title: The use of sub-mental ultrasonography for identifying patients with severe obstructive sleep apnea.
abstract: OBJECTIVE
  This study aimed to explore the association between obstructive sleep apnea (OSA) severity and pharyngeal parameters using sub-mental ultrasonography (US), and investigate the accuracy of US for identifying severe OSA patients.
  
  
  METHODS
  One hundred and five consecutive referrals for suspected OSA were enrolled. The diameters of the retro-glossal (RG) and retro-palatal (RP) regions were measured via sub-mental US upon expiration during tidal breathing, forced inspiration, and Müller maneuver (MM). Independent factors associated with severe OSA identified from two-thirds of randomly-selected patients (model-development group) were used to construct a model for predicting severe OSA. The accuracy of the model was validated in the remaining one-third of patients (validation group).
  
  
  RESULTS
  Fifty severe OSA patients, 30 with mild-moderate OSA, and 25 without OSA were enrolled. Compared to non-OSA and mild-moderate OSA patients, those with severe OSA had narrower RP diameter in all three maneuvers. Using the prediction model constructed with changes of RP diameters at MM and neck circumference, the independent predictors of severe OSA in the model-development group had 100% sensitivity and 65% specificity.
  
  
  CONCLUSIONS
  Sub-mental US can accurately discriminate the severity of OSA and be used to identify patients with severe OSA.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT00674076.
authors.affiliation: Department of Traumatology, National Taiwan University Hospital, Taipei City, Taiwan.
authors.forename: Chin-Chung
authors.initials: CC
authors.lastname: Shu
authors.forename: Peilin
authors.initials: P
authors.lastname: Lee
authors.forename: Jou-Wei
authors.initials: JW
authors.lastname: Lin
authors.forename: Chun-Ta
authors.initials: CT
authors.lastname: Huang
authors.forename: Yeun-Chung
authors.initials: YC
authors.lastname: Chang
authors.forename: Chong-Jen
authors.initials: CJ
authors.lastname: Yu
authors.forename: Hao-Chien
authors.initials: HC
authors.lastname: Wang
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D010614:Pharynx / Q000033:anatomy & histology / Q000000981:diagnostic imaging; D017286:Polysomnography; D012372:ROC Curve; D015203:Reproducibility of Results; D012307:Risk Factors; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000000981:diagnostic imaging*; D014463:Ultrasonography