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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
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.
Characterization of Upper Air Way Tract in Snoring and Non-Snoring Patients: A CT Based Study
Open Journal of Radiology, 2016
Snoring is part of the spectrum of sleep disordered breathing. The patients with snoring should be evaluated for nasal airway obstruction. In this study, the upper air way tract was characterized in snoring patients and compared with none snoring using a quantify method for the corresponding anatomic upper air way (UA) parameters examined by Computerized Tomography (CT). Two hundred Asian patients undergoing CT scanning for head and neck were included and were divided into two groups (snoring group [n = 127] and non-snoring group [n = 73]) (mean age: 44.8 ± 15.9 years and 26.2 ± 7.0). Total 8 parameters were measured on sagital reconstructed CT images for each subject. The differences in neck circumference (NC), linear distance between mandibular plane and hyoid bone (Mp-H), upper airway length (UAL), the maximum thickness of the soft palate (SP max), soft palate length (PNS-U), linear distance between anterior and posterior nasal spine (ANS-PNS), retroglosal width (RS), retroplatal width (RP) between the snoring and non-snoring groups were compared statistically using independent sample t-test. Results showed that the NC, UAL, and SP max were significantly higher in snoring group; however RP was found to be significantly lower. Inferior positioning of hyoid bone gives longer measurement for MP-H. In snoring group UAL was found to be significantly different at p ≤ 0.000 between the two genders. All the measured variables showed no significant differences in respect to age. UA CT quantitative features play an important role in the characterization of the anatomy and are compared between snoring patients and non-snoring subjects.
Cephalometric comparison of pharyngeal airway in snoring and non-snoring patients
European journal of dentistry, 2011
To compare the skeletal and the airway structures of the non-snoring individuals with simple snoring and patients with obstructive sleep apnea (OSA). The first group consisted of 20 simple snoring cases (mean age: 37.5±8.05 years; max: 50 years, min: 21 years), the second group consisted of 20 OSA cases (mean age: 40.0±8.28 years; max: 54 years, min: 27 years) and the third group consisted of 20 individuals without any respiration problems (mean age: 29.6±3.20 years; max: 35 years, min: 24 years). In the cephalometric films, 4 skeletal and 14 airway space measurements were done. The control group and the study groups were compared using the Dunnett t test, and the groups with snoring problems were compared using the Bonferroni test. No statistically significant differences were found between the three groups in skeletal measurements. The OSA and simple snoring groups showed no significant differences in airway measurements. The OSA group showed significantly increased soft palate an...
Morphological Assessment of the Soft Palate in Habitual Snoring Using Image Analysis
Laryngoscope, 1999
Objectives: Define differences in palatal and uvular dimensions between habitual snorers and healthy nonsnoring control subjects. Document the changes in palatal configuration after different types of palatoplasty.Study Design: A prospective controlled clinical study was performed analyzing video recordings of the soft palate and oropharynx of 251 subjects (121 habitual snorers, 79 patients after laser-assisted uvulopalatoplasty ([LAUP], and 51 healthy volunteers).Methods: The recordings were captured using a rigid endoscope with a reference measure applied to the soft palate and a mark at the junction of the soft and hard palate. Four parameters were studied in the captured pictures after correction for the distortion deformity in fiberoptic endoscopic images: 1) length of soft palate, 2) length of uvula, 3) width of uvula, and 4) distance between posterior pillars.Results: Analysis showed that habitual snorers, compared with healthy volunteers have significantly increased soft palate length (P = .00001), increased uvula length (P = .0002) and width (P = .00001), and narrowed oropharyngeal isthmus (distance between the posterior pillars) (P = .04). In patients studied after LAUP, the length of the soft palate is significantly shorter (P = .00001) than in the preoperative cohort, and the oropharyngeal isthmus is significantly narrower (P = .00001). Moreover, this latter distance is significantly narrower (P = .00001) when compared with healthy volunteers.Conclusions: Habitual snorers have a long soft palate, a long wide uvula, and a narrowed oropharyngeal isthmus. LAUP shortens and tightens the elongated palate and causes a further reduction in the space between the posterior pillars.
Pattern of Snoring in Obstructive Sleep Apnea Patients and in Heavy Snorers
Sleep, 1991
We measured respiratory mechanical characteristics during sleep in five heavy, nonapneic snorers (HS) and in five obstructive sleep apnea (OSA) patients. In two HS and in two OSA patients we obtained lateral pharyngeal cineradiographic images during sleep while snoring. Flow limitation preceded all snores in both HS and OSA. Pattern of snoring, hysteresis and temporal relationship between supraglottic pressure (Psg) and fiow rate were different in HS and OSA. Maximal fiow during snoring was less (p < 0.05) in OSA (0.18 ± 0.07 liter/second) than in HS (0.36 ± 0.06 liter/second). Linear supraglottic resistance during inspiratory snoring was higher, though not significantly, in OSA patients (7.11 ± 3.01 cm H 2 0/liter/second) than in HS (4.80 ± 2.83 cm H 2 0/liter/second). We conclude that: 1) Snoring is characterized by high frequency oscillations of the soft palate, pharyngeal walls, epiglottis and tongue. 2) Flow limitation appears to be a sine qua non for snoring during sleep. 3) The pattern of snoring is different in OSA and HS. 4) Pharyngeal size during snoring is probably larger in HS than in OSA patients.
Dynamic upper airway soft-tissue and caliber changes in healthy subjects and snoring patients
AJNR. American journal of neuroradiology
The oropharyngeal airways are smaller in those who snore than in those who do not. We sought to determine which soft-tissue component surrounding the airways contributes to upper airway narrowing in those who snore. Ten control subjects and 19 snoring patients underwent CT, with 2-mm-thick axial sections obtained every 0.6 seconds during the respiration cycle at the same oropharyngeal level. We selected two sections with the widest and narrowest parts of the oropharyngeal airway to measure the anteroposterior and lateral dimensions of the airway and the thickness of the bilateral parapharyngeal fat pads, pterygoid muscles, and parapharyngeal walls. Mean values were calculated for each phase. For each subject, differences were calculated by subtracting the values in narrowest phase from those in the widest phase. Changes in airway dimension (P < .05) and lateral parapharyngeal wall thickness (P < .01) were significantly different between snorers and control subjects. Changes in...
Airway disorders and pulmonary function in snorers. A population-based study
Respiratory Medicine, 2000
The aim of our study was to determine the relationship between snoring, airway disorders and pulmonary function in the general population. We performed a strati®ed random sampling from the population (n=92 364). Four hundred subjects agreed to participate and were invited to the clinic, where a detailed medical history, physical examination, spirometric test and maximal respiratory pressures measurements were carried out. Snoring was reported by 152 subjects (38%). Nasal obstruction and the presence of abnormal pharynx exploration were more frequent in subjects with snoring. Age, body mass index and neck circumference were signi®cantly higher in the snorer group. In addition, we found that the non-snoring group had a signi®cantly higher frequency of tonsillectomy during infancy and adolescence than the snorer group. We did not detect any signi®cant dierence in spirometric test values or in maximal respiratory pressure values between snorer group and non-snorer group. In conclusion, in the general population snoring is associated with nasal obstruction and abnormal pharynx exploration. Furthermore, snoring appears not to be associated with modi®cations in spirometric or in maximal respiratory pressure tests.
Chest, 1991
The purpose of this study was to examine whether a simple test, such as routine roentgenographic views of the upper airway, is useful in identifying anatomic narrowing of the airway in patients with sleep apnea. To accomplish this, we prospectively studied a group of 117 patients (95 male and 22 female subjects) referred for evaluation of heavy snoring and possible obstructive sleep apnea. All patients had full nocturnal polysomnography, including measurements of snoring. Lateral view of the airway obtained after swallowing contrast material was used to measure pharyngeal diameters at three sites along the airway. All measurements were performed with the patients standing and supine. We used three different definitions of sleep apnea (apneal hypopnea index of 10, 20, and 40), and compared airway diameters between the apneic and nonapneic snorers. Only when sleep apnea was defined as greater than 40 apneas plus hypopneas per hour of sleep was there a significant difference in airway diameter at the tip of the palate and 1 cm distal to it between apneic and nonapneic snorers. Both groups of patients demonstrated a significant reduction in the retropalatal distance on assumption of the supine posture. Stepwise, forward, multiple linear regression analysis showed that the retropalatal distance and airway diameter at the tip of the palate and 1 cm distal to it were significant predictors of snoring, but not apnea. We conelude that (1) airway diameters account for some of the variability in snoring, and (2) they
The influence of the lateral pharyngeal wall anatomy on snoring and sleep apnoea
JPMA. The Journal of the Pakistan Medical Association, 2015
To elucidate the variations of the lateral pharyngeal wall anatomy on physical examination and to assess the clinical importance of the examination of the lateral pharyngeal wall on the presence and severity of obstructive sleep apnoea syndrome. The cross-sectional study was conducted at Ege University Medical School, Izmir, Turkey, between May 2010 and April 2011. The patients were divided into four equal groups: Group 1--snoring without apnoea (age 20-40); Group 2--snoring without apnoea (age 40-60); Group 3--apnoea-hypopnoea index < 5/hr; Group 4: apnoea-hypopnoea index > 30/hr. Calibrated oropharynx pictures were taken. Distance between palatoglossal and palatopharyngeal arches, height of palatoglossal and palatopharyngeal arches, uvula width, uvula length and distance between tonsils were measured. SPSS 17 was used for statistical analysis. Of the 80 patients in the study, 44 (55%) were men. Mean distance between palatopharyngeal and palatoglossal arches were 1.55 ± 0.34 ...