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Analysis of the cause of retrolingual obstruction in patients with moderate–severe obstructive sleep apnea

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Abstract

Purpose

To evaluate the percentage of obstructive sleep apnea (OSA) patients with retrolingual obstruction in all moderate–severe OSA patients and the proportions of different causes in all moderate–severe OSA patients with retrolingual obstruction and to discuss the accuracy of the Friedman tongue position (FTP) and retrolingual cross-sectional area (RCSA) in assessing the retrolingual obstruction.

Methods

Two hundred and twenty moderate–severe OSA patients were enrolled. After retrolingual obstruction was diagnosed, the percentage of OSA patients with retrolingual obstruction in all moderate–severe OSA patients was calculated. After that, the different causes of retrolingual obstruction were diagnosed based on different diagnostic criteria, and the proportions of different causes in all moderate–severe OSA patients with retrolingual obstruction were calculated. Finally, the correlations between FTP, RCSA, and apnea–hypopnea index after nasopharyngeal tube insertion (NPT-AHI) were analyzed, and the proportions of different causes of retrolingual obstruction based on different FTP and RCSA were observed.

Results

There were 128 patients with retrolingual obstruction, accounting for 58.2% of all moderate–severe OSA patients. In 128 patients with retrolingual obstruction, the proportions of glossoptosis (48.4%), palatal tonsil hypertrophy (28.1%), and lingual hypertrophy (8.6%) were relatively high. Both FTP and RCSA did not correlate with NPT-AHI. The proportion of lingual hypertrophy increased gradually with the increase of FTP and the proportions of glossoptosis in all FTP classifications were high. The patients with RCSA > 180 mm2 were mainly affected by glossoptosis and palatal tonsil hypertrophy, while patients with RCSA ≤ 180 mm2 were mainly affected by lingual hypertrophy.

Conclusion

The percentage of patients with retrolingual obstruction in all moderate–severe OSA patients is relatively high, mainly glossoptosis, palatal tonsil hypertrophy, and lingual hypertrophy. FTP classification and RCSA can only reflect the retrolingual anatomical stenosis, but cannot fully reflect the retrolingual functional stenosis, especially the presence of glossoptosis.

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Data availability

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

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Authors and Affiliations

  1. Postgraduate Training Base of Jinzhou Medical University in the General Hospital of Northern Theater Command, Jinzhou, 121013, Liaoning, China

    Wanting Gao

  2. Department of Otolaryngology, General Hospital of Northern Theater Command, No.83, Wenhua Road, Shenhe District, Shenyang, 110016, China

    Wanting Gao, Jie Qin, Chenhai Zheng, Shuhua Li & Dahai Wu

  3. Outpatient Department of Fuxing Road, Jingnan Medical District, PLA General Hospital, Beijing, China

    Lei Shi

  4. Department of Medical Information Center, General Hospital of Northern Theater Command, Shenyang, China

    Dengxiang Xing

Authors
  1. Wanting Gao
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  2. Lei Shi
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  4. Jie Qin
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Correspondence to Dahai Wu.

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Ethical approval

This study was approved by the Institutional Review Board of General Hospital of Northern Theater Command (Y (2022) 020).

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Due to the retrospective nature of this study, the need for informed consent was waived.

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Gao, W., Shi, L., Xing, D. et al. Analysis of the cause of retrolingual obstruction in patients with moderate–severe obstructive sleep apnea. Eur Arch Otorhinolaryngol 281, 1031–1039 (2024). https://doi.org/10.1007/s00405-023-08333-x

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