The prognostic role of ultrasound and magnetic resonance imaging in obstructive sleep apnoea based on lateral oropharyngeal wall obstruction

Sleep Breath. 2023 Mar;27(1):319-328. doi: 10.1007/s11325-022-02597-z. Epub 2022 Mar 30.

Abstract

Purpose: This study examined the prognostic value of the lateral pharyngeal wall (LPW)-based obstruction and obstructive sleep apnoea (OSA) prediction using ultrasound (US) and MRI (magnetic resonance imaging).

Methods: One hundred patients with and without OSA were enrolled, according to overnight polysomnography. The LPW thickness (LPWT) was measured using a Philips Ingenia 1.5 T MRI device, and US measurements were carried out at rest and during Müller's manoeuvre (MM) with a Samsung RS85 device. The obstruction was localised under drug-induced sleep endoscopy.

Results: Significantly greater LPWT using MRI was observed in the OSA group compared to the control group, while US results showed a significant difference only in the case of LPWT during MM on the left side. Obese patients presented significantly higher LPWT values. A significant correlation between BMI and LPWT was observed. Men presented significantly higher LPWT MRI values and left-sided LPWT using US compared to women. LPWT and AHI parameters were significantly correlated. The severity of LPW obstruction correlated with LPWT, while the LPW collapse significantly correlated with AHI. The severity of LPW collapse differed depending on the AHI values. Using US LPWT values and anthropometric parameters, a 93% effectiveness in OSA prognostication and 89% in LPWT-based obstruction were detected. MRI detected OSA in 90% and LPW-based obstruction in 84%. US successfully detected LPW-based collapse severity in 67%.

Conclusion: US LPWT measurements were helpful in detecting OSA and LPWT-based obstruction. These examinations may be useful for surgical planning.

Keywords: Drug-induced sleep endoscopy; Lateral pharyngeal wall; MRI; Obstructive sleep apnoea; Ultrasound.

MeSH terms

  • Anthropometry
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Male
  • Pharynx
  • Prognosis
  • Sleep Apnea, Obstructive*