Abstract

Abstract Introduction Determination of intervention to manage obstructive sleep apnea (OSA) is dependent on clinical examination, polysomnography results, and imaging analysis. There remains the need of a non-invasive and cost-effective way to correlate relevant upper airway anatomy with severity of obstructive sleep apnea (OSA ) to direct treatment and optimize outcome. We aimed to determine whether ultrasonography with backscattered imaging (BUI) analysis of the tongue correlates with severity of OSA in adults. Methods A prospective, single-center, observational study of a consecutive series of patients (aged18 years and older) visiting our sleep clinic. All included patients had a polysomnography (PSG) within 3 years from the moment of BUI analysis. Patients were excluded if their BMI had changed more than 10%. We used and standardized the submental ultrasound scan with a laser alignment tool and applied BUI analysis to the tongue. Outcomes were correlated to the patients’ AHI, BUI results were compared to only echo intensity. Results Eighty-nine patients were included between July 2020 and March 2022. Mean age was 38.8±12.7 years, mean BMI was 26.7±5.0 kg/m2, and mean AHI was 17.5±16.8 events/h. Significant differences were found between the subgroups with AHI< 15 and □15 events/h at specific regions of the tongue base using BUI analysis, echo intensity showed no significant differences. BUI values showed a positive correlation with AHI, with Pearson correlation coefficient of 0.42 and 0.37, and Spearman correlation coefficient of 0.43 and 0.43 for the A and B regions of the tongue, respectively. Higher BUI values are associated with more severe AHI, even after correction for covariates (BMI and age). Conclusion Standardized ultrasound scanning of the tongue with backscattered imaging analysis yields strong correlation with severity of OSA. With the intrinsic advantages in the use of ultrasonography in outpatient settings, this analysis is pivotal in reducing the gap between anatomy and physiology in clinical decision-making for treating OSA. Support (if any) None

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