The association of OSAS and uvula: the role of MRI in this egg-chicken problem in OSAS
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SLEEP BREATHING PHYSIOLOGY AND DISORDERS • ORIGINAL ARTICLE
The association of OSAS and uvula: the role of MRI in this egg-chicken problem in OSAS Omer Araz 1 & Adem Karaman 2 & Veysel Esdur 3 & Elif Yilmazel Ucar 1 & Irmak Durur Subasi 4 & Fatih Alper 2 & Metin Akgun 1 Received: 6 March 2019 / Revised: 13 June 2019 / Accepted: 14 June 2019 # Springer Nature Switzerland AG 2019
Abstract Purpose Obstructive sleep apnea syndrome (OSAS) is a condition resulting from repetitive partial or complete upper airway obstruction, and its etiology remains uncertain. Polysomnography is the gold standard diagnostic test for OSAS. However, there are long wait times for this evaluation, so questionnaires or ancillary diagnostic methods are used to select appropriate patients. One of these is magnetic resonance imaging (MRI). The present study aimed to investigate the association between clinical features of OSAS and uvular changes on MRI. Materials and methods A total of 102 participants, 80 with OSAS and 22 controls, were included in the study. All participants underwent full-night polysomnography, MRI, and anthropometric measurements. Results In comparisons of MRI measurements of the uvula, statistically significant differences in uvular length, thickness, and angle were observed between the OSAS and control groups. MRI measurement significantly associated with apnea–hypopnea index was uvular thickness. Evaluation of anthropometric and MRI measurements revealed statistically significant associations between waist circumference and uvular thickness, uvular width, and oropharyngeal space among the OSAS patients. Conclusion Thickened uvula on MRI is associated with the presence of OSAS, and its thickness is well correlated with the severity of the diseases. Thus, it may be a reliable indicator of OSAS and could be used as a supportive finding to identify patients suitable for referral for diagnostic polysomnography. Keywords Obstructive sleep apnea . Magnetic resonance imaging . Uvula
Introduction Obstructive sleep apnea syndrome (OSAS) is a common condition characterized by hypoxia and increased sympathetic activity due to complete or partial upper airway obstruction during sleep, though its etiology has not been fully elucidated [1]. * Omer Araz [email protected] 1
Department of Pulmonary Disease, Faculty of Medicine, Ataturk University, Yakutiye, 25240 Erzurum, Turkey
2
Department of Radiology, Faculty of Medicine, Ataturk University, Erzurum, Turkey
3
Department of Radiology, Erzurum Training and Research Hospital, Erzurum, Turkey
4
Department of Radiology, Dışkapı Yıldırım Beyazıt Training and Research Hospital, Ankara, Turkey
The upper airways play an important role in the etiology of the disease; muscle tone in the oropharyngeal region keeps the upper airway open while we are conscious but is reduced during sleep. Subsequent narrowing of the upper airway increases airflow velocity, which initially causes vibrations in the upper airway that manifest as snoring [2]. These vibrations progressively increase and can
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