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

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Arquivos
art_PASSOS_Statedependent_changes_in_the_upper_airway_assessed_by_2019.PDF (1.01 MB)
Citações na Scopus
10
Tipo de produção
article
Data de publicação
2019
Editora
SOC BRASILEIRA PNEUMOLOGIA TISIOLOGIA
DOI
Indexadores
SciELO
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Autores
PASSOS, Ula Lindoso
Autor de Grupo de pesquisa
Editores
Coordenadores
Organizadores
Citação
JORNAL BRASILEIRO DE PNEUMOLOGIA, v.45, n.4, article ID UNSP e20180264, 9p, 2019
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
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.
Palavras-chave
Multidetector computed tomography, Oropharynx, Sleep apnea, obstructive, Polysomnography, Diagnostic imaging, Sleep
URI
https://observatorio.fm.usp.br/handle/OPI/33458
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MCP
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - HC/InRad
Artigos e Materiais de Revistas Científicas - LIM/63