Fractal quantitative endoscopic evaluation of the upper airway in patients with obstructive sleep apnea syndrome

Delides, Alexander; Viskos, Alexandros

doi:10.1016/j.otohns.2010.03.022

Cited by 6 publications

(4 citation statements)

References 12 publications

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“…Ivanov et al [38,39] used fractal analysis of the human heartbeat to show that a higher Hurst Exponent ( H ), indicative of greater regularity, was associated with disease, while normal heartbeat exhibited more chaotic behavior and lower H value. Such concepts have been extended to study Parkinson's disease [40] , sleep apnea [41] , and sudden cardiac death [42] . In our own studies, healthy individuals responding to malnutrition induced by a diet deficient in essential amino acid had increased H in wavelet-transformed plasma metabolomic data [43] , indicating decreased metabolic flexibility ( Fig.…”

Section: Decreased Genome Adaptability With Differentiation and Exposmentioning

confidence: 99%

Redox theory of aging

2015

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Metazoan genomes encode exposure memory systems to enhance survival and reproductive potential by providing mechanisms for an individual to adjust during lifespan to environmental resources and challenges. These systems are inherently redox networks, arising during evolution of complex systems with O2 as a major determinant of bioenergetics, metabolic and structural organization, defense, and reproduction. The network structure decreases flexibility from conception onward due to differentiation and cumulative responses to environment (exposome). The redox theory of aging is that aging is a decline in plasticity of genome–exposome interaction that occurs as a consequence of execution of differentiation and exposure memory systems. This includes compromised mitochondrial and bioenergetic flexibility, impaired food utilization and metabolic homeostasis, decreased barrier and defense capabilities and loss of reproductive fidelity and fecundity. This theory accounts for hallmarks of aging, including failure to maintain oxidative or xenobiotic defenses, mitochondrial integrity, proteostasis, barrier structures, DNA repair, telomeres, immune function, metabolic regulation and regenerative capacity.

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Section: Decreased Genome Adaptability With Differentiation and Exposmentioning

confidence: 99%

Redox theory of aging

2015

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“…Yao et al [37] found that the airway parameters in Muller's maneuver was highly correlated with the severity of sleep apnea as reflected by respiratory disturbance index (RDI). In other studies, during Muller's maneuver, airway collapsibility was also shown to be significantly correlated with AHI [38] , especially in the retropalatal area [39] . However, Woodson et al showed that the collapse in Muller's maneuver was not associated with the severity of OSAHS [40] .…”

Section: Discussionmentioning

confidence: 68%

Evaluation of airway obstruction at soft palate level in male patients with obstructive sleep apnea/hypopnea syndrome: Dynamic 3-dimensional CT imaging of upper airway

Xiao

Xiong

Shi

et al. 2011

J. Huazhong Univ. Sci. Technol. [Med. Sci.]

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This study examined the dynamic characteristics of upper airway collapse at soft palate level in patients with obstructive sleep apnea/hypopnea syndrome (OSAHS) by using dynamic 3-Dimensional (3-D) CT imaging. A total of 41 male patients who presented with 2 of the following symptoms, i.e., daytime sleepiness and fatigue, frequent snoring, and apnea with witness, were diagnosed as having OSAHS. They underwent full-night polysomnography and then dynamic 3-D CT imaging of the upper airway during quiet breathing and in Muller's maneuver. The soft palate length (SPL), the minimal cross-sectional area of the retropalatal region (mXSA-RP), and the vertical distance from the hard palate to the upper posterior part of the hyoid (hhL) were compared between the two breathing states. These parameters, together with hard palate length (HPL), were also compared between mild/moderate and severe OSAHS groups. Association of these parameters with the severity of OSAHS [as reflected by apnea hypopnea index (AHI) and the lowest saturation of blood oxygen (LSaO(2))] was examined. The results showed that 31 patients had severe OSAHS, and 10 mild/moderate OSAHS. All the patients had airway obstruction at soft palate level. mXSA-RP was significantly decreased and SPL remarkably increased during Muller's maneuver as compared with the quiet breathing state. There were no significant differences in these airway parameters (except the position of the hyoid bone) between severe and mild/moderate OSAHS groups. And no significant correlation between these airway parameters and the severity of OSAHS was found. The position of hyoid was lower in the severe OSAHS group than in the mild/moderate OSAHS group. The patients in group with body mass index (BMI)≥26 had higher collapse ratio of mXSA-RP, greater neck circumference and smaller mXSA-RP in the Muller's maneuver than those in group with BMI<26 (P<0.05 for all). It was concluded that dynamic 3-D CT imaging could dynamically show the upper airway changes at soft palate level in OSAHS patients. All the OSAHS patients had airway obstruction of various degrees at soft palate level. But no correlation was observed between the airway change at soft palate level and the severity of OSAHS. The patients in group with BMI≥26 were more likely to develop airway obstruction at soft palate level than those with BMI<26.

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“…Üst solunum yolları kaynaklı uyku apneli olgularda faringeal duvar genişliğinde artış olması hava yolunda daralmaya yani orofarinks hava yolu alanında azalmaya neden olur (9,10) . Orofarinks hava yolundaki ödem ve inflamasyonunda bu alanı azaltabileceği unutulmamalıdır (11,12) .…”

Section: Discussionunclassified

MRI Evaluation of the Oropharyngeal Region in Patients with Obstructive Sleep Apnea Syndrome

Çetinkaya¹,

Koç²,

Kiraz³

et al. 2016

Terh

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ÖZAmaç: Obstrüktif uyku apnesi (OUA) ve horlama tedavisinin temeli, üst solunum yollarında obstrüksiyonun olduğu yerin belirlenmesidir. Bu çalışmada amacımız, MRG ile üst hava yollarında daralmaya neden olabilecek hava yolunu çevreleyen yumuşak doku kompartmanlarını araştırmak ve sağlıklı kişilerin bulguları ile karşı-laştırmaktır. Yöntem: Ekim 2014-Kasım 2015 tarihleri arasında hastanemiz radyoloji bölümünde servikal manyetik rezonans görüntüleme (MRG) çekilmiş 18 uyku apneli ve 17 apne negatif olgunun MRG kesitleri incelenmiş orofarinks hava yolu alanı, parafaringeal yağ doku genişliği, pterygoid adele, parafaringeal duvar kalınlığını ölçümleri yapılmıştır. Bulgular: MRG aksiyal kesit ölçümlerine göre; OUA pozitif olan olgular ile negatif olan olguların bilateral pterygoid kas genişliği ortalamaları ve faringeal yağ dokusu kalınlığı ortalamaları arasında anlamlı bir farklılık bulunmazken, bu iki grubun parafaringeal duvar kalınlığı ortalaması ve orofarinks hava sütunu alanı ölçümleri ortalamalarında istatistiksel olarak anlamlı düzeyde fark saptanmıştır. Sonuç: MRG, yumuşak doku ve hava yolu rezolüsyonu ile, hava yolunun, yumuşak dokuların ve kemik yapıların üç boyutlu alanının hesaplanmasına olanak sağladığı için OSAS'lı hastaların değerlendirilmesinde kullanılan yararlı bir yöntemdir. Anahtar kelimeler: MRG, uyku apnesi, orofarenks ABSTRACTObjective: The essence of treatment of obstructive sleep apnea (OSA) and snoring is to identify the location of the obstruction in the upper respiratory system. In this study, our aim is to investigate the surrounding soft tissue compartments that might cause the narrowing of the upper airway using MRI and compare the results with those of the healthy people. Method: MRI scans of 18 sleep apnea and 17 apnea negative patients who underwent cervical MRI scanning in the radiology department of our hospital, between October 2014 and November 2015.were examined, and oropharyngeal airway space, pharyngeal fat tissue thickness, pterygoid muscle, and parapharyngeal wall thickness measurements were made. Results: While no significant difference was found between bilateral pterygoid muscle width and pharyngeal fat thickness of the apnea negative and positive patients, mean parapharyngeal wall thickness and oropharynx air column area measurements were found to be statistically significantly different between these two groups of patients. Conclusion: MRI, with resolution of the soft tissues and airways, is a useful method to evaluate patients with OSAS because it allows three-dimensional space calculation of airways, soft tissues, and bone structures required.

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Fractal quantitative endoscopic evaluation of the upper airway in patients with obstructive sleep apnea syndrome

Cited by 6 publications

References 12 publications

Redox theory of aging

Redox theory of aging

Evaluation of airway obstruction at soft palate level in male patients with obstructive sleep apnea/hypopnea syndrome: Dynamic 3-dimensional CT imaging of upper airway

MRI Evaluation of the Oropharyngeal Region in Patients with Obstructive Sleep Apnea Syndrome

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