The influential factors on the morphological changes of upper airway associated with mouth opening

Hu, Bin; Ye, Jingying; Yin, Guisheng; Zhang, Yuhuan

doi:10.1002/lary.27212

Cited by 14 publications

(22 citation statements)

References 20 publications

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“…Lee et al have shown that the upper airway space was reduced with mouth breathing on lateral cephalometry and fiberoptic nasopharyngoscopy 24 . Hu et al demonstrated that the cross‐sectional area of the upper airway, especially the anterior–posterior diameter of the retroglossal space, was significantly decreased with mouth breathing on computed tomography scans, 25 which is in agreement with our study.…”

Section: Discussionsupporting

confidence: 92%

Association Between Breathing Route, Oxygen Desaturation, and Upper Airway Morphology

et al. 2020

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Objectives/Hypothesis This study aimed to assess the role of capnography in objectively evaluating breathing routes during drug‐induced sleep endoscopy (DISE) and further elucidate the relationship between breathing route, obstructive sleep apnea (OSA) severity, and DISE findings. Study Design Prospective observational study. Methods Nighty‐five patients with established OSA were recruited for this study from May 2017 to May 2019. DISE was performed in the operating room. Sedation was maintained with propofol using a target‐controlled infusion system and the depth of sedation was monitored based on the bispectral index. The breathing routes, which included oral breathing, oronasal breathing, and nasal breathing, were detected using capnography. DISE findings were recorded using the VOTE (velum, oropharynx, base of tongue, and epiglottis) classification. Results Patients with mouth breathing were associated with increased OSA severity, worse oximetric variables, and higher body mass index in comparison with those with other breathing routes. Mouth breathing was associated with a higher degree and higher prevalence of lateral pharyngeal wall collapse and tongue base collapse during DISE. Conclusions Mouth breathing was significantly associated with worse oxygen desaturation and increased degree of upper airway collapse. Therefore, patients with mouth breathing during propofol‐based intravenous anesthesia should be carefully monitored. Level of Evidence 4 Laryngoscope, 131:E659–E664, 2021

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Section: Discussionsupporting

confidence: 92%

Association Between Breathing Route, Oxygen Desaturation, and Upper Airway Morphology

et al. 2020

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“…These dramatic differences between the normal and pathological values of the three parameters confirmed the differential-diagnostic role of the acoustic pharyngometry concerning the extent of the pharyngeal dysfunction that underlay the sleep-disordered breathing. The mean cross-sectional areas and airway volumes in any segments assessed by acoustic pharyngometry in 15 OSA patients are statistically significantly smaller in OSA patients than in 15 healthy controls (p<0.05) (7). The minimal cross-sectional area of the upper airway at end-exhalation is measured in upright position and breathing through the mouth in 60 subjects, 35 males and 25 females at a mean age of 42 years (range, 21-81 years) (2).…”

Section: Resultsmentioning

confidence: 83%

Applications of acoustic pharyngometry in screening of the sleep-disordered breathing

Shivarov

2020

International Bulletin of Otorhinolaryngology

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INTRODUCTION:Acoustic pharyngometry is an inexpensive, quick, non-invasive, and easily repeatable method for localizing the upper airway obstruction in sleep-related breathing disorders. АIМ: The purpose of this study was to describe the general characteristics of the method of acoustic pharyngometry and to illustrate its differential-diagnostic role concerning the extent of the pharyngeal dysfunction for the first time in Bulgaria. MATERIALS AND METHODS:Between April 1, 2019 and December 31, 2019, a total of 400 adult subjects, 272 males and 128 females, at a mean age of 50.8±14.1 years from the city of Varna underwent screening examinations for OSA and snoring by using acoustic pharyngometry with Eccovision® acoustic pharyngometer. The acoustic pharyngometric findings of healthy subjects and patients with pharyngeal dysfunction were illustrated and discussed. RESULTS: There were considerable differences between the values of the pharyngeal volume, mean and minimal cross-sectional areas and minimal distance in healthy subjects and patients with slightly expressed and severe pharyngeal dysfunction causing sleep-related breathing disorders. CONCLUSION: The detection of these differences in terms of the main acoustic pharyngometric parameters between normal subjects and patients with pharyngeal dysfunction proves that a much broader acoustic pharyngometry application for the screening and early diagnosis of these socially significant disturbances in Bulgaria is undoubtedly beneficial.

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“…Ayuse et al [22] reported that mouth breathing increased upper airway collapsibility during midazolam sedation. A study which enrolled 138 OSAS patients proved that mouth breathing resulted in reduction of oropharyngeal lumen by computed tomography scans [23]. It had been reported that oral patches for prevention open mouth breathing are useful to treat mild OSAS [24].…”

Section: Discussionmentioning

confidence: 99%

The Influence of Functional Endoscopic Sinus Surgery on Sleep Related Outcomes in Patients with Chronic Rhinosinusitis

Jiang

Liang

2019

International Journal of Otolaryngology

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Purpose. Chronic rhinosinusitis (CRS) patients often complain of nasal obstruction, which may cause sleep impairment for them. The goal of this study was to investigate the influence of functional endoscopic sinus surgery (FESS) on sleep related outcomes in CRS patients. Materials and Methods. CRS patients who received FESS were included in this study. Prior to FESS and 3 months after surgery the patients were asked about the severity of nasal obstruction and completed the 20-item Sinonasal Outcome Test (SNOT-20), along with the Epworth Sleepiness Scale (ESS) questionnaire. Endoscopic examination, acoustic rhinometry, and polysomnography were performed in all patients. They were divided into four groups according to their preoperative apnea hypopnea index (AHI) scores: nonobstructive sleep apnea syndrome (non-OSAS), mild OSAS, moderate OSAS, and severe OSAS. Results. A total of 96 subjects completed the study. The scores of the sleep domain of the SNOT-20 and ESS decreased in all of the AHI groups, with the exception of the severe OSAS group, after FESS. A reduction in the AHI of less than 5 was achieved in 9 patients (13.2%) after FESS. Conclusions. Our results showed that FESS improved sleep quality in CRS patients, except those with severe OSAS, and a preoperative lower AHI was the only significant predictor of post-FESS OSAS outcome.

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The influential factors on the morphological changes of upper airway associated with mouth opening

Abstract: IV. Laryngoscope, 2018.

Cited by 14 publications

References 20 publications

Association Between Breathing Route, Oxygen Desaturation, and Upper Airway Morphology

Association Between Breathing Route, Oxygen Desaturation, and Upper Airway Morphology

Applications of acoustic pharyngometry in screening of the sleep-disordered breathing

The Influence of Functional Endoscopic Sinus Surgery on Sleep Related Outcomes in Patients with Chronic Rhinosinusitis

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