Evaluation of the upper airway in obstructive sleep apnoea

Evaluation of the upper airway in obstructive sleep apnoea

Author Togeiro, Sonia Maria G. P. Autor UNIFESP Google Scholar
Chaves, Cauby M. Google Scholar
Palombini, Luciana Autor UNIFESP Google Scholar
Tufik, Sergio Autor UNIFESP Google Scholar
Hora, Francisco Autor UNIFESP Google Scholar
Nery, Luiz Eduardo Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Univ Fed Ceara
Universidade Federal da Bahia (UFBA)
Abstract The evaluation of the upper airway (UA) includes the physical examination of pharyngeal structures and a number of imaging techniques that vary from the mostly used lateral cephalometry and computed tomography to more sophisticated methods such as tri-dimensional magnetic resonance image (MRI). Other complex techniques addressing UA collapsibility assessed by measurement of pharyngeal critical pressure and negative expiratory pressure however are not routinely performed. These methods provide information about anatomic abnormalities and the level of pharyngeal narrowing or collapse while the patient is awake or asleep. Data suggest that individual patients have different patterns of UA narrowing. So, the best method for evaluating obstruction during obstructive events remains controversial. In general, in clinical practice physical examination including a systematic evaluation of facial morphology, mouth, nasal cavity and the pharynx as well as simple imaging techniques such as nasopharyngoscopy and cephalometry have been more routinely utilized. Findings associated with obstructive sleep apnoea (OSA) are UA narrowing by the lateral pharyngeal walls and enlargements of tonsils, uvula and tongue. Additionally cephalometry identifies the most significant craniofacial characteristics associated with this disease. MRI studies demonstrated that lateral narrowing of UA in OSA is due to parapharyngeal muscle hypertrophy and/or enlargement of non adipose soft tissues.The upper airway evaluation has indubitably contributed to understand the pathophysiology and the diagnosis of OSA and snoring. Additionally, it also helps to identify the subjects with increased OSA risk as well as to select the more appropriate modality of treatment, especially for surgical procedures.
Keywords Acoustic reflection
nasopharyngoscopy
negative expiratory pressure
pharyngeal collapse
OSA
upper airway
Language English
Date 2010-02-01
Published in Indian Journal Of Medical Research. New Delhi: Indian Council Medical Res, v. 131, n. 2, p. 230-235, 2010.
ISSN 0971-5916 (Sherpa/Romeo, impact factor)
Publisher Indian Council Medical Res
Extent 230-235
Origin http://www.ijmr.org.in/article.asp?issn=0971-5916;year=2010;volume=131;issue=2;spage=230;epage=235;aulast=Togeiro;type=0
Access rights Open access Open Access
Type Review
Web of Science ID WOS:000275635200014
URI http://repositorio.unifesp.br/11600/43920

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