Acoustic pharyngometry: clinical and instrumental correlations in sleep disorders

Matteo Gelardi, Alessandro Maselli Del Giudice, Francesco Cariti, Michele Cassano, Aline Castelante Farras, Maria Luisa Fiorella, Pasquale Cassano, Matteo Gelardi, Alessandro Maselli Del Giudice, Francesco Cariti, Michele Cassano, Aline Castelante Farras, Maria Luisa Fiorella, Pasquale Cassano

Abstract

Acoustic Pharyngometry is a modern diagnostic method based on physical principle of acoustic reflection. It is useful for volume analysis of oro-pharyngo-laryngeal spaces.

Aim: To evaluate variations of pharyngometric parameters in patients with sleep disorders and to establish a correlation between morpho-volumetric variations of oro-pharyngo-laryngeal spaces and the presence and severity of disease.

Study design: a clinical and experimental study.

Material and method: 110 patients, of which 70 with sleep disorders and 40 healthy patients as a control group, were analysed between June 2004 and June 2005. All patients underwent acoustic pharyngometry to evaluate the mouth and hypopharynx based on an explanatory chart.

Results: A significant difference in parameters was observed between sleep disorder patients and the control group, especially in the amplitude of the I wave (significantly lower in patients with macroglossia), the extension of the O-F segment, and the amplitude of the O-F segment and hypopharyngeal area.

Conclusion: Although not a standardized test, acoustic pharyngometry was proved to be a useful method both in the diagnosis and severity of obstructive sleep apnea, and in post-operative monitoring of upper airway surgery in patients with sleep disorders.

Figures

Figure 1
Figure 1
Pharyngometer (device)
Figure 2
Figure 2
The exam
Figure 3
Figure 3
Outline of acoustic pharyngometry
Figure 4A
Figure 4A
Pharyngogram: morphology
Figure 4B
Figure 4B
Pharyngogram: corresponding anatomical sites
Figure 5A
Figure 5A
Main pharyngometric parameters
Figure 5B
Figure 5B
Pharyngogram
Figure 6
Figure 6
Correlation between anthropometric parameters and the severity of SDB.
Figure 7
Figure 7
Wave I amplitude in normal subjects and patients with disease
Figure 8
Figure 8
Pharyngometric parameters in normal subjects and patients with disease
Figure 9
Figure 9
Wave I decrease in patients with macroglossia
Figure 10
Figure 10
Increased OF segment in patients with redundant soft palate and uvular hypertrophy.
Figure 11
Figure 11
Decreased OF segment amplitude and reduction of the hypopharynx in patients with redundant soft palate, uvular hypertrophy, and reduced cross-sectional area of the hypopharynx.
Figure 12
Figure 12
Increased OF segment with a relative reduction of the OF point amplitude. Decreased hypoglottic area in patients with redundant soft palate, uvular hypertrophy, and reduced cross-sectional area of the hypopharynx.

References

    1. Sidell R, Fredberg JJ. Non invasive inference of airway network geometry from broadband lung reflection data. J Biomech Eng. 1978;100:131–138.
    1. Gosepath J, Belafsky P, Kaldebanch T, Rolfe KW, Mann WJ, Ronald G, Amedee RG. The use of acustic rhinometry in predicting outcomes after sinonasal surgery. Am J Rhinol. 2000;14(2):97–100.
    1. Hoffstein V, Fredberg JJ. The acoustic reflection technique for non invasive assessment of upper airway area. Europ Resp J. 1991;4(5):602–611.
    1. Kamal I. Normal standart curve for acoustic pharyngometry. Otolaryngol Head Neck Surg. 2001;124(3):323–330.
    1. Fredberg JJ, Wohl MB, Glass GM, Dorkin LH. Airway area by acoustic reflection measured at the mouth. Environ Exercise Physiol. 1980;48(5):749–758.
    1. Fujita S. In: Snoring and obstructive sleep apnea. 2nd edition. DN Fairbanks, Fujita S., editors. Raven press; NY: 1994. Pharyngeal surgery for obstructive sleep apnea and snoring. pp. 77–96.
    1. Bradley TD, Philipson EA. Pathogenesis and Pathophysiology of obstruction sleep apnea syndrome. Med Clin North Am. 1985;69:1169–1171.
    1. Brooks LJ, castile RG, Glass GM, Griscom NT, Wohl ME, Fredberg JJK. Reproducibility and accuracy of airway area by acoustic reflection. J Appl Physiol: Environ Exercise Physiol. 1984;57(3):777–787.
    1. Bradley TD, Brown IG, Grossmann RF, Zamel N, Martinez D, Philipson EA, Hoffstein V. Pharyngeal size in snorers, nonsnorers and patient with obstructive sleep apnea. N Engl J Med. 1986;315:1327–1331.
    1. Olsen KD, Kern EB. Nasal influences on snoring and obstructive sleep apnea. Mayo Clin Proc. 1990;65:1095–1105.
    1. Young T, Finn L, Kim H. Nasal obstruction as a risk factor for spleep apnea disordered breathing. J Allergy Clin Immunol. 1997;99:757–762.
    1. Brown IG, Zamel N, Hoffstein V. Pharyngeal cross-sectional area in normal man and women. J Appl Physiol. 1986;61(3):890–895.
Uncited Reference
    1. D'Urzo AD, Rubinstein I, Lavson VG, Vassal KT, Rebuck SS, Slutsky AS, et al. Comparison of glottic areas measured by acoustic reflections vs. computerized tomography. J Appl Physiol. 1988;64:367–370.
    1. Rivlin J, Hoffstein V, Kalbfleish J. Upper airway morphology in patient with obstrutive sleep apnee. Am Rev Respir Dis. 1984;129:355–360.
    1. Boccio CM, Chinski A. Obstructive sleep apnea sindrome in children In: Manual of Pediatric Otorhinolaryngology, IAPO/IFOS - Liz Gráfica Editora; 2001. p.37-42

Source: PubMed

Sponsorer och medarbetare

Medicinska tillstånd

Läkemedelsinterventioner

3
Prenumerera