Journal article
Upper airway and soft tissue anatomy in normal subjects and patients with sleep-disordered breathing : significance of the lateral pharyngeal walls
American journal of respiratory and critical care medicine, Vol.152(5), pp.1673-1689
1995
DOI: 10.1164/ajrccm.152.5.7582313
PMID: 7582313
Abstract
The geometry and caliber of the upper airway in apneic patients differs from those in normal subjects. The apneic airway is smaller and is narrowed laterally. Examination of the soft tissue structures surrounding the upper airway can lead to an understanding of these apneic airway dimensional changes. Magnetic resonance imaging was utilized to study the upper airway and surrounding soft tissue structures in 21 normal subjects, 21 snorer/mild apneic subjects, and 26 patients with obstructive sleep apnea. The major findings of this investigation in the 68 subjects were as follows: (1) minimum airway area was significantly smaller in apneic compared with normal subjects and occurred in the retropalatal region; (2) airway narrowing in apneic patients was predominantly in the lateral dimension; there was no significant difference in the anterior-posterior (AP) airway dimension between subject groups; and (3) distance between the rami of the mandible was equal between subject groups, and thus the narrowing of the lateral dimension was not explained by differences in bony structure; (4) lateral air way narrowing was explained predominantly by larger lateral pharyngeal walls in apneic patients (the parapharyngeal fat pads were not closer together as one would expect if the airway walls were compressed by fat); and (5) fat pad size at the level of the minimum airway was not greater in apneic than normal subjects. At the minimum airway area, thickness of the lateral pharyngeal muscular walls rather than enlargement of the parapharyngeal fat pads was the predominant anatomic factor causing airway narrowing in apneic subjects.
Details
- Title: Subtitle
- Upper airway and soft tissue anatomy in normal subjects and patients with sleep-disordered breathing : significance of the lateral pharyngeal walls
- Creators
- R. J Schwab - University of PennsylvaniaK. B Gupta - Univ. Pennsylvania medical cent., dep. medicine, pulmonary critical care div., Philadelphia PA 19104-4283, United StatesW. B Gefter - University of PennsylvaniaL. J Metzger - Univ. Pennsylvania medical cent., dep. medicine, pulmonary critical care div., Philadelphia PA 19104-4283, United StatesE. A Hoffman - University of PennsylvaniaA. I Pack - University of Pennsylvania
- Resource Type
- Journal article
- Publication Details
- American journal of respiratory and critical care medicine, Vol.152(5), pp.1673-1689
- Publisher
- American Lung Association
- DOI
- 10.1164/ajrccm.152.5.7582313
- PMID
- 7582313
- ISSN
- 1073-449X
- eISSN
- 1535-4970
- Language
- English
- Date published
- 1995
- Academic Unit
- Roy J. Carver Department of Biomedical Engineering; Radiology; Internal Medicine
- Record Identifier
- 9984318814502771
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