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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
Issue Date
Adult ; Aged ; Cephalometry/methods ; Humans ; Male ; Mandible/metabolism ; Mandible/physiopathology ; Middle Aged ; Oxygen/metabolism* ; Polysomnography/methods ; Retrospective Studies ; Severity of Illness Index ; Sleep/physiology ; Sleep Apnea, Obstructive/metabolism ; Sleep Apnea, Obstructive/physiopathology* ; Snoring/metabolism ; Snoring/physiopathology ; Tongue/physiopathology* ; Young Adult
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. College of Medicine (의과대학) > Dept. of Otorhinolaryngology (이비인후과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Jinna(김진아) ORCID logo https://orcid.org/0000-0002-9978-4356
Kim, Chang Hoon(김창훈) ORCID logo https://orcid.org/0000-0003-1238-6396
Ahn, Sang Hyeon(안상현) ORCID logo https://orcid.org/0000-0002-2389-0005
Lee, Jeung Gweon(이정권)
Chung, Hyo Jin(정효진)
Cho, Hyung Ju(조형주) ORCID logo https://orcid.org/0000-0002-2851-3225
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