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. 2023 Aug 27;23(1):254.
doi: 10.1186/s12893-023-02144-x.

The relationship of tongue fat content and efficacy of uvulopalatopharyngoplasty in Chinese patients with obstructive sleep apnea

Bingjie Zhao #  1 , Zine Cao #  1 , Yushan Xie #  1 , Yewen Shi  1 , Yitong Zhang  1 , Shiyu Liu  2 , Xi Chen  1 , Lina Ma  1 , Xiaoxin Niu  1 , Yonglong Su  1 , Yani Feng  1 , Chunfeng Lian  3 , Xiaoyong Ren  4 , Haiqin Liu  5
Affiliations

The relationship of tongue fat content and efficacy of uvulopalatopharyngoplasty in Chinese patients with obstructive sleep apnea

Bingjie Zhao et al. BMC Surg. .

Abstract

Background: To investigate the relationship between tongue fat content and severity of obstructive sleep apnea (OSA) and its effects on the efficacy of uvulopalatopharyngoplasty (UPPP) in the Chinese group.

Method: Fifty-two participants concluded to this study were diagnosed as OSA by performing polysomnography (PSG) then they were divided into moderate group and severe group according to apnea hypopnea index (AHI). All of them were also collected a series of data including age, BMI, height, weight, neck circumference, abdominal circumference, magnetic resonance imaging (MRI) of upper airway and the score of Epworth Sleepiness Scale (ESS) on the morning after they completed PSG. The relationship between tongue fat content and severity of OSA as well as the association between tongue fat content in pre-operation and surgical efficacy were analyzed.Participants underwent UPPP and followed up at 3rd month after surgery, and they were divided into two groups according to the surgical efficacy.

Results: There were 7 patients in the moderate OSA group and 45 patients in the severe OSA group. The tongue volume was significantly larger in the severe OSA group than that in the moderate OSA group. There was no difference in tongue fat volume and tongue fat rate between the two groups. There was no association among tongue fat content, AHI, obstructive apnea hypopnea index, obstructive apnea index and Epworth sleepiness scale (all P > 0.05), but tongue fat content was related to the lowest oxygen saturation (r=-0.335, P < 0.05). There was no significantly difference in pre-operative tongue fat content in two different surgical efficacy groups.

Conclusions: This study didn't show an association between tongue fat content and the severity of OSA in the Chinese group, but it suggested a negative correlation between tongue fat content and the lowest oxygen saturation (LSaO2). Tongue fat content didn't influence surgical efficacy of UPPP in Chinese OSA patients.

Trial registration: This study didn't report on a clinical trial, it was retrospectively registered.

Keywords: Magnetic resonance imaging; Obstructive sleep apnea; Tongue fat; Upper airway; Uvulopalatopharyngoplasty.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Magnetic resonance imaging analysis. A) Sagittal view of segmentation in tongue with segmentation of tongue (area in yellow). B) The region of tongue fat which is marked in red. C) Upper airway is divided into two parts: Retropalatal (RP) area is from the level of hard palate to the tip of uvula (transparent yellow); Retroglossal (RG) area is from the level of the tip of uvula to the base of epiglottis (transparent green). D) The diagram of landmarks which are used to calculate the length from posterior nasal spine (PNS) to hyoid (Hy) and soft palate tip (SPt). The angle of tongue base is defined as the inferior margin of geniohyoid and the posterior of pharyngeal wall
Fig. 2
Fig. 2
Characteristics of tongue fat. The sagittal slice of MRI in tongue fat which characteristics of distribution are fanned out (A), fat was marked by yellow (B)
Fig. 3
Fig. 3
Correlations between indicators of intra-tongue fat and LSaO2. 95% confidence intervals are plotted on each graph. LSaO2: lowest oxygen saturation
Fig. 4
Fig. 4
Correlations between related indicators of tongue fat and other anatomical measurements. 95% confidence intervals are plotted on each graph. PNS-SPt: length from posterior nasal spine to soft palate tip; CSA: Cross-sectional area; RP: Retropalatal; RG: Retroglossal
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