MEASUREMENT OF THE CROSS-SECTIONAL AREA OF THE PHARYNX USING COMPUTED TOMOGRAPHY IN OBSTRUCTIVE SLEEP APNEA PATIENTS
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The present study was designed to apply computed tomography (Cl? scanning for the positional diagnosis of airway obstruction in patients with obstructive sleep apnea (OSA) and to compare the apnea index (Al) and the square measure of the pharynx obtained before and after uvulopalatopharyngoplasty (UPPP) and included 25 adult patients complained of snoring and symptoms of OSA. CT imaging of the patients was performed at nasopharynx and oropharynx levels and measurements (saggitat and coronal dimensions) were obtained and the cross-sectional area was calculated. At 6 weeks postoperatively, all patients underwent postoperative CT scanning and the same measurements were obtained at the same level. All patients complained of day-time sleepiness and snoring and being mouth breathers night-sleep and. Nine (47.4%) of the male patients complained of erectile dysfunction. Preoperative apnea index was determined for all patients and was ranging between 13 and 42; mean AI=27.4-9.2. Postoperatively, 14 patients (56%) had improvement in snoring during night sleep with disappearance of mouth breathing. On contrary, only two meth's reported improvement of their erectile dysfunction. Subjectively, 16 patients (64%) had Aft 10 while 9 patients (36%) still having Al>10. Preoperative determincition of cross-sectional area using CT showed sensitivity for defining cases with OSA of 90% and accuracy of diagnosis being 92%, and is the most specific data obtained by CT scanning (specificity and PPV=100%). Moreover, there was a negative sig- . nificarit con-elation between Al and cross-sectional area, (r=-0.749, P<0.001). Postoperative CT scan data showed a significant (P<0.00.1) in- 1031 Ashraf AI-Hamshry et al.... crease in both dimensions and in the cross-sectional area compared to the preoperative values. It can be conch (tied that CT imaging of the pharynx at the levels of nasopharynx and oropharynx and defining the crosssectional area coincide with the severity of OSA and could precisely predict the surgical outcome.