Capabilities of Magnetic Resonance Imaging in the Evaluation of Soft Tissues Surrounding the Upper Airway in Patients With Obesity and Obstructive Sleep Apnea Syndrome

Background: Sleep MRI is a new emerging non invasive modality in the preoperative evaluation of patients with obstructive sleep apnoea. Rather than subjective, the aim of the study is to evaluate the competency of certain dynamic and static parameters (variables and diemensions), that can be used in day to day reporting. Incorporating such parameters, may prove to be helpful in guiding surgical decision making. Materials and Methods: A retrospective analytical study included 27 subjects with OSA aged between 18 and 70 years using 1.5 T MRI . We measured variables such as the cross-sectional area and diameter of the retropalatal and retroglossal airway during the asleep and awakened states.We also measured comprehensive airway dimensions such as antero-posterior diameter of the tongue, midline saggital diameter of tongue, intermandibular rami distance, mentum spine distance and relative size of the tongue using the spine as the posterior border of the bony confines. Results: 21 patients had significant retropalatal airway compromise, and was evidenced by statistically significant variables in awakened and asleep states. The mean minimum anterior–posterior diameter (mm) of retropalatal airway during respiratory cycle was statistically significant measuring 3.1±1.5 mm in awaken state and 1.1±1.5 mm during asleep state (p- value 0.01). The mean minimum cross sectional area during respiratory cycle was statistically significant measuring 98±11 mm2 in awaken state and 63 ±12 mm2 during asleep state (p- value 0.04). 6 patients had significant retroglossal airway compromise, and was evidenced by statistically significant. The thickness of the soft palate and the relative size of the tongue (0.5± 0.01mm) was statistically significant in these patients (p- value 0.01). Conclusion: Our study shows that retropalatal airway is a significant cause of obstruction in patients with OSA, compared with retroglossal airway. We suggest that, when the compromise of the retroplatine aiway is to be evaluated, variables such as cross sectional area and antero-posterior diameter of the retropalatal airway during the respiratory phase in asleep and awakened states proves valuable and dimensions such as soft palate thickness as tool for objective measurement of OSA. When the compromise of the retroglossal aiway is to be evaluated, the relative size of the tongue , proves offers more advantage than the variables of airway compromise such as area and antero-posterior diameter.To further evaluate if some of our parameters correlate with the outcomes of the surgeries of OSA, a multivariate analysis would have been required.

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Usefulness of Various Dynamic and Static Parameters in Sleep Mri Studies -Do Their Incorporation in Routine Reporting in Patients With Obstructive Sleepapnea Prove Valuable ?

Chellathurai

Vadivel

Jayabalan

et al. 2020

IJAR

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Erectile Dysfunction and Obesity in Patients With Obstructive Sleep Apnea and Arterial Hypertension

Alekseeva,

Gamidov,

Elfimova

et al. 2018

Evrazijskij kardiologičeskij žurnal

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Objective: to study the relationship between erectile dysfunction and obesity parameters and the severity of obstructive sleep apnea in patients with arterial hypertension.Material and methods: 71 patients with different severity of erectile dysfunction, overweight and obesity of grade 1, mild and severe obstructive sleep apnea and arterial hypertension were included in the study. The data of cardiorespiratory monitoring, anthropometric parameters of obesity were analyzed and the severity of erectile dysfunction was assessed by intracavernous pharmacodopplerography, the results were compared with the subjective opinion of patients on the degree of severity of erectile dysfunction according to the IIEF-5 questionnaire. All patients underwent psychosomatic status analysis according to the questionnaire scales: assessment of daytime drowsiness on the Epworth scale, severity of personal and situational anxiety on the Spielberger scale and depression level on the Beck scale.Results: comparative analysis revealed statistically significant links between anthropometric data of obesity with OSA parameters (apnea/hypopnea index, desaturation index) (p<0.05), as well as the severity of erectile dysfunction (in terms of erection and dopplerography with evaluation of the of penile blood flow) (p<0.05). A statistically significant negative relationship between the quality of penile blood flow and the degree of arterial hypertension was revealed too (p=0.02). In a comparative analysis of the subjective state of erectile function and objective examination, no statistically significant association was revealed (p=0.07). As a result of the multifactorial linear regression, we have shown that with an increase of the waist circumference to the hip circumference ratio and a higher apnea/hypopnea index, the condition of penile arterial blood flow worsens, namely, a decrease in the peak systolic blood flow velocity (β=-0.39, p=0.05; β=-0.44, p=0.03, respectively). When assessing the psychosomatic state of patients, a significant correlation has been found between the severity of depression in the Beck scale and the level of personal and situational anxiety according to the Spielberger scale (p<0.05). The relationship between depression level on the Beck scale and the degree of situational anxiety with the severity of erectile dysfunction on the Juname scale has been also shown (p<0.05). Conclusion: the combination of overweight or obesity with obstructive sleep apnea and arterial hypertension gives ground to suspect the presence of different severity of erectile dysfunction. The severity of ED is directly proportional to the level of anxiety and depression according to the questionnaire scales.

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Capabilities of Magnetic Resonance Imaging in the Evaluation of Soft Tissues Surrounding the Upper Airway in Patients With Obesity and Obstructive Sleep Apnea Syndrome

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Usefulness of Various Dynamic and Static Parameters in Sleep Mri Studies -Do Their Incorporation in Routine Reporting in Patients With Obstructive Sleepapnea Prove Valuable ?

Usefulness of Various Dynamic and Static Parameters in Sleep Mri Studies -Do Their Incorporation in Routine Reporting in Patients With Obstructive Sleepapnea Prove Valuable ?

Erectile Dysfunction and Obesity in Patients With Obstructive Sleep Apnea and Arterial Hypertension

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