Assessment of upper airway anatomy in awake, sedated, and anaesthetized patients using magnetic resonance imaging.

1996 ◽  
Vol 97 (Supplement) ◽  
pp. 1093
Author(s):  
Rony Moscona
2005 ◽  
Vol 133 (3) ◽  
pp. 397-402 ◽  
Author(s):  
Boris A. Stuck ◽  
Wolfgang Neff ◽  
Karl Hörmann ◽  
Thomas Verse ◽  
Gregor Bran ◽  
...  

OBJECTIVE: To assess the effects of isolated hyoid suspension on subjective and objective parameters of obstructive sleep apnea and to evaluate changes in upper airway anatomy with the help of standardized magnetic resonance imaging. STUDY DESIGN AND SETTING: Fifteen patients received isolated hyoid suspension. Changes in respiratory disturbance index were assessed with polysomnography, and anatomical changes with standardized magnetic resonance imaging. Snoring, daytime sleepiness, and functional parameters were assessed with questionnaires. Lateral x-ray cephalometry was performed preoperatively. RESULTS: Mean respiratory disturbance index was reduced from 35.2 ± 19.1 to 27.4 ± 26.2. Forty percent of the patients were classified as responders. Daytime sleepiness improved significantly. Relevant changes in upper airway anatomy could not be detected. There were no remarkable differences between responders and nonresponders in regard to imaging. CONCLUSIONS: Hyoid suspension is effective only in a subgroup of patients and does not lead to relevant changes in airway diameters in the awake patient. Magnetic resonance imaging and x-ray cephalometry do not add additional information for patient selection. SIGNIFICANCE: The reported clinical effects of hyoid suspension are more likely due to functional changes in airway collapsibility than to an enlargement of the upper airway.


SLEEP ◽  
2002 ◽  
Vol 25 (5) ◽  
pp. 530-540 ◽  
Author(s):  
Kevin C. Welch ◽  
Gary D. Foster ◽  
Christen T. Ritter ◽  
Thomas A. Wadden ◽  
Raanan Arens ◽  
...  

1994 ◽  
Vol 22 (2) ◽  
pp. 165-169 ◽  
Author(s):  
G. D. Shorten ◽  
N. J. Opie ◽  
P. Graziotti ◽  
I. Morris ◽  
M. Khangure

Magnetic Resonance Imaging was used to quantify the effects of 1. sedation and 2. general anaesthesia with a laryngeal mask airway (LMA) in place on the minimum antero-posterior (A-P) diameters of the naso-, oro- and hypopharynx and on the angle of the epiglottis relative to the adjacent posterior pharyngeal wall. Median saggital T1-weighted images of the pharynx were obtained in 46 patients (16 awake, 14 sedated, 16 under general anaesthesia). In sedated patients, the A-P diameters of the pharynx were less than in awake patients, in particular at the levels of the epiglottis and soft palate. General anaesthesia and placement of a LMA was also associated with a reduced A-P diameter at the level of the soft palate, but with increased diameters at the levels of the tongue and epiglottis. Placement of a LMA caused abnormal downfolding of the epiglottis in most cases but this did not cause clinically significant airway obstruction.


Pulse ◽  
2018 ◽  
Vol 10 (1) ◽  
pp. 38-41
Author(s):  
SMAA Mamun

Obstructive sleep apnea (OSA) is characterized by repetitive airflow reduction caused by collapse of the upper airway during sleep in addition to daytime sleepiness, clinical symptoms include fatigue, insomnia, and snoring. The condition is associated with adverse clinical outcomes, including cardiovascular disease, hypertension, cognitive impairment, and metabolic abnormalities.1 Among the risk factors for OSA, obesity is probably the most important. Several studies have consistently found an association between increased body weight and risk of OSA. Tomographic scanned images have shown that obesity causes increased fatty deposits in the pharyngeal area.2 The deposits encroach on the airway and contribute to airway narrowing. Also, among obese patients as compared to normal controls, fat deposits appear to alter the shape of the upper airway without necessarily reducing the cross-sectional area. M. A. Ciscar et al used magnetic resonance imaging to investigate differences between obese and normal controls.2 Ultrafast magnetic resonance imaging was used to study the upper airway and surrounding soft tissue in 17 patients with OSA during wakefulness and sleep, and in eight healthy subjects whilst awake. Coronal sections of awake OSA patients showed elliptical-shaped airways with long axes that were oriented anteroposterior; normal controls had airways that were oriented transversely. Studies using computed tomography have produced similar results.14Pulse Vol.10 January-December 2017 p.38-41


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