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Cervical computed tomography in patients with obstructive sleep apnea: influence of head elevation on the assessment of upper airway volume

Authors :
Fábio José Fabrício de Barros Souza
Anne Rosso Evangelista
Juliana Veiga Silva
Grégory Vinícius Périco
Kristian Madeira
Source :
Jornal Brasileiro de Pneumologia, Vol 42, Iss 1, Pp 55-60 (2016)
Publication Year :
2016
Publisher :
Sociedade Brasileira de Pneumologia e Tisiologia, 2016.

Abstract

Objective : Obstructive sleep apnea syndrome (OSAS) has a high prevalence and carries significant cardiovascular risks. It is important to study new therapeutic approaches to this disease. Positional therapy might be beneficial in reducing the apnea-hypopnea index (AHI). Imaging methods have been employed in order to facilitate the evaluation of the airways of OSAS patients and can be used in order to determine the effectiveness of certain treatments. This study was aimed at determining the influence that upper airway volume, as measured by cervical CT, has in patients diagnosed with OSAS. Methods : This was a quantitative, observational, cross-sectional study. We evaluated 10 patients who had been diagnosed with OSAS by polysomnography and on the basis of the clinical evaluation. All of the patients underwent conventional cervical CT in the supine position. Scans were obtained with the head of the patient in two positions (neutral and at a 44° upward inclination), and the upper airway volume was compared between the two. Results : The mean age, BMI, and neck circumference were 48.9 ± 14.4 years, 30.5 ± 3.5 kg/m2, and 40.3 ± 3.4 cm, respectively. The mean AHI was 13.7 ± 10.6 events/h (range, 6.0-41.6 events/h). The OSAS was classified as mild, moderate, and severe in 70%, 20%, and 10% of the patients, respectively. The mean upper airway volume was 7.9 cm3 greater when the head was at a 44° upward inclination than when it was in the neutral position, and that difference (17.5 ± 11.0%) was statistically significant (p = 0.002). Conclusions : Elevating the head appears to result in a significant increase in the caliber of the upper airways in OSAS patients.

Details

Language :
English, Portuguese
ISSN :
18063756
Volume :
42
Issue :
1
Database :
Directory of Open Access Journals
Journal :
Jornal Brasileiro de Pneumologia
Publication Type :
Academic Journal
Accession number :
edsdoj.96c2ad84769415588ff46033417d7df
Document Type :
article
Full Text :
https://doi.org/10.1590/S1806-37562016000000092