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

 Sang Hyeon Ahn  ;  Jinna Kim  ;  Hyun Jin Min  ;  Hyo Jin Chung  ;  Jae Min Hong  ;  Jeung Gweon Lee  ;  Chang-Hoon Kim  ;  Hyung Ju Cho 
 PLoS One, Vol.10(8) : e0135796, 2015 
Journal Title
 PLoS One 
Issue Date
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 apnea-hypopnea 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 O2 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 O2 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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1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
Yonsei Authors
김진아(Kim, Jinna) ORCID logo https://orcid.org/0000-0002-9978-4356
김창훈(Kim, Chang Hoon)
안상현(Ahn, Sang Hyeon) ORCID logo https://orcid.org/0000-0002-2389-0005
이정권(Lee, Jeung Gweon)
정효진(Chung, Hyo Jin)
조형주(Cho, Hyung Ju) ORCID logo https://orcid.org/0000-0002-2851-3225
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