Morphological Assessment of the Soft Palate in Habitual Snoring Using Image Analysis (original) (raw)
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The effect of pharyngeal soft tissue components on snoring
Clinical Imaging, 2007
To determine the effect of oropharyngeal air column area, parapharyngeal fat pad thickness, pterygoid muscle thickness, and parapharyngeal wall thickness on snoring. Materials and Methods: Fifty-six individuals (35 men, 21 women) complaining of snoring in a questionnaire administered to patients attending the MR unit for cervical MR imaging were enrolled as the study group, and 39 (23 men, 16 women) individuals with no complaint of snoring were enrolled as the control group. Firstly, patients' body mass index (BMI) was determined. Then turbo spin echo T2-weighted MR imaging in the axial plane was performed, from the nasopharynx to the hyoid bone level, in both groups. From the MR images, oropharyngeal air column area, parapharyngeal fat pad thickness, pterygoid muscle thickness and parapharyngeal wall thickness measurements were made. Finally, the results were statistically analysed using SPSS (Statistical Package for Social Sciences) for Windows 10.0. Student's t-test was used as a complementary method in the analysis of the study data. The correlations between BMI and parapharyngeal wall thickness, and BMI and oropharyngeal air column area were determined by Pearson's correlation analysis. Results: No statistically significant difference was found between study and control groups in terms of mean age, pterygoid muscle thickness, or pharyngeal fat pad thickness ( P N.05). Snorers' BMI levels ( P b.01) and average parapharyngeal wall thicknesses ( P b.05) were statistically significantly higher than those of the control subjects. Snorers' oropharyngeal air column area was significantly narrower than that of the control subjects, statistically ( P b.01). Conclusion: As a result of the study, it was concluded that only oropharyngeal air column area and parapharyngeal muscle thickness had an effect on snoring. D
The Laryngoscope, 2012
Objectives/Hypothesis: The objective of this study was to evaluate the long-term effectiveness of palatal implants as the treatment of primary snoring. Study Design: Prospective longitudinal cohort study. Methods: This study compared snoring outcomes before and after soft palate implantation for patients diagnosed with primary snoring (no sleep apnea). Snoring severity was obtained by the subjects' sleep partners on a 10-point Likert scale. A paired Student t test compared the mean scale values preoperatively at week 52 and at the current 4-year follow-up. Body mass index for each patient was also compared to evaluate for any significant confounders. Results: Data were obtained from 23 patients out of 26 who were followed for the full study term. The follow-up time was on average 4 years following palatal implantation. A statistically (P < .016) and clinically significant improvement in the snoring scale was noted when comparing snoring severity between the preoperative and 4-year period and between the 52week and 4-year scores. Although statistically significant improvement was found between the preoperative period and 52 weeks, there was a clinical deterioration in snoring scale scores between 52 weeks and 4 years. The mean (standard deviation) preoperative score was 9.5 (0.5), mean week-52 score was 5.0 (1.6), and mean 4-year score was 7.0 (1.8). Body mass index did not change through the observation interval. Conclusions: Soft palate implantation is a possible surgical technique with which to attempt to achieve subjective improvement of primary snoring severity. Subjective improvement, however, deteriorates significantly over time, and is only minimally sustained at 4 years postoperatively. This study provides new information on long-term palatal implant effectiveness.
The Characteristics of Snoring at Pharyngeal Anatomy in Natural Sleep: Snoring Duration
Journal of Mechanics, 2012
ABSTRACTThe present study utilized audio recordings of snoring during natural sleep to analyze characteristics related to the snoring duration at the soft palate, epiglottis, and tongue base. 10 subjects were recruited for the study, with an average age of 23.7 years. These audio files were then used to analyze the characteristics of snoring duration at the soft palate, epiglottis, and tongue base responsible for sound generation. Findings indicated that snoring duration was 3.7 seconds at the soft palate, 2.2 seconds at the epiglottis and 1.29 seconds at the tongue. Since the soft palate is the softest structure of the three, snoring sound by vibration was most easily induced at this structure, leading to the longest snoring duration. This was followed by the epiglottis and the tongue base respectively. Of the 10 subjects, 6 had BMI in the overweight range, and snoring durations for these individuals were seen to be lengthened by 0.13 seconds, with the tongue base snoring duration ...
Does A Hyperflexible Tongue Cause Snoring?
The Internet Journal of Otorhinolaryngology
A sixteen years old boy was admitted to our clinic with suffering of snoring for three years. Physical examination showed an enlarged and elongated uvula. Endoscopic examination revealed hyperflexible tongue which is able to reach nasopharynx backwards and move there in different ways. From the history it was learned that he had been doing it for 6 years habitually. Snoring may have been the result of unusual tongue movement or secondary to enlarged and elongated uvula that may be caused by habitual backward movement of tongue. Laser-assisted uvulopalatoplasty was performed for snoring. No recurrence is noted in six months. This case report was presented at 20th Congress of the European Rhinologic Society & 23rd international symposium on infection and allergy of the nose. June 18-25, 2004.
Evaluation of morphological changes in pharynx with dynamic CT and MRI in snoring patients
Revista médica de Chile, 2016
Background: Identifying the craniofacial abnormalities that cause snoring and the narrowest area of the upper airway creating obstructions can help to determine the proper method of treatment. Aim: To identify the factors that can cause snoring and the areas of the airway that are the most likely to collapse with upper airway imaging. Material and Methods: Axial pharynx examinations with CT (computerized tomography) and magnetic resonance imaging (MRI) were performed to 38 patients complaining of snoring and 12 patients who did not complain of snoring. The narrowest areas of nasopharynx, hypophraynx, oropharynx, bilateral para-pharyngeal fat pad and para-pharyngeal muscle thickness were measured. Results: In snoring patients, the narrowest part of the upper airway was the retro-palatal region in the oropharynx, as measured with both imaging methods. When patients with and without snoring were compared, the former that a higher body mass index and neck diameter and a narrower oropharynx area. In dynamic examinations, we determined that as para-pharyngeal muscle thickness increased, medial-lateral airway diameter and the oropharynx area decreased. Conclusions: The narrowest section of the airway is the retro-palatal region of the oropharynx, measured both with CT and MRI.
CHEST Journal, 2005
Study objectives: To identify upper airway changes in snoring using CT scanning, to clarify the snoring mechanism, and to identify the key structures involved. Participants: Forty patients underwent CT examination of the head and neck region according to snoring habits; patients were classified into nonsnoring (n ؍ 14), moderately loud snoring (n ؍ 13), and loud snoring (n ؍ 13) groups. Design: Comparative analysis. Measurements: Using CT images, areas, the anteroposterior and transversal distances of the pharyngeal space at different levels, and the thickness and length of the soft palate and uvula and their angle against the hard palate were measured; evidence of impaired nasal passages was noted; the extent of pharyngeal inspiratory narrowing was the ratio between the area at the hard palate level and most narrow area; and expiratory narrowing was the ratio between the area behind the root of the tongue and the most narrow area. Results: Greater pharyngeal inspiratory narrowing (p ؍ 0.0015) proportional to the loudness of snoring (p ؍ 0.0016), and a longer soft palate with uvula (p ؍ 0.0173) were significant for snoring. Impaired nasal breathing was significantly related (p ؍ 0.029) only to the loud snoring group. The body mass index and age of snoring persons were also significantly higher. Conclusions: Snoring is associated with typical changes that can be revealed by CT scanning. Greater pharyngeal narrowing is the most important factor. Given the "Venturi tube" shape of the pharynx, the Bernoulli pressure principle plays a major role in snoring. The key structure in snoring is the soft palate: it defines the constriction and is sucked into vibrating by negative pressure that develops at this site. Its repetitive closures present an obstruction to breathing, producing the snoring sound, and should therefore be the target for causal treatment of snoring. Obstacles in the upper airway that increase negative inspiratory pressure could not be confirmed as important for the development of snoring, although they may increase its loudness.
Long-term effects of radiofrequency ablation of the soft palate on snoring
European Archives of Oto-Rhino-Laryngology, 2010
The objective of the study was to evaluate short-and long-term effects of radiofrequency treatment of the soft palate on snoring. Twenty-nine patients with habitual snoring were studied prospectively and treated up to four times at 4-6 week intervals with an Ellman Surgitrone ®. Electromyography (EMG) of m. palatoglossus was performed in ten patients. Patients and partners evaluated snoring, sleep quality and daytime sleepiness 1 week preoperatively, 6 months and 3-4 years postoperatively. Snoring was reduced postoperatively (P < 0.0001). Sleep time increased, daytime sleepiness was reduced, and the partners slept better after 6 months. However, 3-4 years postoperatively only 25% of patients were satisfied. Another 25% had received additional treatment. EMG was normal in 6/10 patients preoperatively. They all continued to snore postoperatively. Four patients had pathological EMGs; three were responders. In conclusion, radiofrequency treatment for snoring may lead to long-term improvement in one out of four cases. Pre-evaluation with EMG may predict the outcome.