CT Characterization and Comparison with Polysomnography for Obstructive Sleep Apnea Evaluation

Publication date: Available online 12 September 2017
Source:Journal of Oral and Maxillofacial Surgery
Author(s): Khaisang Chousangsuntorn, Thongchai Bhongmakapat, Navarat Apirakkittikul, Witaya Sungkarat, Nucharin Supakul, Jiraporn Laothamatas
PurposeWe hypothesized that computed tomography (CT) combined with portable polysomnography (PSG) may visualize anatomical data related to obstructive sleep apnea (OSA). This study aims to evaluate computed tomographic findings during sleep apnea and assess their associations with PSG data and patient characteristics.Patients and MethodsWe designed a prospective cross-sectional study in patients with OSA. The patients were scanned during awake states and apneic episodes. Associations of predictor variables, i.e. PSG data [respiratory disturbance index (RDI)] and patient characteristics [body-mass index (BMI), neck circumference (NC) and waist circumference (WC)], and outcome variables, i.e. CT findings during apneic episodes, were assessed by logistic regression analysis. CT findings during apneic episodes were categorized as to: level of obstruction, single-level [retropalatal (RP) or retroglossal (RG)] or multi-level (mixed RP and RG); degree of obstruction (partial or complete); and pattern of collapse [complete concentric collapse (CCC) or other patterns].ResultsFifty-eight adult patients with OSA were scanned. The mean ± standard deviation (SD) RDI, BMI, NC, and WC were 41.6 ± 28.55, 27.80 ± 5.43 kg/m², 38.3 ± 4.3 cm, and 93.8 ± 13.6 cm, respectively. There were no variables observed which distinguished between the presence of single- and multi-level airway obstruction in this study. A high RDI (≥30) was associated with the presence of complete obstruction and CCC [odds ratios (95% confident interval) were 6.33 (1.55–25.90) and 3.77 (1.02–13.91) compared to those with lesser RDIs, respectively].ConclusionIncreased RDI appears to be an important variable for predicting the presence of complete obstruction and CCC during sleep apnea. Scanning during apneic episodes, using low-dose volumetric CT combined with portable PSG, provided better anatomic and pathologic findings in OSA than detected with scans during awake state.



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