Abstract
To correlate anatomical and functional changes of the oral cavity, pharynx and larynx to the severity of obstructive sleep apnea syndrome (OSAS). We conducted a cross-sectional study of 66 patients of both genders, aged between 21 and 59 years old with complaints of snoring and / or apnea. All underwent full clinical evaluation, including physical examination, nasolarybgoscopy and polisonography. We classified individuals into groups by the value of the apnea-hypopnea index (AHI), calculated measures of association and analyzed differences by the Kruskal-Wallis and chi-square tests. all patients with obesity type 2 had OSAS. We found a relationship between the uvula projection during nasoendoscopy and OSAS (OR: 4.9; p-value: 0.008; CI: 1.25-22.9). In addition, there was a major strength of association between the circular shape of the pharynx and the presence of moderate or severe OSAS (OR: 9.4, p-value: 0.002), although the CI was wide (1.80-53.13). The septal deviation and lower turbinate hypertrophy were the most frequent nasal alterations, however unrelated to gravity. Nasal obstruction was four times more common in patients without daytime sleepiness. The other craniofacial anatomical changes were not predictors for the occurrence of OSAS. oral, pharyngeal and laryngeal disorders participate in the pathophysiology of OSAS. The completion of the endoscopic examination is of great value to the evaluation of these patients.
Highlights
Ostructive sleep apnea (OSAS) has impacts on quality of life and is a risk factor for heart, metabolic, neurological and perioperative diseases 1
The pathophysiology of obstructive sleep apnea syndrome (OSAS) is multifactorial, evidence shows that upper airways (UA) muscle control is the result of a delicate balance between different forces of intraluminal pressure during inspiration, which leads to a negative transpharyngeal pressure gradient, and the extraluminal pressure forces derived from muscle contractions that contribute to opening of the pharynx
It is speculated that this difference between genders is due to hormones, to body fat distribution, to UA anatomy and function, to neural breathing control mechanisms[5,10] and possibly to factors related to clinical presentation, which is less evident in women
Summary
Ostructive sleep apnea (OSAS) has impacts on quality of life and is a risk factor for heart, metabolic, neurological and perioperative diseases 1. The pathophysiology of OSAS is multifactorial, evidence shows that UA muscle control is the result of a delicate balance between different forces of intraluminal pressure during inspiration, which leads to a negative transpharyngeal pressure gradient, and the extraluminal pressure forces derived from muscle contractions that contribute to opening of the pharynx. Factors such as vasomotor tone and mucosal adhesive forces seem to collaborate with UA narrowing or collapse[3]. This study aims to identify larynx and pharynx anatomical and functional changes visible through endoscopy in patients with varying degrees of OSAS and correlate them with their gravity
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