Upper Airway Imaging in Relation to Obstructive Sleep Apnea

Ja, Fleetham

doi:10.1016/s0272-5231(21)00870-4

Cited by 58 publications

(5 citation statements)

References 69 publications

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“…This will cause a trace fall at a point that marks the oropharyngeal junction (back of the oral cavity). Differences in the pharyngeal cross-sectional area between males and females were documented in previous studies, 1,3,12,14,16,26,34 this finding has been validated in this study by the repeatability of the acoustic reflection measurements in both genders. The fact that females have a smaller pharyngeal cross-sectional area did not affect the geometric configuration of the curve.…”

Section: Discussionsupporting

confidence: 86%

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Normal Standard Curve for Acoustic Pharyngometry

Ibrahim¹

2001

Otolaryngol.--head neck surg.

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Pharyngeal size, compliance, and the dynamic behavior of the upper airway are important factors in the production of obstructive sleep apnea. Assessment of the upper airway for possible site(s) of obstruction is one of the keys to a successful management of the condition. Acoustic pharyngometry has the potential for localizing such sites, however, standardizing the operating technique and producing a standard normal curve is a prerequisite before exploring the potential of this equipment. A total number of 350 normal volunteers (271 males and 79 females) were examined by acoustic pharyngometry and a coefficient of variance of 5% to 7% was obtained from each of them. Mean and standard deviation of pharyngeal area at each point of X-axis (distance) was obtained and analyzed statistically to produce a general standard curve. Using special techniques during examination, the oropharyngeal junction and glottis were located, and thus a mapped acoustic pharyngogram was produced. Mean pharyngeal area was 3.194 cm(2) in males (SD 0.311) and 2.814 cm(2) in females (SD 0.331). Mean glottic area was 1.06 cm(2) in males (SD 0.119) and 0.936 cm(2) in females (SD 0.108). A minimal pharyngeal area is probably needed as a "golden standard" to evaluate patients with obstructive sleep apnea.

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Section: Discussionsupporting

confidence: 86%

“…In patients with sleep apnea, studies involving acoustic reflection have demonstrated reductions in upper airway area compared with normal controls, 34 , 35 yet perhaps a minimal pharyngeal cross‐sectional area is rather needed as a “gold standard” to refer to in managing OSA patients.…”

Section: Discussionmentioning

confidence: 99%

Normal Standard Curve for Acoustic Pharyngometry

Ibrahim¹

2001

Otolaryngol.--head neck surg.

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“…The hypotonic pharynx of OSA patients collapses at multiple sites—oropharynx, retrolingual, or hypopharynx (Fig 5A). Alternatively, upper airway occlusion during sleep may start at the velopharynx and extend caudally 31,32 (Fig 5B) as apnea persists with pharyngeal muscle contractions and high transpharyngeal pressures modify the shape of the airway caudal to the main site of occlusion 14 …”

Section: Discussionmentioning

confidence: 99%

Acoustic Pharyngometry Patterns of Snoring and Obstructive Sleep Apnea Patients

Ibrahim¹

2004

Otolaryngol.--head neck surg.

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“…While we cannot implement a voluntary deep breathing scenario for rodent studies similar to clinical experiments (22,25,26), we instead investigated the effect of augmenting lung function via continuous positive airway pressure (CPAP) on glymphatic-lymphatic function in anesthetized, spontaneously breathing rats. In the clinical arena, CPAP works by delivering a continuous pressure during inspiration as well as expiration, which increases the upper airway volume and the functional residual capacity (FRC), thereby opening collapsed alveoli, decreasing pulmonary shunt, and improving oxygenation (27)(28)(29). CPAP is effective in treating obstructive sleep apnea (OSA) (30) and maintaining airway patency in anesthetized/sedated spontaneously breathing individuals (31).…”

Section: Introductionmentioning

confidence: 99%

Continuous positive airway pressure increases CSF flow and glymphatic transport

Ozturk¹,

Koundal²,

Bizri³

et al. 2023

JCI Insight

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Respiration can positively influence cerebrospinal fluid (CSF) flow in the brain, yet its effects on central nervous system (CNS) fluid homeostasis, including waste clearance function via glymphatic and meningeal lymphatic systems, remain unclear. Here, we investigated the effect of supporting respiratory function via continuous positive airway pressure (CPAP) on glymphatic-lymphatic function in spontaneously breathing anesthetized rodents. To do this, we used a systems approach combining engineering, MRI, computational fluid dynamics analysis, and physiological testing. We first designed a nasal CPAP device for use in the rat and demonstrated that it functioned similarly to clinical devices, as evidenced by its ability to open the upper airway, augment end-expiratory lung volume, and improve arterial oxygenation. We further showed that CPAP increased CSF flow speed at the skull base and augmented glymphatic transport regionally. The CPAP-induced augmented CSF flow speed was associated with an increase in intracranial pressure (ICP), including the ICP waveform pulse amplitude. We suggest that the augmented pulse amplitude with CPAP underlies the increase in CSF bulk flow and glymphatic transport. Our results provide insights into the functional crosstalk at the pulmonary-CSF interface and suggest that CPAP might have therapeutic benefit for sustaining glymphatic-lymphatic function.

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Upper Airway Imaging in Relation to Obstructive Sleep Apnea

Cited by 58 publications

References 69 publications

Normal Standard Curve for Acoustic Pharyngometry

Normal Standard Curve for Acoustic Pharyngometry

Acoustic Pharyngometry Patterns of Snoring and Obstructive Sleep Apnea Patients

Continuous positive airway pressure increases CSF flow and glymphatic transport

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