, respectively).
Conclusions
Adjusted for BMI, soft palate length does not consistently predict sleep apnea severity. Adjusted for BMI, tonsil size predicts the LSat but not the RDI. These results highlight difficulties associated with correlating soft tissue anatomy with sleep apnea severity.
Get full access to this article
View all access options for this article.