Brazilian Journal of Pulmonology

ISSN (on-line): 1806-3756 | ISSN (printed): 1806-3713

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State-dependent changes in the upper airway assessed by multidetector CT in healthy individuals and during obstructive events in patients with sleep apnea

Alterações nas vias aéreas superiores avaliadas por TC multidetectores durante a vigília e o sono em indivíduos saudáveis e em pacientes com apneia do sono durante eventos obstrutivos

Ula Lindoso Passos1,a, Pedro Rodrigues Genta1,b, Bianca Fernandes Marcondes2,c, Geraldo Lorenzi-Filho2,d, Eloisa Maria Mello Santiago Gebrim1,e

J Bras Pneumol.2019;45(4):e20180264-e20180264

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Objective: To determine whether airway narrowing during obstructive events occurs predominantly at the retropalatal level and results from dynamic changes in the lateral pharyngeal walls and in tongue position. Methods: We evaluated 11 patients with severe obstructive sleep apnea (OSA) and 7 healthy controls without OSA during wakefulness and during natural sleep (documented by full polysomnography). Using fast multidetector CT, we obtained images of the upper airway in the waking and sleep states. Results: Upper airway narrowing during sleep was significantly greater at the retropalatal level than at the retroglossal level in the OSA group (p < 0.001) and in the control group (p < 0.05). The retropalatal airway volume was smaller in the OSA group than in the control group during wakefulness (p < 0.05) and decreased significantly from wakefulness to sleep only among the OSA group subjects. Retropalatal pharyngeal narrowing was attributed to reductions in the anteroposterior diameter (p = 0.001) and lateral diameter (p = 0.006), which correlated with an increase in lateral pharyngeal wall volume (p = 0.001) and posterior displacement of the tongue (p = 0.001), respectively. Retroglossal pharyngeal narrowing during sleep did not occur in the OSA group subjects. Conclusions: In patients with OSA, upper airway narrowing during sleep occurs predominantly at the retropalatal level, affecting the anteroposterior and lateral dimensions, being associated with lateral pharyngeal wall enlargement and posterior tongue displacement.

 


Keywords: Multidetector computed tomography; Oropharynx; Sleep apnea, obstructive; Polysomnography; Diagnostic imaging; Sleep.

 


How and why to review articles for the Jornal Brasileiro de Pneumologia

Como e por que revisar artigos para o Jornal Brasileiro de Pneumologia

Bruno Guedes Baldi1,2,a, Pedro Rodrigues Genta1,3,b

J Bras Pneumol.2019;45(5):e20190319-e20190319

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The JBP and sleep medicine

JBP e a medicina do sono

Pedro Rodrigues Genta1

J Bras Pneumol.2016;42(6):401-401

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