Laryngeal and velopharyngeal sensory impairment in obstructive sleep apnea.
OBJECTIVE
To determine whether mucosal sensory dysfunction is present at multiple upper-airway sites in patients with obstructive sleep apnea (OSA).


METHODS
Physiologic testing of consecutive patients with OSA and nonsnoring controls.


METHODS
University hospital sleep center.


METHODS
Thirty-nine subjects with OSA and 17 controls.


METHODS
Endoscopic testing was used to determine sensory detection thresholds for air-pressure pulses delivered to the oropharynx, velopharynx, hypopharynx, and larynx (aryepiglottic eminence). The air-pulse stimulus intensity required to elicit the protective laryngeal adductor reflex was also determined.


RESULTS
There was a significant impairment in sensory detection threshold for OSA versus control subjects in the oropharynx, as previously described by ourselves using other techniques, as well as at the velopharynx (median 11 mm Hg [confidence interval 9-11] for subjects with OSA vs 8 mm Hg [confidence interval 4-11] for controls, P = .03) and, at the larynx, 4 mm Hg [confidence interval 2-9] for subjects with OSA vs 2 mm Hg [confidence interval 2-3] for controls, P < .001). The threshold stimulus intensity for the laryngeal adductor reflex was also significantly higher for OSA subjects. For OSA patients with abnormal laryngeal sensation (61% of OSA subjects), there were significant correlations between laryngeal sensory values and measures of apnea severity, including apnea-hypopnea index (r = 0.82, P < .001) and nadir SaO2 (r = -0.48, P < .05).


CONCLUSIONS
Mucosal sensory function is impaired at multiple upper-airway sites in OSA.
Nguyen
Anh Tu Duy
AT
Respiratory Division and Sleep Laboratory, McGill University Health Centre, and Meakins-Christie Laboratories, McGill University, Montreal, Quebec, Canada.
Jobin
Vincent
V
Payne
Richard
R
Beauregard
Josée
J
Naor
Naftaly
N
Kimoff
R John
RJ
D000328:Adult; D000368:Aged; D000388:Air; D015992:Body Mass Index; D006801:Humans; D007013:Hypopharynx / Q000503:physiopathology; D007828:Laryngoscopy; D007830:Larynx / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D009092:Mucous Membrane / Q000502:physiology; D009960:Oropharynx / Q000503:physiopathology; D010160:Palate, Soft / Q000503:physiopathology*; D010614:Pharynx / Q000503:physiopathology*; D017286:Polysomnography; D011312:Pressure; D012018:Reflex / Q000502:physiology; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000503:physiopathology*