Influence of Lingual Tonsillar Volume in Patients with Obstructive Sleep Apnea

Abstract

This study aimed to evaluate the influence of lingual tonsil (LT) volume measured using a three-dimensional (3D) reconstruction volume rendering program on clinical parameters and polysomnography (PSG) results. A total of 100 patients who underwent PSG, computed tomography (CT), and allergy test from April 2016 to April 2020 were randomly selected. LT volume was measured using an imaging software program that enables 3D reconstruction of CT images. PSG parameters were analyzed by dividing the subjects into two groups according to LT volume (each 50 people). Based on the medial volume of 0.863 cm3, the upper half LT volume group and the lower half LT volume group were analyzed. Clinical factors such as body weight, neck circumference, body mass index (BMI), and age showed no difference between the two groups. Among PSG parameters, supine arousal index and non-rapid eye movement (NREM) arousal index were significantly higher in the upper half LT volume group (p = 0.012, 0.037). However, there was no significant difference in apnea-hypopnea index (AHI) between the upper and lower half LT volume groups (p = 0.749). Arousal snoring index and REM arousal index also showed no difference between the two groups. The prevalence of allergic rhinitis was not different in the two groups. High LT volume is associated with NREM arousal and arousal in the supine position, but it is not related to AHI.

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“…Besides, we found the NREM‐arousal index and the TST‐arousal index were higher in the POD group, and were the risk factors for POD. Similar to Kang's (Kang et al, 2022) research, they found that patients with a greater volume of lingual tonsil had a significantly higher NREM‐arousal index. Despite the controversial relationship between OSA and the volume of lingual tonsil, our research hints at a close association between OSA and POD through the predictive value of N1 sleep and micro‐arousal indexes.…”

“…Besides, we found the NREM-arousal index and the TST-arousal index were higher in the POD group, and were the risk factors for POD. Similar to Kang's (Kang et al, 2022)…”