Tongue volume influences lowest oxygen saturation but not apnea-hypopnea index in obstructive sleep apnea

Sang Hyeon Ahn, Jinna Kim, Hyun Jin Min, Hyo Jin Chung, Jae Min Hong, Jeung Gweon Lee, Chang Hoon Kim, Hyung Ju Cho

Research output: Contribution to journalArticle

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Abstract

Objectives The aim of this study was to identify correlations between sleep apnea severity and tongue volume or posterior airway space measured via three-dimensional reconstruction of volumetric computerized tomography (CT) images in patients with obstructive sleep apnea (OSA) for use in predicting OSA severity and in surgical treatment. We also assessed associations between tongue volume and Mallampati score. Methods Snoring/OSA male patients (n = 64) who underwent polysomnography, cephalometry, and CT scans were enrolled in this retrospective study. OSA was diagnosed when the apneahypopnea index (AHI) was greater than 5 (mild 5-14; moderate 15-29; severe 30). The patients were also categorized into the normal-mild group (n = 22) and the moderate-severe group (n = 42). Using volumetric CT images with the three-dimensional reconstruction technique, the volume of the tongue, posterior airway space volume, and intra-mandibular space were measured. The volumes, polysomnographic parameters, and physical examination findings were compared, and independent factors that are related to OSA were analysed. Results No associations between tongue volume or posterior airway space and the AHI were observed. However, multivariate linear analyses showed that tongue volume had significantly negative association with lowest O2 saturation (r = 0.365, p = 0.027). High BMI was related to an increase in tongue volume. Modified Mallampati scores showed borderline significant positive correlations with absolute tongue volume (r = 0.251, p = 0.046) and standardized tongue volume (absolute tongue volume / intramandibular area; r = 0.266, p =0.034). Between the normal-mild and moderate-severe groups, absolute tongue volumes were not different, although the standardized tongue volume in the moderate-severe group was significantly higher. Conclusion Absolute tongue volume showed stronger associations with lowest O2 saturation during sleep than with the severity of AHI. We also found that high BMI was a relevant factor for an increase in absolute tongue volume and modified Mallampati grading was a useful physical examination to predict tongue size.

Original languageEnglish
Article numbere0135796
JournalPloS one
Volume10
Issue number8
DOIs
Publication statusPublished - 2015 Aug 17

Fingerprint

sleep apnea
apnea
Obstructive Sleep Apnea
Apnea
tongue
Tongue
Oxygen
oxygen
Computerized tomography
tomography
Tomography
Sleep
Physical Examination
clinical examination
Cephalometry
Snoring
Three-Dimensional Imaging
Polysomnography
Sleep Apnea Syndromes

All Science Journal Classification (ASJC) codes

  • Biochemistry, Genetics and Molecular Biology(all)
  • Agricultural and Biological Sciences(all)

Cite this

Ahn, S. H., Kim, J., Min, H. J., Chung, H. J., Hong, J. M., Lee, J. G., ... Cho, H. J. (2015). Tongue volume influences lowest oxygen saturation but not apnea-hypopnea index in obstructive sleep apnea. PloS one, 10(8), [e0135796]. https://doi.org/10.1371/journal.pone.0135796
Ahn, Sang Hyeon ; Kim, Jinna ; Min, Hyun Jin ; Chung, Hyo Jin ; Hong, Jae Min ; Lee, Jeung Gweon ; Kim, Chang Hoon ; Cho, Hyung Ju. / Tongue volume influences lowest oxygen saturation but not apnea-hypopnea index in obstructive sleep apnea. In: PloS one. 2015 ; Vol. 10, No. 8.
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Tongue volume influences lowest oxygen saturation but not apnea-hypopnea index in obstructive sleep apnea. / Ahn, Sang Hyeon; Kim, Jinna; Min, Hyun Jin; Chung, Hyo Jin; Hong, Jae Min; Lee, Jeung Gweon; Kim, Chang Hoon; Cho, Hyung Ju.

In: PloS one, Vol. 10, No. 8, e0135796, 17.08.2015.

Research output: Contribution to journalArticle

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AU - Ahn, Sang Hyeon

AU - Kim, Jinna

AU - Min, Hyun Jin

AU - Chung, Hyo Jin

AU - Hong, Jae Min

AU - Lee, Jeung Gweon

AU - Kim, Chang Hoon

AU - Cho, Hyung Ju

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N2 - Objectives The aim of this study was to identify correlations between sleep apnea severity and tongue volume or posterior airway space measured via three-dimensional reconstruction of volumetric computerized tomography (CT) images in patients with obstructive sleep apnea (OSA) for use in predicting OSA severity and in surgical treatment. We also assessed associations between tongue volume and Mallampati score. Methods Snoring/OSA male patients (n = 64) who underwent polysomnography, cephalometry, and CT scans were enrolled in this retrospective study. OSA was diagnosed when the apneahypopnea index (AHI) was greater than 5 (mild 5-14; moderate 15-29; severe 30). The patients were also categorized into the normal-mild group (n = 22) and the moderate-severe group (n = 42). Using volumetric CT images with the three-dimensional reconstruction technique, the volume of the tongue, posterior airway space volume, and intra-mandibular space were measured. The volumes, polysomnographic parameters, and physical examination findings were compared, and independent factors that are related to OSA were analysed. Results No associations between tongue volume or posterior airway space and the AHI were observed. However, multivariate linear analyses showed that tongue volume had significantly negative association with lowest O2 saturation (r = 0.365, p = 0.027). High BMI was related to an increase in tongue volume. Modified Mallampati scores showed borderline significant positive correlations with absolute tongue volume (r = 0.251, p = 0.046) and standardized tongue volume (absolute tongue volume / intramandibular area; r = 0.266, p =0.034). Between the normal-mild and moderate-severe groups, absolute tongue volumes were not different, although the standardized tongue volume in the moderate-severe group was significantly higher. Conclusion Absolute tongue volume showed stronger associations with lowest O2 saturation during sleep than with the severity of AHI. We also found that high BMI was a relevant factor for an increase in absolute tongue volume and modified Mallampati grading was a useful physical examination to predict tongue size.

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