Computed Tomography Characterization and Comparison With Polysomnography for Obstructive Sleep Apnea Evaluation

dc.contributor.authorKhaisang Chousangsuntornen_US
dc.contributor.authorThongchai Bhongmakapaten_US
dc.contributor.authorNavarat Apirakkittikulen_US
dc.contributor.authorWitaya Sungkaraten_US
dc.contributor.authorNucharin Supakulen_US
dc.contributor.authorJiraporn Laothamatasen_US
dc.contributor.otherIndiana University School of Medicine Indianapolisen_US
dc.contributor.otherFaculty of Medicine, Ramathibodi Hospital, Mahidol Universityen_US
dc.contributor.otherMahidol Universityen_US
dc.description.abstract© 2017 The Authors Purpose: We hypothesized that computed tomography (CT) combined with portable polysomnography (PSG) might better visualize anatomic data related to obstructive sleep apnea (OSA). The present study evaluated the CT findings during OSA and assessed their associations with the PSG data and patient characteristics. Patients and Methods: We designed a prospective cross-sectional study of patients with OSA. The patients underwent scanning during the awake state and apneic episodes. Associations of the predictor variables (ie, PSG data, respiratory disturbance index [RDI]), patient characteristics (body mass index [BMI], neck circumference [NC], and waist circumference [WC]), and outcome variables (ie, CT findings during apneic episodes) were assessed using logistic regression analysis. The CT findings during apneic episodes were categorized regarding the level of obstruction, single level (retropalatal [RP] or retroglossal [RG]) or multilevel (mixed RP and RG), degree of obstruction (partial or complete), and pattern of collapse (complete concentric collapse [CCC] or other patterns). Results: A total of 58 adult patients with OSA were scanned. The mean ± standard deviation for the RDI, BMI, NC, and WC were 41.6 ± 28.55, 27.80 ± 5.43 kg/m 2 , 38.3 ± 4.3 cm, and 93.8 ± 13.6 cm, respectively. No variables distinguished between the presence of single- and multilevel airway obstruction in the present study. A high RDI (≥30) was associated with the presence of complete obstruction and CCC (odds ratio 6.33, 95% confidence interval 1.55 to 25.90; and odds ratio 3.77, 95% confidence interval 1.02 to 13.91, respectively) compared with those with a lesser RDI. Conclusions: An increased RDI appears to be an important variable for predicting the presence of complete obstruction and CCC during OSA. Scanning during apneic episodes, using low-dose volumetric CT combined with portable PSG provided better anatomic and pathologic findings of OSA than did scans performed during the awake state.en_US
dc.identifier.citationJournal of Oral and Maxillofacial Surgery. Vol.76, No.4 (2018), 854-872en_US
dc.rightsMahidol Universityen_US
dc.titleComputed Tomography Characterization and Comparison With Polysomnography for Obstructive Sleep Apnea Evaluationen_US