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Evaluation of the Upper Airway in Patients with Obstructive Sleep Apnea
Journal article   Open access

Evaluation of the Upper Airway in Patients with Obstructive Sleep Apnea

John W Shepard, Warren B Gefter, Christian Guilleminault, Eric A Hoffman, Victor Hoffstein, David W Hudgel, Paul M Suratt and David P White
Sleep (New York, N.Y.), Vol.14(4), pp.361-371
07/1991
DOI: 10.1093/sleep/14.4.361
PMID: 1947602
url
https://doi.org/10.1093/sleep/14.4.361View
Published (Version of record) Open Access

Abstract

Multiple methods have been used to study the structure and physiological behavior of the upper airway (UA) in patients with obstructive sleep apnea (OSA). Valuable information may be obtained from the physiologic measurement of pressure and resistance along the UA, as well as from imaging techniques that include: direct or fiberoptic visualization, cephalometric roentgenograms, fluoroscopy, acoustic reflection, computerized tomography, and magnetic resonance imaging. This review summarizes the information that each of these methods has contributed to our understanding of the UA. The results obtained with these different methodologies have generally been complementary with structural narrowing being identified in the majority of patients with OSA. This narrowing is usually focal and located in the velopharyngeal or retropalatal segment of the UA. This is also the predominant site of initial UA collapse. Although obesity with enlargement of soft tissue structures is considered the predominant mechanism leading to UA narrowing, abnormal craniofacial development on a genetic or developmental basis plays an important contributory role.

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