Skip to main content
Log in

Lingua–epiglottis position predicts glossopharyngeal obstruction in patients with obstructive sleep apnea hypopnea syndrome

  • Laryngology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

The objective of the study was to investigate the relationship between lingua–epiglottis position and glossopharyngeal obstruction in patients with obstructive sleep apnea hypopnea syndrome (OSAHS). One hundred and four patients with OSAHS diagnosed by polysomnography (PSG) were enrolled. Lingua–epiglottis position was visualized using endoscopy and classified into three types. Spiral CT imaging of the upper respiratory tract was performed to measure the cross-sectional area and inner diameter of the glossopharyngeal airway. The PSG was repeated after nasopharyngeal tube insertion (NPT-PSG). The NPT-PSG results, CT-measured data and incidence of stenosis were compared among the different lingua–epiglottis position groups. Obstructive sleep apnea hypopnea syndrome patients with different lingua–epiglottis positions had similar demographics. As lingua–epiglottis position type varied from type I to type III, cross-sectional area and inner diameter of the glossopharyngeal area decreased, glossopharyngeal airway stenosis rate increased, and apnea hypopnea index measured by NPT-PSG increased. The lowest oxygen saturation decreased. Lingua–epiglottis position was significantly related to glossopharyngeal obstruction. Lingua–epiglottis position should be used in clinical practice for the preliminary assessment of glossopharyngeal obstruction.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Isono S, Remmers JE (1994) Anatomy and physiology of upper airway obstruction. In: Kryger HH (ed) Principles and practice of sleep medicine, 2nd edn. Saunders, Philadelphia, pp 642–656

    Google Scholar 

  2. Tanyeri H, Serin GM, Ayanoglu EA, Polat S, Cuhadaroglu C (2013) Effect of uvulopalatopharyngoplasty on retropalatal region. Eur Arch Otorhinolaryngol 270(3):1161–1165

    Article  PubMed  Google Scholar 

  3. Braga A, Carboni LH, do Lago T, Kipper DS, Eckeli A, Valera FC (2013) Is uvulopalatopharyngoplasty still an option for the treatment of obstructive sleep apnea? Eur Arch Otorhinolaryngol 270(2):549–554

    Article  PubMed  Google Scholar 

  4. Friedman M, Ibrahim H, Joseph NJ (2004) Staging of obstructive sleep apnea/hypopnea syndrome: a guide to appropriate treatment. Laryngoscope 114(3):454–459

    Article  PubMed  Google Scholar 

  5. Soares D, Folbe AJ, Yoo G, Badr MS, Rowley JA, Lin HS (2013) Drug-induced sleep endoscopy vs awake Muller’s maneuver in the diagnosis of severe upper airway obstruction. Otolaryngol Head Neck Surg 148(1):151–156

    Article  PubMed  Google Scholar 

  6. Singh A, Al-Reefy H, Hewitt R, Kotecha B (2008) Evaluation of ApneaGraph in the diagnosis of sleep-related breathing disorders. Eur Arch Otorhinolaryngol 265(12):1489–1494

    Article  PubMed  Google Scholar 

  7. Demin H, Jingying Y, Jun W, Qingwen Y, Yuhua L, Jiangyong W (2002) Determining the site of airway obstruction in obstructive sleep apnea with airway pressure measurements during sleep. Laryngoscope 112(11):2081–2085

    Article  PubMed  Google Scholar 

  8. Bachar G, Nageris B, Feinmesser R, Hadar T, Yaniv E, Shpitzer T, Eidelman L (2012) Novel grading system for quantifying upper-airway obstruction on sleep endoscopy. Lung 190(3):313–318 (Epub 2012 Jan 20)

    Article  PubMed  Google Scholar 

  9. Tang XL, Yi HL, Luo HP, Xiong YP, Meng LL, Guan J, Chen B, Yin SK (2012) The application of CT to localize the upper airway obstruction plane in patients with OSAHS. Otolaryngol Head Neck Surg 147(6):1148–1153

    Article  PubMed  Google Scholar 

  10. Li S, Dong X, Shi H, Dong W, Qu S, Chen D, Wang G, Bao J (2002) Localization of upper airway stricture in patients with obstructive sleep apnea syndrome by CT scan. Chin J Otorhinolaryngol 37(2):133–136 (Chinese)

    Google Scholar 

  11. Li S, Shi H (2013) Lingual artery CTA-guided midline partial glossectomy for treatment of obstructive sleep apnea hypopnea syndrome. Acta Otolaryngol 133(7):749–754

    Article  PubMed  Google Scholar 

  12. Iber C, Ancoli-Israel S, Chesson AL, Quan SF (2007) The AASM manual for the scoring of sleep and associated events: rules, terminology and technical specifications. American Academy of Sleep Medicine, Westchester, p 57

    Google Scholar 

  13. Li SH, Wu DH, Bao JM, Shi HJ (2013) Outcomes of upper airway reconstructive surgery for obstructive sleep apnea syndrome based on polysomnography after nasopharyngeal tube insertion. Chin Med J (Engl) 126(24):4674–4678

    Google Scholar 

  14. Li S, Wu D, Shi H (2013) Treatment of obstructive sleep apnea hypopnea syndrome caused by glossoptosis with tongue-base suspension. Eur Arch Otorhinolaryngol 270(11):2915–2920

    Article  PubMed  Google Scholar 

  15. Soares D, Sinawe H, Folbe AJ, Yoo G, Badr S, Rowley JA, Lin HS (2012) Lateral oropharyngeal wall and supraglottic airway collapse associated with failure in sleep apnea surgery. Laryngoscope 122(2):473–479

    Article  PubMed  Google Scholar 

  16. Li SH, Shi HJ, Wu DH, Dong WD, Zou LG, Liu R (2007) Relationship of lingual region upper airway stricture and lingua–palate position type in obstructive sleep apnea hypopnea syndrome patients. Chin J Otorhinolaryngol 42(12):910–914 (Chinese)

    Google Scholar 

Download references

Acknowledgments

No financial disclosures.

Conflict of interest

None.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Shuhua Li.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Li, S., Wu, D., Jie, Q. et al. Lingua–epiglottis position predicts glossopharyngeal obstruction in patients with obstructive sleep apnea hypopnea syndrome. Eur Arch Otorhinolaryngol 271, 2737–2743 (2014). https://doi.org/10.1007/s00405-014-3033-3

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-014-3033-3

Keywords

Navigation