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Volume 20, Issue 1
  • ISSN: 1573-4056
  • E-ISSN: 1875-6603
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Abstract

Background

Obstructive sleep apnea syndrome (OSAS) can cause sudden death during sleep. Previous findings have suggested that OSAS development is related to maxillofacial morphology. Evaluation of facial morphology can determine the risk of developing the disease, and establishing an objective method to assess the underlying etiology of OSAS-related death would be advantageous.

Objective

The objective of this study is to determine the key features of obstructive sleep apnea syndrome (OSAS) using postmortem oral and pharyngeal computed tomography (CT).

Methods

We retrospectively assessed autopsy cases of patients with (n=25) and without (n=25) OSAS-related death. We used oral and pharyngeal CT images to compare the oral and pharyngeal cavity volume (OPCV), oral and pharyngeal soft tissue volume (OPSV), oral and pharyngeal air space volume (OPAV), and OPAV to OPCV ratio (%air). Receiver operating curve (ROC) analysis was used to determine the accuracy of OSAS prediction. We assessed participants with body mass index (BMI) values within the normal range.

Results

Among the 50 subjects, we observed significant between-group differences in OPSV, OPAV, and % air, whereas there were significant between-group differences in OPSV and %air among 28 subjects with normal BMI values. Both comparisons suggested that OSAS-related death was associated with low %air and high OPSV values.

Conclusion

The % air and OPSV are useful for assessing postmortem oropharyngeal CT images. OSAS-related sudden death is likely when %air and OPSV values are ≤20.1% and ≥127.2 ml, respectively. Among those with normal BMI values, % air and OPSV values of ≤22.8% and ≥111.5 ml, respectively, predict OSAS-related sudden death.

© 2024 The Author(s). Published by Bentham Open.
© 2024 The Author(s). Published by Bentham Open. This is an open access article published under CC BY 4.0 https://creativecommons.org/licenses/by/4.0/legalcode
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2024-01-01
2024-11-23

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References

  1. GamiA.S. HowardD.E. OlsonE.J. SomersV.K. Day-night pattern of sudden death in obstructive sleep apnea.N. Engl. J. Med.2005352121206121410.1056/NEJMoa04183215788497
     [Google Scholar]
  2. UemuraK. HaradaK. ShiotaniA. KaiA. UrataY. YasuharaM. YoshidaK. Obesity-sleep apnea (Pickwickian) syndrome: Autopsy findings and a medicolegal review.Leg. Med.200021364110.1016/S1344‑6223(00)80007‑312935464
     [Google Scholar]
  3. ZhangM. LiL. FowlerD. ZhaoZ. WeiD. ZhangY. BurkeA. Causes of sudden death in patients with obstructive sleep apnea.J. Forensic Sci.20135851171117410.1111/1556‑4029.1222023865847
     [Google Scholar]
  4. Clinical practice guidelines for sleep apnea syndrome (SAS).The Japanese Respiratory SocietyJapan: Nankodo2020
     [Google Scholar]
  5. PeppardP.E. YoungT. PaltaM. DempseyJ. SkatrudJ. Longitudinal study of moderate weight change and sleep-disordered breathing.JAMA2000284233015302110.1001/jama.284.23.301511122588
     [Google Scholar]
  6. YoungT. ShaharE. NietoF.J. RedlineS. NewmanA.B. GottliebD.J. WalslebenJ.A. FinnL. EnrightP. SametJ.M. Predictors of sleep-disordered breathing in community-dwelling adults: The sleep heart health study.Arch. Intern. Med.2002162889390010.1001/archinte.162.8.89311966340
     [Google Scholar]
  7. YoungT. SkatrudJ. PeppardP.E. Risk factors for obstructive sleep apnea in adults.JAMA2004291162013201610.1001/jama.291.16.201315113821
     [Google Scholar]
  8. YangL. SamarasingheY.P. KaneP. AmielS.A. AylwinS.J.B. Visceral adiposity is closely correlated with neck circumference and represents a significant indicator of insulin resistance in WHO grade III obesity.Clin. Endocrinol.201073219720020050862
     [Google Scholar]
  9. TangugsornV. SkatvedtO. KrogstadO. LybergT. Obstructive sleep apnoea: A cephalometric study. Part I. Cervico-craniofacial skeletal morphology.Eur. J. Orthod.1995171455610.1093/ejo/17.1.457737345
     [Google Scholar]
  10. BaconW.H. KriegerJ. TurlotJ.C. StierleJ.L. Craniofacial characteristics in patients with obstructive sleep apneas syndrome.Cleft Palate J.19882543743783203468
     [Google Scholar]
  11. HuiD.S.C. KoF.W.S. ChuA.S.Y. FokJ.P.C. ChanM.C.H. LiT.S.T. ChoyD.K.L. LaiC.K.W. AhujaA. ChingA.S.C. Cephalometric assessment of craniofacial morphology in Chinese patients with obstructive sleep apnoea.Respir. Med.200397664064610.1053/rmed.2003.149412814148
     [Google Scholar]
  12. EndoS. MatakiS. KurosakiN. Cephalometric evaluation of craniofacial and upper airway structures in Japanese patients with obstructive sleep apnea.J. Med. Dent. Sci.200350110912012715927
     [Google Scholar]
  13. OngK.C. ClerkA.A. Comparison of the severity of sleep-disordered breathing in Asian and Caucasian patients seen at a sleep disorders center.Respir. Med.199892684384810.1016/S0954‑6111(98)90386‑99850368
     [Google Scholar]
  14. LiK.K. KushidaC. PowellN.B. RileyR.W. GuilleminaultC. Obstructive sleep apnea syndrome: A comparison between Far-East Asian and white men.Laryngoscope2000110101689169310.1097/00005537‑200010000‑0002211037826
     [Google Scholar]
  15. LiuaY. LoweaA.A. ZengbX. FubM. FleethamcJ.A. Cephalometric comparisons between Chinese and Caucasian patients with obstructive sleep apnea.Am. J. Orthod. Dentofacial Orthop.2000117447948510.1016/S0889‑5406(00)70169‑710756275
     [Google Scholar]
  16. LeeR.W.W. VasudavanS. HuiD.S. PrvanT. PetoczP. DarendelilerM.A. CistulliP.A. Differences in craniofacial structures and obesity in Caucasian and Chinese patients with obstructive sleep apnea.Sleep20103381075108010.1093/sleep/33.8.107520815189
     [Google Scholar]
  17. MomomuraS. AkashibaT. AsanoiH. Guideline for diagnosis and treatment of sleep disordered breathing in cardiovascular disease.Circ. J.201074S29631084
     [Google Scholar]
  18. LoweA.A. GionhakuN. TakeuchiK. FleethamJ.A. Three-dimensional CT reconstructions of tongue and airway in adult subjects with obstructive sleep apnea.Am. J. Orthod. Dentofacial Orthop.198690536437410.1016/0889‑5406(86)90002‑83465231
     [Google Scholar]
  19. AhnS.H. KimJ. MinH.J. ChungH.J. HongJ.M. LeeJ.G. KimC.H. ChoH.J. Tongue volume influences lowest oxygen saturation but not apnea-hypopnea index in obstructive sleep apnea.PLoS One2015108e013579610.1371/journal.pone.013579626280546
     [Google Scholar]
  20. ArisakaT. Upper respiratory tract morphological evaluation (cephalogram and 3DCT) (Topics Surveillance around sleeping medical care) UPDATE: The latest technology and evaluation method.Jpn J Sleep Med201484577584
     [Google Scholar]
  21. YasuiK. HasegawaY. MaedaN. An autopsy case of multiple system atrophy who died of CO2 narcosis with severe sleep apnea syndrome.Neuropathology2013333361
     [Google Scholar]
  22. TakeuchiA. HyodohH. MatobaK. MurakamiM. KudoK. MinowaK. Evaluation of oral air space volume in obstructive sleep apnea syndrome using clinical and postmortem CT imaging.Oral Radiol.2022381293610.1007/s11282‑021‑00520‑y33743131
     [Google Scholar]
  23. AbramsonZ.R. SusarlaS. TagoniJ.R. KabanL. Three-dimensional computed tomographic analysis of airway anatomy.J. Oral Maxillofac. Surg.201068236337110.1016/j.joms.2009.09.08620116709
     [Google Scholar]
  24. OgawaT. EncisoR. ShintakuW.H. ClarkG.T. Evaluation of cross-section airway configuration of obstructive sleep apnea.Oral Surg. Oral Med. Oral Pathol. Oral Radiol. Endod.2007103110210810.1016/j.tripleo.2006.06.00817178502
     [Google Scholar]
  25. RodensteinD.O. DoomsG. ThomasY. LiistroG. StanescuD.C. CuléeC. Aubert-TulkensG. Pharyngeal shape and dimensions in healthy subjects, snorers, and patients with obstructive sleep apnoea.Thorax1990451072272710.1136/thx.45.10.7222247861
     [Google Scholar]
  26. KapurV.K. AuckleyD.H. ChowdhuriS. KuhlmannD.C. MehraR. RamarK. HarrodC.G. Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine clinical practice guideline.J. Clin. Sleep Med.201713347950410.5664/jcsm.650628162150
     [Google Scholar]
  27. AnandamA. PatilM. AkinnusiM. JaoudeP. El-SolhA.A. Cardiovascular mortality in obstructive sleep apnoea treated with continuous positive airway pressure or oral appliance: An observational study.Respirology20131881184119010.1111/resp.1214023731062
     [Google Scholar]
  28. Akar BayramN Prevalence of cardiac arrhythmia in obstructive sleep apnea syndrome.Turk. J. Med. Sci.2010406843850
     [Google Scholar]
/content/journals/cmir/10.2174/1573405620666230328082804
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Objective Evaluation of Oral and Pharyngeal Areas in Autopsy Cases of Obstructive Sleep Apnea Syndrome via Postmortem CT
Curr. Med. Imaging 20, E280323215022 (2024); https://doi.org/10.2174/1573405620666230328082804
/content/journals/cmir/10.2174/1573405620666230328082804
/content/journals/cmir/10.2174/1573405620666230328082804
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  • Article Type:     Research Article
Keyword(s): Air space volume; Obstructive sleep apnea syndrome; Oral volume metric; Oropharynx; Postmortem computed tomography; Postmortem imaging; Three-dimensional computed tomography

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