title: Characterization of upper airway obstruction by fiber-optic nasolaryngoscopy and MRI in preoperative OSAHS patients.
abstract: OBJECTIVE
  To investigate changes in the upper airway and its surrounding soft tissue and to characterize the extent and severity of upper airway obstruction in 136 obstructive sleep apnea/hypopnea syndrome (OSAHS) patients who were awake.
  
  
  METHODS
  OSAHS patients and healthy controls were evaluated by fiber-optic nasolaryngoscopy and MRI. The cross-sectional area and pharyngeal wall thickness of the retropalatal, retroglossal and epiglottic region were determined.
  
  
  RESULTS
  Ninety-five percent of the mild OSAHS subjects had single-plane obstruction (vs. severe OSAHS, p < 0.05), 5.0% of the mild OSAHS subjects had two-plane obstruction (p < 0.05) and none of them had three-plane obstruction (p < 0.05). The cross-sectional area of the retropalatal, retroglossal and epiglottic region progressively declined as the severity of OSAHS increased (severe OSAHS vs. controls, p < 0.05). The lateral pharyngeal wall was significantly thicker in OSAHS subjects than in healthy controls (p < 0.05). The cross-sectional area of the soft palate in moderate and severe OSAHS subjects was markedly larger than that of the healthy controls (p < 0.05) and positively correlated with the apnea/hypopnea index (p < 0.05).
  
  
  CONCLUSIONS
  Moderate and severe OSAHS patients exhibit multi-plane obstruction of the upper airway, particularly in the retropalatal and retroglossal region. The severity of OSAHS negatively correlates with the thickness, length and cross-sectional area size of the soft palate.
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Changhai Hospital, The Second Military Medical University, Shanghai, China.
authors.forename: Song
authors.initials: S
authors.lastname: Shi
authors.forename: Yanghui
authors.initials: Y
authors.lastname: Xia
authors.forename: Minhui
authors.initials: M
authors.lastname: Zhu
authors.forename: Kaixuan
authors.initials: K
authors.lastname: Wei
authors.forename: Fei
authors.initials: F
authors.lastname: Liu
authors.forename: Donghui
authors.initials: D
authors.lastname: Chen
authors.forename: Shicai
authors.initials: S
authors.lastname: Chen
authors.forename: Hongliang
authors.initials: H
authors.lastname: Zheng
mesh_terms: D000328:Adult; D000402:Airway Obstruction / Q000175:diagnosis* / Q000209:etiology*; D016022:Case-Control Studies; D005260:Female; D005336:Fiber Optic Technology; D006801:Humans; D007828:Laryngoscopy / Q000295:instrumentation*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D017286:Polysomnography; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications*