Affiliation:
1. Department of Otorhinolaryngology—Head & Neck Surgery University of Pennsylvania Philadelphia Pennsylvania USA
2. Department of Radiology University of Pennsylvania Philadelphia Pennsylvania USA
3. Division of Sleep Medicine/Department of Medicine University of Pennsylvania Philadelphia Pennsylvania USA
Abstract
IntroductionThe significance of hyoid dynamics in OSA pathophysiology remains unclear. Drug‐induced sleep endoscopy (DISE) is often used for evaluating patients intolerant to positive airway pressure (PAP) therapy. We performed DISE with concurrent hyoid‐focused ultrasonography to quantify hyoid dynamics during obstructive and non‐obstructive breathing.MethodsA cross‐sectional analysis from a prospective cohort of patients undergoing DISE with PAP titration (DISE‐PAP) and hyoid‐focused ultrasound was conducted. Hyoid ultrasound was performed during obstructive breathing, and non‐obstructive breathing after PAP administration. Motion was quantified by generating displacement curves based on echo‐tracking hyoid movement. The image analysis protocol for quantifying hyoid displacement was performed independently by two researchers, and reliability of measures was assessed. Univariate and multivariate regressions were performed for various clinical data and hyoid displacement during obstructive breathing.ResultsTwenty patients met inclusion criteria. On average, the cohort was male (75%), elderly (65.9 ± 10 years), overweight (29.3 ± 3.99 kg/m2), and with moderate‐to‐severe OSA (29.3 ± 12.5 events/h). Mean hyoid displacement during obstructive breathing was 5.81 mm (±3.48). In all patients, hyoid displacement decreased after PAP administration (−3.94 mm [95% CI: −5.10, −2.78]; p < 0.0001). Inter‐rater reliability for measures of hyoid displacement was excellent. After multivariate regression, hyoid displacement at baseline was associated with higher AHI (β [95% CI] = 0.18 [0.03, 0.33], p = 0.020).ConclusionDuring DISE, hyoid displacement is greater during obstructive breathing with significant variability amongst patients. Further, these ultrasonographic measurements had excellent intra‐ and inter‐rater reliability. Additional, larger studies are needed to understand contributors to hyoid mobility.Level of Evidence4 Laryngoscope, 133:3221–3227, 2023
Funder
Foundation for the National Institutes of Health
Cited by
2 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献