Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Feb;281(2):1031-1039.
doi: 10.1007/s00405-023-08333-x. Epub 2023 Nov 17.

Analysis of the cause of retrolingual obstruction in patients with moderate-severe obstructive sleep apnea

Affiliations

Analysis of the cause of retrolingual obstruction in patients with moderate-severe obstructive sleep apnea

Wanting Gao et al. Eur Arch Otorhinolaryngol. 2024 Feb.

Abstract

Purpose: To evaluate the percentage of obstructive sleep apnea (OSA) patients with retrolingual obstruction in all moderate-severe OSA patients and the proportions of different causes in all moderate-severe OSA patients with retrolingual obstruction and to discuss the accuracy of the Friedman tongue position (FTP) and retrolingual cross-sectional area (RCSA) in assessing the retrolingual obstruction.

Methods: Two hundred and twenty moderate-severe OSA patients were enrolled. After retrolingual obstruction was diagnosed, the percentage of OSA patients with retrolingual obstruction in all moderate-severe OSA patients was calculated. After that, the different causes of retrolingual obstruction were diagnosed based on different diagnostic criteria, and the proportions of different causes in all moderate-severe OSA patients with retrolingual obstruction were calculated. Finally, the correlations between FTP, RCSA, and apnea-hypopnea index after nasopharyngeal tube insertion (NPT-AHI) were analyzed, and the proportions of different causes of retrolingual obstruction based on different FTP and RCSA were observed.

Results: There were 128 patients with retrolingual obstruction, accounting for 58.2% of all moderate-severe OSA patients. In 128 patients with retrolingual obstruction, the proportions of glossoptosis (48.4%), palatal tonsil hypertrophy (28.1%), and lingual hypertrophy (8.6%) were relatively high. Both FTP and RCSA did not correlate with NPT-AHI. The proportion of lingual hypertrophy increased gradually with the increase of FTP and the proportions of glossoptosis in all FTP classifications were high. The patients with RCSA > 180 mm2 were mainly affected by glossoptosis and palatal tonsil hypertrophy, while patients with RCSA ≤ 180 mm2 were mainly affected by lingual hypertrophy.

Conclusion: The percentage of patients with retrolingual obstruction in all moderate-severe OSA patients is relatively high, mainly glossoptosis, palatal tonsil hypertrophy, and lingual hypertrophy. FTP classification and RCSA can only reflect the retrolingual anatomical stenosis, but cannot fully reflect the retrolingual functional stenosis, especially the presence of glossoptosis.

Keywords: Cause; Obstructive sleep apnea; Retrolingual obstruction.

PubMed Disclaimer

References

    1. Farmer WC, Giudici SC (2000) Site of airway collapse in obstructive sleep apnea after uvulopalatopharyngoplasty. Ann Otol Rhinol Laryngol 109(6):581–584. https://doi.org/10.1177/000348940010900609 - DOI - PubMed
    1. Gamaleldin O, Bahgat A, Anwar O, Seif-Elnasr M, Eissa L, Razek A et al (2021) Role of dynamic sleep MRI in obstructive sleep apnea syndrome. Oral Radiol 37(3):376–384. https://doi.org/10.1007/s11282-020-00455-w - DOI - PubMed
    1. Wu D, Shi H, Guo X, Li S (2013) Predictive value of lingua/pharynx ratio for retroglossal obstruction in patients with obstructive sleep apnea hypopnea syndrome. Acta Otolaryngol 133(5):504–508. https://doi.org/10.3109/00016489.2012.743172 - DOI - PubMed
    1. Friedman M, Ibrahim H, Joseph NJ (2004) Staging of obstructive sleep apnea/hypopnea syndrome: a guide to appropriate treatment. Laryngoscope 114(3):454–459. https://doi.org/10.1097/00005537-200403000-00013 - DOI - PubMed
    1. Friedman M, Tanyeri H, La Rosa M, Landsberg R, Vaidyanathan K, Pieri S et al (1999) Clinical predictors of obstructive sleep apnea. Laryngoscope 109(12):1901–1907. https://doi.org/10.1097/00005537-199912000-00002 - DOI - PubMed

MeSH terms

LinkOut - more resources