Correlation between airway size and imaging examination in OSAHS patients

Abstract

Background The relationship between polysomnography (PSG) and three-dimensional computed tomography (3D-CT) hasn't been well investigated in Obstructive sleep apnea/hypopnea syndrome (OSAHS) . Objectives By analyzing PSG and 3D-CT, we obtain anatomical factors that affect the severity of OSAHS. Methods 78 OSAHS patients were retrospectively analyzed who were admitted to the First Affiliated Hospital of University of Science and Technology of China from January 1, 2022 to November 1, 2023. All of them had completed PSG and upper airway 3D-CT. The correlation between PSG and 3D-CT parameters was analyzed in these OSAHS patients. Results The study showed that body mass index (BMI) was significantly correlated with the diameter of soft palate (r = 0.359, p < 0.05). Apnea-hypopnea index (AHI) was significantly correlated with soft palate diameter (r = 0.258, p < 0.05). Mean blood oxygen saturation (MSaO2%) was significantly correlated with the length of soft palate (r= -0.330, p < 0.05). The lowest blood oxygen saturation (LSaO2%) was significantly correlated with the airway area at the level of free edge of epiglottis (r = 0.266, p < 0.05). The cumulative time of oxygen saturation below 90% (CT90) was significantly correlated with the length of soft palate (r = 0.271, p < 0.05). CT90 was positively correlated with the diameter of soft palate (r = 0.269, p < 0.05). Other upper airway anatomical parameters, such as distance from uvula to epiglottis (UED), uvula diameter (UD), posterior pharyngeal wall thickness (PWD), hard palate horizontal airway area (HPA), uvula apex horizontal airway area (UA), hyoid horizontal airway area (HA), were not clearly correlated with AHI and blood oxygen saturation. Conclusion and significance The severity of OSAHS is mainly affected by the diameter and length of the soft palate, and the treatment of soft palate is the key to the surgical treatment of OSAHS. In patients with low minimum blood oxygenation, the treatment should focus on expanding the airway area in the plane of the free edge of the epiglottis.