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A Han S, Cha H, Yang SK, Kim SY, Han DH, Kim DY, Rhee CS, Kim HJ. Sleep parameter characteristics of patients with OSA who have retropalatal circumferential narrowing and the clinical significance of lateral pharyngeal wall collapse during sleep. Sleep Breath 2023; 27:2165-2173. [PMID: 36959432 PMCID: PMC10656349 DOI: 10.1007/s11325-023-02808-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 02/13/2023] [Accepted: 03/06/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND The lateral pharyngeal wall (LPW) is a critical anatomic structure in patients with obstructive sleep apnea (OSA). Resolving the retropalatal circumferential (RC) narrowing caused by combination of both LPW collapse and antero-posterior (AP) narrowing holds promise for surgical treatment of OSA. We sought to determine the clinical characteristics and distinctive alterations in sleep parameters of patients with OSA who have RC narrowing and LPW collapse. METHODS Drug-induced sleep endoscopy (DISE), polysomnography findings, and sleep questionnaires were reviewed retrospectively in patients with OSA. RESULTS Of the 106 OSA patients examined, 48% showed RC narrowing and 44% showed AP narrowing at the oropharynx level during sleep while 8% of the patients showed only LPW collapse. Patients with RC narrowing with LPW collapse exhibited a higher BMI than those with AP narrowing only. In addition, patients with RC narrowing showed more aggravated sleep parameters including apneic events than patients with AP narrowing alone. The degree of RC narrowing correlated significantly with the severity of OSA as shown by a higher apnea index and lower oxygen desaturations. CONCLUSIONS Our clinical findings suggest that the presence of RC narrowing with LPW collapse in OSA is closely related to increased apneic and oxygen desaturation events. RC narrowing with LPW collapse may be targets for surgical correction in patients with OSA to improve therapeutic outcomes.
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Affiliation(s)
- Sun A Han
- Department of Otorhinolaryngology-Head and Neck Surgery, Hallym University Dongtan Sacred Heart Hospital, Hwaseong-si, Gyeonggi-do, 18450, Korea
| | - Hyunkyung Cha
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Hospital, 103 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea
| | - Seung Koo Yang
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Hospital, 103 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea
| | - Seo Young Kim
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Hospital, 103 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea
| | - Doo Hee Han
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Hospital, 103 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea
| | - Dong-Young Kim
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Hospital, 103 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea
| | - Chae-Seo Rhee
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Hospital, 103 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea
| | - Hyun Jik Kim
- Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul National University Hospital, 103 Daehak-Ro, Jongno-Gu, Seoul, 03080, Korea.
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