Prediction of Epiglottic Collapse in Obstructive Sleep Apnea Patients: Epiglottic Length

I-Chun Kuo,1,2 Li-Jen Hsin,1,2 Li-Ang Lee,1,2 Tuan-Jen Fang,1,2 Ming-Shao Tsai,2,3 Yi-Chan Lee,2,4 Shih-Chieh Shen,2,5 Hsueh-Yu Li1,2 1Departments of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Tao-yuan City, Taiwan; 2College of Medicine, Chang Gung Univ...

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Autores principales:	Kuo IC, Hsin LJ, Lee LA, Fang TJ, Tsai MS, Lee YC, Shen SC, Li HY
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	obstructive sleep apnea epiglottic collapse drug-induced sleep computed tomography epiglottic length hyoid bone movement Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
Acceso en línea:	https://doaj.org/article/6da667243ec2441996b30b5e7dba3340
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spelling	oai:doaj.org-article:6da667243ec2441996b30b5e7dba33402021-12-02T19:33:34ZPrediction of Epiglottic Collapse in Obstructive Sleep Apnea Patients: Epiglottic Length1179-1608https://doaj.org/article/6da667243ec2441996b30b5e7dba33402021-11-01T00:00:00Zhttps://www.dovepress.com/prediction-of-epiglottic-collapse-in-obstructive-sleep-apnea-patients--peer-reviewed-fulltext-article-NSShttps://doaj.org/toc/1179-1608I-Chun Kuo,1,2 Li-Jen Hsin,1,2 Li-Ang Lee,1,2 Tuan-Jen Fang,1,2 Ming-Shao Tsai,2,3 Yi-Chan Lee,2,4 Shih-Chieh Shen,2,5 Hsueh-Yu Li1,2 1Departments of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Tao-yuan City, Taiwan; 2College of Medicine, Chang Gung University, Tao-Yuan, Taiwan; 3Departments of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi City, Taiwan; 4Departments of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Keelung Branch, Keelung City, Taiwan; 5Departments of Otolaryngology-Head & Neck Surgery, New Taipei City Municipal Tucheng Hospital, New Taipei City, TaiwanCorrespondence: Hsueh-Yu LiDepartments of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Tao-yuan City, TaiwanTel +886-3-328-1200 ext.3966Fax +886-3-397-9361Email hily38@cgmh.org.twObjective: This study aims to explore the factors that contribute to epiglottic collapse (EC) in patients with obstructive sleep apnea (OSA).Methods: This study enrolled 35 patients (34 males; median age, 39 years; median apnea–hypopnea index (AHI), 55.4 events/h; median body mass index (BMI), 26.9 kg/m2). EC (epiglottis attaching onto the posterior pharyngeal wall) was diagnosed by drug-induced sleep computed tomography (DI-SCT). Three dimensions were assessed for comparison between the EC and non-EC (NEC) groups that included anatomical measurement: epiglottic length and angle, endoscopic classification of epiglottis obstructing the glottis (Type I, none; Type II, partial; and Type III, total), and dynamic hyoid movement during DI-SCT (Δ hyoid = √(x2 + y2), maximal displacement of hyoid in x and y axes during sleep breathing cycle).Results: EC was found in 12 patients (34%). No difference in age, gender, AHI, and BMI between the two groups was noted. The anatomical measurement revealed that epiglottis length was significantly different between the EC and NEC groups (21.2 vs 15.8 mm; p < 0.001), with a cutoff value of 16.6 mm (sensitivity, 100%; specificity, 65.2%). The EC group patients showed larger hyoid movement than the NEC group patients (Δ hyoid, 4.8 vs 3.0 mm; p = 0.027). By contrast, epiglottic angle and endoscopic classification revealed an insignificant difference between the two groups.Conclusion: Epiglottis is a potential collapse site among multilevel obstruction in moderate to severe OSA patients. Epiglottic length is highly sensitive in predicting EC, with the cutoff value of 16.6 mm. Hyoid movement plays a role in contributing to EC in OSA patients.Keywords: obstructive sleep apnea, epiglottic collapse, drug-induced sleep computed tomography, epiglottic length, hyoid bone movementKuo ICHsin LJLee LAFang TJTsai MSLee YCShen SCLi HYDove Medical Pressarticleobstructive sleep apneaepiglottic collapsedrug-induced sleep computed tomographyepiglottic lengthhyoid bone movementPsychiatryRC435-571Neurophysiology and neuropsychologyQP351-495ENNature and Science of Sleep, Vol Volume 13, Pp 1985-1992 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	obstructive sleep apnea epiglottic collapse drug-induced sleep computed tomography epiglottic length hyoid bone movement Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495
spellingShingle	obstructive sleep apnea epiglottic collapse drug-induced sleep computed tomography epiglottic length hyoid bone movement Psychiatry RC435-571 Neurophysiology and neuropsychology QP351-495 Kuo IC Hsin LJ Lee LA Fang TJ Tsai MS Lee YC Shen SC Li HY Prediction of Epiglottic Collapse in Obstructive Sleep Apnea Patients: Epiglottic Length
description	I-Chun Kuo,1,2 Li-Jen Hsin,1,2 Li-Ang Lee,1,2 Tuan-Jen Fang,1,2 Ming-Shao Tsai,2,3 Yi-Chan Lee,2,4 Shih-Chieh Shen,2,5 Hsueh-Yu Li1,2 1Departments of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Tao-yuan City, Taiwan; 2College of Medicine, Chang Gung University, Tao-Yuan, Taiwan; 3Departments of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Chiayi Branch, Chiayi City, Taiwan; 4Departments of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Keelung Branch, Keelung City, Taiwan; 5Departments of Otolaryngology-Head & Neck Surgery, New Taipei City Municipal Tucheng Hospital, New Taipei City, TaiwanCorrespondence: Hsueh-Yu LiDepartments of Otolaryngology-Head & Neck Surgery, Chang Gung Memorial Hospital, Linkou Main Branch, Tao-yuan City, TaiwanTel +886-3-328-1200 ext.3966Fax +886-3-397-9361Email hily38@cgmh.org.twObjective: This study aims to explore the factors that contribute to epiglottic collapse (EC) in patients with obstructive sleep apnea (OSA).Methods: This study enrolled 35 patients (34 males; median age, 39 years; median apnea–hypopnea index (AHI), 55.4 events/h; median body mass index (BMI), 26.9 kg/m2). EC (epiglottis attaching onto the posterior pharyngeal wall) was diagnosed by drug-induced sleep computed tomography (DI-SCT). Three dimensions were assessed for comparison between the EC and non-EC (NEC) groups that included anatomical measurement: epiglottic length and angle, endoscopic classification of epiglottis obstructing the glottis (Type I, none; Type II, partial; and Type III, total), and dynamic hyoid movement during DI-SCT (Δ hyoid = √(x2 + y2), maximal displacement of hyoid in x and y axes during sleep breathing cycle).Results: EC was found in 12 patients (34%). No difference in age, gender, AHI, and BMI between the two groups was noted. The anatomical measurement revealed that epiglottis length was significantly different between the EC and NEC groups (21.2 vs 15.8 mm; p < 0.001), with a cutoff value of 16.6 mm (sensitivity, 100%; specificity, 65.2%). The EC group patients showed larger hyoid movement than the NEC group patients (Δ hyoid, 4.8 vs 3.0 mm; p = 0.027). By contrast, epiglottic angle and endoscopic classification revealed an insignificant difference between the two groups.Conclusion: Epiglottis is a potential collapse site among multilevel obstruction in moderate to severe OSA patients. Epiglottic length is highly sensitive in predicting EC, with the cutoff value of 16.6 mm. Hyoid movement plays a role in contributing to EC in OSA patients.Keywords: obstructive sleep apnea, epiglottic collapse, drug-induced sleep computed tomography, epiglottic length, hyoid bone movement
format	article
author	Kuo IC Hsin LJ Lee LA Fang TJ Tsai MS Lee YC Shen SC Li HY
author_facet	Kuo IC Hsin LJ Lee LA Fang TJ Tsai MS Lee YC Shen SC Li HY
author_sort	Kuo IC
title	Prediction of Epiglottic Collapse in Obstructive Sleep Apnea Patients: Epiglottic Length
title_short	Prediction of Epiglottic Collapse in Obstructive Sleep Apnea Patients: Epiglottic Length
title_full	Prediction of Epiglottic Collapse in Obstructive Sleep Apnea Patients: Epiglottic Length
title_fullStr	Prediction of Epiglottic Collapse in Obstructive Sleep Apnea Patients: Epiglottic Length
title_full_unstemmed	Prediction of Epiglottic Collapse in Obstructive Sleep Apnea Patients: Epiglottic Length
title_sort	prediction of epiglottic collapse in obstructive sleep apnea patients: epiglottic length
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/6da667243ec2441996b30b5e7dba3340
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Prediction of Epiglottic Collapse in Obstructive Sleep Apnea Patients: Epiglottic Length

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