The Evaluation Of Severity And Treatment For Obstructive Sleep Apnea Hypopnea Syndrome By Acoustic Pharyngometry

Objectives: This study is designs to investigate the optimal position in application of acoustic pharyngometry to detect the pharyngeal condition and to assess its therapeutic effect on obstructive sleep apnea syndrome(OSAHS).Methods: Eight adult males were assigned to the normal group,and 57 patients were assigned to the snoring group who were diagnosed with OSAHA by polysomnograhy(PSG).Specifically,patients in the snoring group were further categorized into three subgroups : mild(N = 8),moderate(N = 9)and severe(N = 40)according to apnea-hypopnea index(AHI).Of the severe OSAHS subgroup,11 patients underwent low-temperature plasma uvulopaltopharyngoplasty(UPPP)+ coblation-channeling of the tongue(CCT),who were assigned to the operation subgroup;eight patients underwent continuous positive airway pressure(CPAP),which was assugned to the CPAP subgroup.And remainders underwent conservative treatment,including weight loss and position change.Acoustic pharyngometry(three positions including sitting position,supine position and lateral position)and PSG exam were performed in all participants.Additionally,acoustic pharyngometry under three positions was conducted again in patients in the operation and CPAP subgroups three months after treatment.Results: 1.The minimum cross-sectional area was negatively associated with both AHI and the percentage of time with oxygen saturation below 90%(SIT90)(P< 0.01).The correlation coefficient of the minimum cross-sectional area in supine position with AHI and SIT90 were r=-0.569,r=-0.478,respectively.2.Under supine position,the minimum cross-sectional area was statistically different from that in the mild,moderate and severe OSAHS subgroups(P< 0.01).3.Under supine position,the minimum cross-sectional area was negatively correlated with body mass index(BMI)(r=-0.265,P=0.033),and the minimum cross-sectional area was negatively associated with neck circumference(r=-0.309,P=0.012).4.The minimum cross-sectional area was significantly increased after treatment of OSAHS(both operation and CPAP),which was statistically different before and after treatment compared to the control group(P < 0.01).Conclusions: 1.Acoustic pharyngometry could reflect the severity of OSAHS.The minimum cross-sectional area which significantly correlated with AHI and SIT90,as best characterizing the severity of OSAHS.2.Among the positions,the minimum cross-sectional area under supine position was significantly smaller than that under sitting position.In addition,the minimum cross-sectional area under supine position harbored a better correlation with AHI and SIT90,which could better reflect the narrowness of pharyngeal cavity during sleep.3.Acoustic pharyngometry could be a simple,rapid and non-invasive technique that can objectively evaluate the efficacy of surgical and CPAP methods and provided a more favorable basis for future clinical work.