title: Morphometric endoscopic study of the pharynx in patients with sleep apnea.
abstract: OBJECTIVE
  The aims of the study were to measure endoscopically the retrolingual pharynx during wakefulness and sleep before and after maxillomandibular advancement surgery and to quantify the changes observed.
  
  
  METHODS
  Eighteen patients with mild to severe grade obstructive sleep apnea hypopnea were evaluated during wakefulness while sitting and lying down and during induced sleep in dorsal decubitus while breathing naturally. Images of the retrolingual region of the pharynx were captured with a nasofibroscope and recorded on a DVD using the Sony Vegas 8.0 software (Sony Creative Software, Madison, WI). The images captured in greater and smaller aperture were measured with the Image J software (produced by Wayne Rasband, United States National Institutes of Health, Bethesda, MD) in linear anteroposterior and linear laterolateral areas. A correction factor was then applied to equalize the size of the images and thus compare them to one another.
  
  
  RESULTS
  The postoperative dimensions of the pharynx always increased significantly in all measurements compared with the preoperative ones. During induced sleep in dorsal decubitus, there was a greater gain in the area of smaller aperture (201.33%).
  
  
  CONCLUSIONS
  The proposed method showed that the dimensions of the pharynx always increased significantly after surgery for maxillomandibular advancement, although the gain was not homogeneous in all dimensions and also varied according to state of consciousness. The greatest gain was observed in the area of smaller aperture with the patient in induced sleep, thus reducing the collapse of the pharynx.
authors: Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
authors: Sávio Nogueira
authors: SN
authors: da Silva Junior
authors: Ana Célia
authors: AC
authors: Faria
authors: Luis Vicente
authors: LV
authors: Garcia
authors: Francisco Veríssimo
authors: FV
authors: de Mello-Filho
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007828:Laryngoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010614:Pharynx / Q000473:pathology*; D017286:Polysomnography; D012891:Sleep Apnea Syndromes / Q000175:diagnosis* / Q000503:physiopathology; D014851:Wakefulness