Department of Otolaryngology, head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA.
Department of Otolaryngology, head and Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA.
Sleep Med. 2024 Aug;120:15-21. doi: 10.1016/j.sleep.2024.05.051. Epub 2024 May 31.
Ultrasound imaging has been explored as a potential diagnostic tool for obstructive sleep apnea (OSA); we reported backscatter ultrasound imaging (BUI) of the tongue correlates with OSA severity in adults. We focus on anatomical features of the tongue using standardized ultrasonography and hypothesize that differences in morphology correlate with OSA severity.
This prospective study was IRB approved (53,172) and conducted at Stanford University Sleep Surgery Clinic. Patients ≥18 years with polysomnography (PSG) underwent a standardized submental ultrasound scan using a laser alignment tool to observe the upper airway in supine position during tidal respiration. Images acquired from this scan were divided into 4 equiangular regions (A-D).
A total of 144 patients (30 women) July 2020-December 2022 were included with mean age 41.6 years (±12.9 SD), BMI 27.2 kg/m(±4.7 SD), and AHI 19.7 (±20.0 SD). Moderate-to-severe OSA patients had significantly narrower airspace at regions A, B and C with p-values ranging from <0.0001 to 0.0003. These patients had a significantly wider (p = 0.0021-0.0045 for regions A, B and C) tongue and thicker (p = 0.0403 for region B) deep tissue. The predictive model to assess the risk of moderate-to-severe OSA achieved an area under the receiver operating characteristic curve of 0.839 (95 % CI: 0.769 to 0.895).
With standardized, computerized ultrasound imaging of the shape and configuration of the tongue, we identified regions that correlated well with OSA severity. Further research is needed to determine the clinical implications of such pathophysiological findings.
超声成象已被探索作为阻塞性睡眠呼吸暂停（OSA）的一种潜在诊断工具；我们曾报道过舌背散射超声成象（BUI）与成人 OSA 严重程度相关。我们使用标准化超声技术关注舌的解剖特征，并假设形态学差异与 OSA 严重程度相关。
这是一项经 IRB 批准的前瞻性研究（53172），在斯坦福大学睡眠外科诊所进行。≥18 岁的患者进行多导睡眠图（PSG）检查，然后进行标准化颏下超声扫描，使用激光对准工具观察仰卧位时的上气道在潮式呼吸过程中的情况。从该扫描中获取的图像被分为 4 个等角区（A-D）。
共有 144 名患者（30 名女性）纳入研究，纳入时间为 2020 年 7 月至 2022 年 12 月，平均年龄为 41.6 岁（±12.9 SD），BMI 为 27.2 kg/m²（±4.7 SD），AHI 为 19.7（±20.0 SD）。中重度 OSA 患者在 A、B 和 C 区的气道间隙明显变窄，p 值范围从<0.0001 到 0.0003。这些患者的舌体明显更宽（p 值分别为 0.0021-0.0045，A、B 和 C 区），深部组织更厚（p 值为 0.0403，B 区）。评估中重度 OSA 风险的预测模型获得了 0.839 的受试者工作特征曲线下面积（95%CI：0.769 至 0.895）。
通过对舌的形状和结构进行标准化、计算机化的超声成像，我们确定了与 OSA 严重程度密切相关的区域。需要进一步研究来确定这种病理生理学发现的临床意义。
