Comparison of nasal geometry among adults with obstructive sleep apnea: a preliminary study

Jackson Ítalo Tavares Da Rocha,Hilton Justino Da Silva,Danielle Cristina Silva Clímaco,Adriana De Oliveira Camargo Gomes,Paulo Augusto Vitorino,Anna Myrna Jaguaribe De Lima,Daniele Andrade Da Cunha

doi:10.1590/1982-0216/201921610719

Jackson Ítalo Tavares Da Rocha, Hilton Justino Da Silva + Show 5 more

Open Access

https://doi.org/10.1590/1982-0216/201921610719

Copy DOI

Abstract

ABSTRACT Purpose: to compare nasal geometry between two groups of patients with different degrees of obstructive sleep apnea and to correlate apnea-hypopnea index, apnea severity and degree of daytime sleepiness with nasal areas and volume. Methods: a total of 20 adults (15 women and 5 men, mean age of 52.0±11.4 years old) without nasal obstruction were submitted to polysomnography. The subjects were divided into two groups: a) 10 individuals without apnea or with mild-grade apnea; b) 10 with moderate or severe apnea. Nasal geometry was evaluated by acoustic rhinometry. The volume, comprising the distance from the nasal valve to the posterior part of the middle nasal turbinate, and the three sectional areas corresponding to nasal valve, anterior part of the inferior nasal turbinate and posterior part of the inferior nasal turbinate, were considered. The Shapiro-Wilk, Mann-Whitney, Student’s t tests for independent samples and Spearman’s correlation coefficient were used for the analysis, with a significance level lower than 5%. Results: group 2 presented lower values in the area corresponding to the nasal valve (on the right), and higher values in the nasal turbinate areas. There was no correlation between the drowsiness scale and nasal areas and volumes. Conclusion: the area of the nasal valve was unilaterally smaller in the group with moderate and severe apnea. There was no correlation between volumes and nasal areas and excessive daytime sleepiness.

Highlights

Obstructive sleep apnea (OSA) is a chronic, developmental disorder characterized by respiratory dysfunction during the sleep period, secondary to anatomic-structural and neuromuscular factors
The mean values found in Acoustic rhinometry (AR) for the crosssectional area (CSA) and of the nasal cavity volumes (V) of both groups were calculated (Table 2)
When comparing the left and right nasal cavities separately, it was observed that group 2 presented a lower value in CSA1 in the right nasal cavity compared to group 1, and a higher value in the left CSA2 and total CSA3, meaning in the analysis of the sum of the two cavities

Summary

Introduction

Obstructive sleep apnea (OSA) is a chronic, developmental disorder characterized by respiratory dysfunction during the sleep period, secondary to anatomic-structural and neuromuscular factors. It is known that the etiology of OSA is multifactorial and that morphometric and functional changes in oropharyngeal and nasal structures are among the cause and effect processes of OSA6,7. These changes promote upper airways (UAW) narrowing, one of the main factors for the emergence of this disorder 6-8. The influence of nasal obstruction on OSA9 has not been proven, one study indicated a high incidence of nasal structural alterations in patients with this sleep disorder 10, which justifies further research on the subject. Other screening procedures may be useful for combining different risk factors[12], such as airway abnormalities, including examinations that assess nasal cavity geometry[8,13]

Objectives

Methods

Results

Conclusion