Conclusions

Upper airway imaging techniques employed to study the human upper airway have significantly advanced our understanding of OSA. Important determinants of airway geometry have been identified: volume of tongue, lateral pharyngeal wall thickness, and total amount of soft tissue surrounding the airway. The sleep apneic airway has been characterized as an elliptical or circular shape that is oriented in the anteroposterior axis. Static imaging studies have shown that soft tissue and cranio-facial structures are influenced by important factors such as body mass, neck circumference, gender, and genetics. The effects of sleep apnea treatments have also been clarified through imaging techniques. Upper airway imaging is not routinely indicated in the assessment of a sleep apnea patient. If CPAP therapy is efficacious, then upper airway imaging is not warranted. However, imaging does have role in the preoperative (and postoperative) evaluation of patients undergoing upper airway surgery to characterize the airway geometry. The likelihood of success of UPPP is related to the site of airway obstruction and this can be assessed by MRI (preferably three-dimensional) or by nasopharyngoscopy with the M├╝ller maneuver. Imaging should also be considered when utilizing an oral appliance to determine if upper airway caliber increases with the appliance (especially if the AHI does not improve). Upper airway imaging studies have provided important new insights into the pathogenesis, genetics, and treatment of OSA.

Sleep Apnea

Sleep Apnea

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