The Usefulness of Modified Mallampati Score and CT Upper Airway Volume Measurements in Diagnosing OSA among Patients with Breathing-Related Sleep Disorders

Bartosz Dalewski,Ewa Sobolewska,Aleksandra Syrico,Alicja Kałdunska,Łukasz Pałka,Agata Kamińska

doi:10.3390/app11093764

Bartosz Dalewski, Ewa Sobolewska + Show 4 more

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https://doi.org/10.3390/app11093764

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Abstract

Background: Obstructive sleep apnea (OSA) is a condition causing restriction of the airflow through the upper airways during sleep, despite preserved inspiratory muscle activity. This may lead to the development of secondary hypertension, ischemic heart disease, myocardial infarction, and arrhythmia. Moreover, the prevalence of OSA is on the rise. Methods: Comparison of scores from the Berlin Questionnaire, modified Mallampati scores (MMP), pulse oximetry readings and Upper Airway Volume (UAV) data obtained from CBCT (Cone Beam Computed Tomography). The study group of 129 patients of both sexes reporting sleep-related breathing problems completed the Berlin Questionnaire, had their oxygen saturation (SpO2) measured with a PO40 pulse oximeter, and oropharyngeal tissues assessed according to MMP. CBCT scans were put into 3D Amira TM 3D computer analysisto obtain UAV values. Results: Snoring was associated with significantly higher BMI compared to non-snoring patients. Furthermore, snoring patients had higher heart rate, modified Mallampati score, and lower UAV than the non-snoring group. The multifactorial analysis showed MMP as a useful indicator of the risk of snoring (OR = 7.468 (3863–14, 507, p < 0.001)). Conclusions: The composition of MMP together with UAV and the Berlin questionnaire might be reliable indicators to assess the risk of snoring.

Highlights

It is characterized by repeated episodes of complete or partial obstruction of the upper airways during sleep, with preserved inspiratory muscle activity [3,4,5]
The aim of this study was to estimate the usefulness and value of combined diagnostic tools like modified Mallampati scores (MMP) and upper airway volume (UAV) in diagnosing high risk Obstructive sleep apnea (OSA) among patients reporting breathing problems during sleep treated in the Prosthetics Outpatient Clinic, Pomeranian Medical
The questions in Berlin Questionnaire are divided into three categories: the first five relate to sleep, the following 4 questions are used to determine the degree of daytime sleepiness, and the last question refers to the presence of concomitant hypertension [20]

Summary

Introduction

Snoring is a harsh and buzzing noise produced by the vibration of the respiratory structures, primarily with inspiration during sleep When it is present at least three nights per week, it may be associated with OSA [2]. It is characterized by repeated episodes of complete or partial obstruction of the upper airways during sleep, with preserved inspiratory muscle activity [3,4,5]. Obstructive sleep apnea (OSA) is a condition causing restriction of the airflow through the upper airways during sleep, despite preserved inspiratory muscle activity. This may lead to the development of secondary hypertension, ischemic heart disease, myocardial infarction, and arrhythmia.

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