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Characteristics and Mechanism of Upper Airway Collapse Revealed by Dynamic MRI During Natural Sleep in Patients with Severe Obstructive Sleep Apnea

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机构: [1]School of Biomedical Engineering, Capital Medical University, Beijing, People’s Republic of China [2]Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, People’s Republic of China [3]Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China
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关键词: airway obstruction patterns obstruction location tissue motion characteristics hyoid position retropalatal space

摘要:
Purpose: Upper airway collapse during sleep in patients with obstructive sleep apnea (OSA) is a complex and dynamic phenomenon. By observing and analyzing the dynamic changes in the upper airway and its surrounding tissues during airway obstruction, we aim to reveal dynamic characteristics in different obstruction patterns, and the relationship between anatomical features during normal breathing and dynamic characteristics of airway obstruction. Patients and Methods: Dynamic MRI was performed in 23 male patients (age range 26-63) with severe OSA diagnosed by overnight polysomnography, and obstruction events were identified from their images. Dynamic changes in parameters of the upper airway and surrounding tissues were measured to assess the key characteristics in different obstruction patterns. Results: We categorized airway obstruction into four types based on the obstruction location and motion characteristics of tissues during collapse, and detailed the alterations in the airway and surrounding tissues under each obstruction pattern. In all 112 obstruction events extracted from the dynamic images of 23 patients, type A (retropalatal obstruction caused by the soft palate separated from the tongue), BI, BII (both retropalatal obstructions caused by the soft palate attached to the tongue, and C (retropalatal and retroglossal obstruction caused by the soft palate and the tongue), accounted for 28.6%, 44.6%, 12.5%, and 14.3% respectively. In severe OSA patients with tongue and palatal obstruction related to type B or C, the more posterior hyoid position, shorter distance between tongue and uvula, and wider retropalatal space, the larger the tongue displacement and deformation during collapse, and the greater the reduction in airway space. Conclusion: There are multiple airway obstruction patterns, each with its own anatomical characteristics and behaviors during collapse. Hyoid position, tongue and uvula distance, and retropalatal space play an important role in airway collapse and should be paid more attention in the treatment of OSA.

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出版当年[2022]版:
大类 | 3 区 医学
小类 | 3 区 临床神经病学 4 区 神经科学
最新[2023]版:
大类 | 2 区 医学
小类 | 3 区 临床神经病学 3 区 神经科学
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出版当年[2021]版:
Q3 CLINICAL NEUROLOGY Q3 NEUROSCIENCES
最新[2023]版:
Q2 CLINICAL NEUROLOGY Q2 NEUROSCIENCES

影响因子: 最新[2023版] 最新五年平均 出版当年[2021版] 出版当年五年平均 出版前一年[2020版] 出版后一年[2022版]

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第一作者机构: [1]School of Biomedical Engineering, Capital Medical University, Beijing, People’s Republic of China [2]Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, People’s Republic of China
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通讯机构: [1]School of Biomedical Engineering, Capital Medical University, Beijing, People’s Republic of China [2]Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, People’s Republic of China [3]Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China [*1]School of Biomedical Engineering, Capital Medical University, Beijing, People’s Republic of China [*2]Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China
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