Characteristics and Mechanism of Upper Airway Collapse Revealed by Dynamic MRI During Natural Sleep in Patients with Severe Obstructive Sleep Apnea
Yuqi Li,1,2,* Changjin Ji,1,2,* Weiao Sun,1,2 Huahui Xiong,1,2 Zheng Li,3 Xiaoqing Huang,1,2 Tingting Fan,1,2 Junfang Xian,3 Yaqi Huang1,2 1School of Biomedical Engineering, Capital Medical University, Beijing, People’s Republic of China; 2Beijing Key Laboratory of Fundamental Resear...
| Main Authors: | , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Dove Medical Press
2023-11-01
|
| Series: | Nature and Science of Sleep |
| Subjects: | |
| Online Access: | https://www.dovepress.com/characteristics-and-mechanism-of-upper-airway-collapse-revealed-by-dyn-peer-reviewed-fulltext-article-NSS |
| _version_ | 1797643766134210560 |
|---|---|
| author | Li Y Ji C Sun W Xiong H Li Z Huang X Fan T Xian J Huang Y |
| author_facet | Li Y Ji C Sun W Xiong H Li Z Huang X Fan T Xian J Huang Y |
| author_sort | Li Y |
| collection | DOAJ |
| description | Yuqi Li,1,2,* Changjin Ji,1,2,* Weiao Sun,1,2 Huahui Xiong,1,2 Zheng Li,3 Xiaoqing Huang,1,2 Tingting Fan,1,2 Junfang Xian,3 Yaqi Huang1,2 1School of Biomedical Engineering, Capital Medical University, Beijing, People’s Republic of China; 2Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, People’s Republic of China; 3Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yaqi Huang, School of Biomedical Engineering, Capital Medical University, Beijing, People’s Republic of China, Tel +86-10-83911809, Email yqhuang@ccmu.edu.cn Junfang Xian, Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China, Email cjr.xianjunfan@vip.163.comPurpose: Upper airway collapse during sleep in patients with obstructive sleep apnea (OSA) is a complex and dynamic phenomenon. By observing and analyzing the dynamic changes in the upper airway and its surrounding tissues during airway obstruction, we aim to reveal dynamic characteristics in different obstruction patterns, and the relationship between anatomical features during normal breathing and dynamic characteristics of airway obstruction.Patients and Methods: Dynamic MRI was performed in 23 male patients (age range 26– 63) with severe OSA diagnosed by overnight polysomnography, and obstruction events were identified from their images. Dynamic changes in parameters of the upper airway and surrounding tissues were measured to assess the key characteristics in different obstruction patterns.Results: We categorized airway obstruction into four types based on the obstruction location and motion characteristics of tissues during collapse, and detailed the alterations in the airway and surrounding tissues under each obstruction pattern. In all 112 obstruction events extracted from the dynamic images of 23 patients, type A (retropalatal obstruction caused by the soft palate separated from the tongue), BI, BII (both retropalatal obstructions caused by the soft palate attached to the tongue, and C (retropalatal and retroglossal obstruction caused by the soft palate and the tongue), accounted for 28.6%, 44.6%, 12.5%, and 14.3% respectively. In severe OSA patients with tongue and palatal obstruction related to type B or C, the more posterior hyoid position, shorter distance between tongue and uvula, and wider retropalatal space, the larger the tongue displacement and deformation during collapse, and the greater the reduction in airway space.Conclusion: There are multiple airway obstruction patterns, each with its own anatomical characteristics and behaviors during collapse. Hyoid position, tongue and uvula distance, and retropalatal space play an important role in airway collapse and should be paid more attention in the treatment of OSA.Keywords: airway obstruction patterns, obstruction location, tissue motion characteristics, hyoid position, retropalatal space |
| first_indexed | 2024-03-11T14:20:47Z |
| format | Article |
| id | doaj.art-d4ac29df8bc8446793caf3ab29ca552b |
| institution | Directory Open Access Journal |
| issn | 1179-1608 |
| language | English |
| last_indexed | 2024-03-11T14:20:47Z |
| publishDate | 2023-11-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Nature and Science of Sleep |
| spelling | doaj.art-d4ac29df8bc8446793caf3ab29ca552b2023-10-31T17:33:54ZengDove Medical PressNature and Science of Sleep1179-16082023-11-01Volume 1588590287773Characteristics and Mechanism of Upper Airway Collapse Revealed by Dynamic MRI During Natural Sleep in Patients with Severe Obstructive Sleep ApneaLi YJi CSun WXiong HLi ZHuang XFan TXian JHuang YYuqi Li,1,2,* Changjin Ji,1,2,* Weiao Sun,1,2 Huahui Xiong,1,2 Zheng Li,3 Xiaoqing Huang,1,2 Tingting Fan,1,2 Junfang Xian,3 Yaqi Huang1,2 1School of Biomedical Engineering, Capital Medical University, Beijing, People’s Republic of China; 2Beijing Key Laboratory of Fundamental Research on Biomechanics in Clinical Application, Capital Medical University, Beijing, People’s Republic of China; 3Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yaqi Huang, School of Biomedical Engineering, Capital Medical University, Beijing, People’s Republic of China, Tel +86-10-83911809, Email yqhuang@ccmu.edu.cn Junfang Xian, Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, People’s Republic of China, Email cjr.xianjunfan@vip.163.comPurpose: Upper airway collapse during sleep in patients with obstructive sleep apnea (OSA) is a complex and dynamic phenomenon. By observing and analyzing the dynamic changes in the upper airway and its surrounding tissues during airway obstruction, we aim to reveal dynamic characteristics in different obstruction patterns, and the relationship between anatomical features during normal breathing and dynamic characteristics of airway obstruction.Patients and Methods: Dynamic MRI was performed in 23 male patients (age range 26– 63) with severe OSA diagnosed by overnight polysomnography, and obstruction events were identified from their images. Dynamic changes in parameters of the upper airway and surrounding tissues were measured to assess the key characteristics in different obstruction patterns.Results: We categorized airway obstruction into four types based on the obstruction location and motion characteristics of tissues during collapse, and detailed the alterations in the airway and surrounding tissues under each obstruction pattern. In all 112 obstruction events extracted from the dynamic images of 23 patients, type A (retropalatal obstruction caused by the soft palate separated from the tongue), BI, BII (both retropalatal obstructions caused by the soft palate attached to the tongue, and C (retropalatal and retroglossal obstruction caused by the soft palate and the tongue), accounted for 28.6%, 44.6%, 12.5%, and 14.3% respectively. In severe OSA patients with tongue and palatal obstruction related to type B or C, the more posterior hyoid position, shorter distance between tongue and uvula, and wider retropalatal space, the larger the tongue displacement and deformation during collapse, and the greater the reduction in airway space.Conclusion: There are multiple airway obstruction patterns, each with its own anatomical characteristics and behaviors during collapse. Hyoid position, tongue and uvula distance, and retropalatal space play an important role in airway collapse and should be paid more attention in the treatment of OSA.Keywords: airway obstruction patterns, obstruction location, tissue motion characteristics, hyoid position, retropalatal spacehttps://www.dovepress.com/characteristics-and-mechanism-of-upper-airway-collapse-revealed-by-dyn-peer-reviewed-fulltext-article-NSSairway obstruction patternsobstruction locationtissue motion characteristicshyoid positionretropalatal space |
| spellingShingle | Li Y Ji C Sun W Xiong H Li Z Huang X Fan T Xian J Huang Y Characteristics and Mechanism of Upper Airway Collapse Revealed by Dynamic MRI During Natural Sleep in Patients with Severe Obstructive Sleep Apnea Nature and Science of Sleep airway obstruction patterns obstruction location tissue motion characteristics hyoid position retropalatal space |
| title | Characteristics and Mechanism of Upper Airway Collapse Revealed by Dynamic MRI During Natural Sleep in Patients with Severe Obstructive Sleep Apnea |
| title_full | Characteristics and Mechanism of Upper Airway Collapse Revealed by Dynamic MRI During Natural Sleep in Patients with Severe Obstructive Sleep Apnea |
| title_fullStr | Characteristics and Mechanism of Upper Airway Collapse Revealed by Dynamic MRI During Natural Sleep in Patients with Severe Obstructive Sleep Apnea |
| title_full_unstemmed | Characteristics and Mechanism of Upper Airway Collapse Revealed by Dynamic MRI During Natural Sleep in Patients with Severe Obstructive Sleep Apnea |
| title_short | Characteristics and Mechanism of Upper Airway Collapse Revealed by Dynamic MRI During Natural Sleep in Patients with Severe Obstructive Sleep Apnea |
| title_sort | characteristics and mechanism of upper airway collapse revealed by dynamic mri during natural sleep in patients with severe obstructive sleep apnea |
| topic | airway obstruction patterns obstruction location tissue motion characteristics hyoid position retropalatal space |
| url | https://www.dovepress.com/characteristics-and-mechanism-of-upper-airway-collapse-revealed-by-dyn-peer-reviewed-fulltext-article-NSS |
| work_keys_str_mv | AT liy characteristicsandmechanismofupperairwaycollapserevealedbydynamicmriduringnaturalsleepinpatientswithsevereobstructivesleepapnea AT jic characteristicsandmechanismofupperairwaycollapserevealedbydynamicmriduringnaturalsleepinpatientswithsevereobstructivesleepapnea AT sunw characteristicsandmechanismofupperairwaycollapserevealedbydynamicmriduringnaturalsleepinpatientswithsevereobstructivesleepapnea AT xiongh characteristicsandmechanismofupperairwaycollapserevealedbydynamicmriduringnaturalsleepinpatientswithsevereobstructivesleepapnea AT liz characteristicsandmechanismofupperairwaycollapserevealedbydynamicmriduringnaturalsleepinpatientswithsevereobstructivesleepapnea AT huangx characteristicsandmechanismofupperairwaycollapserevealedbydynamicmriduringnaturalsleepinpatientswithsevereobstructivesleepapnea AT fant characteristicsandmechanismofupperairwaycollapserevealedbydynamicmriduringnaturalsleepinpatientswithsevereobstructivesleepapnea AT xianj characteristicsandmechanismofupperairwaycollapserevealedbydynamicmriduringnaturalsleepinpatientswithsevereobstructivesleepapnea AT huangy characteristicsandmechanismofupperairwaycollapserevealedbydynamicmriduringnaturalsleepinpatientswithsevereobstructivesleepapnea |