https://orcid.org/0000-0001-9730-1798
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Abstract
Introduction
Current diagnostic routines in obstructive sleep apnea syndrome (OSAS), including drug-induced sleep endoscopy (DISE), provide qualitative data. Quantitative morphometric measurements of oropharyngeal structures remain challenging. This study aims to introduce a special linear laser projection device that can facilitate computer-assisted digitalized analysis and provide important quantitative information for OSAS prediction.
Materials and Methods
We used a single-wavelength green three-linear laser to provide the scaling reference, with one at an angle of 8.5 degrees with the other two which were parallel. The oropharyngeal images were divided into two groups: the non-OSAS and OSAS group, after polysomnography. A minimum of three evaluations were carried out to determine the maximum cross-sectional area of the oropharyngeal inlet (CSAOI) and the retropalatal depth.
Results
A total of 132 subjects were enrolled in this study, with 76 subjects in the non-OSAS group and 56 cases in the OSAS group. In the non-OSAS group, the CSAOI was significantly larger in males than in females. There was a trend toward deeper retropalatal region in men than in women (14.25 vs 11.76 mm). Correlation analysis revealed that retropalatal depth is significantly related to body height and the CSAOI. The body weight and BMI of patients with OSAS were significantly higher than those of participants without OSAS. The retropalatal depth and CSAOI were significantly decreased in OSAS patients as compared to those without OSAS. Our new parameter, the oropharyngeal index, showed the most outstanding discrimination by ROC analysis to predict OSAS.
Conclusion
Our innovative module can provide reference parameters, which make it possible to directly estimate the objective absolute values of relevant oropharyngeal structures. Our non-invasive approach can be used for outpatient screening, since it allows the identification of potential OSAS patients who should be referred for polysomnography, as many patients do not require DISE early in their evaluation.
Data Sharing Statement
The datasets generated from this study are available from the corresponding author on reasonable request.
Ethical Considerations
The research protocol (NO: 1-108-05-132) has been reviewed and approved by the Institutional Review Board of Tri-Service General Hospital.
Consent for Publication
Written informed consent to publish has been obtained from all participants (including the healthy volunteers), and this study complied with the Declaration of Helsinki.
Acknowledgments
The research was supported by Tri-Service General Hospital, National Defense Medical Center-National Taiwan University of Science and Technology Joint Research Program (TSGH-D-109054, TSGH-NTUST-107-01).
Author Contributions
All authors have agreed on the journal to which the article will be submitted.
All authors have reviewed and agreed on all versions of the article before submission, during revision, the final version accepted for publication, and any significant changes introduced at the proofing stage.
All authors agree to take responsibility and be accountable for the contents of the article.
The specific role of each author are as follows:
1. Chung-Feng Jeffrey Kuo, PhD: study design, critical article review/editing.
2. Chun-Shu Lin: data analysis and interpretation, article and images review/editing.
3. Cheng-Hsien Chuang: acquisition of data, image editing, article drafting
4. Chung-Shen Lin, MD: acquisition of data, critical article review/editing.
5. Feng-Shiang Chiu: acquisition of data, critical article review/editing.
6. Shao-Cheng Liu, MD, PhD: study design, data collection, literature search, image editing, article drafting, article submission.
Disclosure
The authors report no conflicts of interest for this work and have no interests that might be perceived to influence the results and/or discussion reported in this paper.