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-
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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. |
