Anatomy of pharynx in patients with obstructive sleep apnea and in normal subjects

Journal of Applied Physiology

Volumn 82, Issue 4, 1997, Pages 1319-1326

  Isono, Shiroh ^a   Remmers, John E ^b   Tanaka, Atsuko ^a   Sho, Yasuhide ^a   Sato, Jiro ^a   Nishino, Takashi ^a  

^a CHIBA UNIVERSITY   (Japan)

^b UNIVERSITY OF CALGARY   (Canada)

Author keywords

closing pressure; oxygen desaturation; pharyngeal compliance; static pressure area relationship

Indexed keywords

ADULT; ARTICLE; BODY MASS; CONTROLLED STUDY; FEMALE; HUMAN; MAJOR CLINICAL STUDY; MALE; MULTIVARIATE ANALYSIS; OROPHARYNX; OXIMETRY; OXYGEN SATURATION; PHARYNX; PRIORITY JOURNAL; SLEEP APNEA SYNDROME;

EID: 0031000679     PISSN: 87507587     EISSN: None     Source Type: Journal    
DOI: 10.1152/jappl.1997.82.4.1319     Document Type: Article

References (43)

1. Anch, A. M., J. E. Remmers, and H. Bruce III. Supraglottic airway resistance in normal subjects and patients with obstructive sleep apnea. J. Appl. Physiol. 53: 1158-1163, 1982.
2. Bohlman, M. E., E. F. Haponik, P. L. Smith, R. P. Allen, E. R. Bleeker, and S. M. Goldman. CT demonstration of pharyngeal narrowing in adult obstructive sleep apnea. Am. J. Roentgenol. 140: 543-548, 1983.
3. Brooks, L. J., and K. P. Strohl. Size and mechanical properties of the pharynx in healthy men and women. Am. Rev. Respir. Dis. 145: 1394-1397, 1992.
4. Brouillette, R. T., and B. T. Thach. A neuromuscular mechanism maintaining extrathoracic airway patency. J. Appl. Physiol. 46: 772-779, 1979.
5. Burger, C. D., A. W. Stanson, P. F. Sheedy II, B. K. Daniels, and J. W. Shepard, Jr. Fast-computed tomography evaluation of age-related changes in upper airway structure and function in normal men. Am. Rev. Respir. Dis. 145: 846-852, 1992.
6. Cistulli, P. A., and C. E. Sullivan. Pathophysiology of sleep apnea. In: Sleep and Breathing (2nd ed.), edited by N. A. Saunders and C. E. Sullivan. New York: Dekker, 1994, vol. 71, p. 405-448. (Lung Biol. Health Dis. Ser.)
7. Douglas, N. J., S. Thomas, and M. A. Jan. Clinical value of polysomnography. Lancet 339: 347-350, 1992.
8. Gleadhill, I. C., A. R. Schwartz, N. Schubert, R. A. Wise, S. Permutt, and P. L. Smith. Upper airway collapsibility in snorers and in patients with obstructive sleep apnea. Am. Rev. Respir. Dis. 143: 1300-1303, 1991.
9. Gyulay, S., L. G. Olson, M. J. Hensley, M. T. King, K. M. Allen, and N. A. Saunders. A comparison of clinical assessment and home oxymetry in the diagnosis of obstructive sleep apnea. Am. Rev. Respir. Dis. 147: 50-53, 1993.
10. Haponik, E. F., P. L. Smith, M. E. Bohlman, R. P. Allen, S. M. Goldman, and E. R. Bleeker. Computerized tomography in obstructive sleep apnea. Am. Rev. Respir. Dis. 127: 221-226, 1983.
11. Hoffstein, V., N. Zamel, and E. A. Phillipson. Lung volume dependence of pharyngeal cross-sectional area in patients with obstructive sleep apnea. Am. Rev. Respir. Dis. 130: 175-178, 1984.
12. Holt, J. P. Flow of liquid through collapsible tubes. Circ. Res. 7: 342-353, 1959.
13. Horner, R. L., R. H. Mohiaddin, D. G. Lowell, S. A. Shea, E. D. Burman, B. Longmore, and A. Guz. Sites and sizes of fat deposits around the pharynx in obese patients with obstructive sleep apnea and weight matched controls. Eur. Respir. J. 2: 613-622, 1989.
14. Horner, R. L., S. A. Shea, J. McIvor, and A. Guz. Pharyngeal size and shape during wakefulness and sleep in patients with obstructive sleep apnoea. Q. J. Med. 72: 719-735, 1989.
15. Isono, S., D. L. Morrison, S. H. Launois, T. R. Feroah, W. A. Whitelaw, and J. E. Remmers. Static mechanics of the velopharynx of patients with obstructive sleep apnea. J. Appl. Physiol. 75: 148-154, 1993.
16. Isono, S., A. Tanaka, Y. Sho, A. Konno, and T. Nishino. Advancement of the mandible improves velopharyngeal airway patency. J. Appl. Physiol. 79: 2132-2138, 1995.
17. Jamieson, A., C. Guilleminault, M. Partinen, and M. A. Quera-Salva. Obstructive sleep apneic patients have craniomandibular abnormalities. Sleep 9: 469-477, 1986.
18. Jones, J. G., R. B. Fraser, and J. A. Nadel. Effect of changing airway mechanics on maximum expiratory flow. J. Appl. Physiol. 38: 1012-1021, 1975.
19. Jones, J. G., R. B. Fraser, and J. A. Nadel. Prediction of maximum expiratory flow rate from area-transmural pressure curve of compressed airway. J. Appl. Physiol. 38: 1002-1011, 1975.
20. Kuna, S. T., D. G. Bedi, and C. Ryckman. Effect of nasal airway positive pressure on upper airway size and configuration. Am. Rev. Respir. Dis. 138: 969-975, 1988.
21. Launois, S. H., T. R. Feroah, W. N. Campbell, F. G. Issa, D. Morrison, W. A. Whitelaw, S. Isono, and J. E. Remmers. Site of pharyngeal narrowing predicts outcome of surgery for obstructive sleep apnea. Am. Rev. Respir. Dis. 147: 182-189, 1993.
22. Lowe, A. A., N. Gionhaku, K. Takeuchi, and J. A. Fleetham. Three-dimensional CT re-constructions of tongue and airway in adults subjects with obstructive sleep apnea. Am. J. Orthod. Dentofacial Orthop. 90: 364-374, 1986.
23. Lowe, A. A., J. D. Santamaria, J. A. Fleetham, and C. Price. Facial morphology and obstructive sleep apnea. Am. J. Orthod. Dentofacial Orthop. 90: 484-491, 1986.
24. Mezzanotte, W. S., D. G. Tangel, and D. P. White. Waking genioglossal electromyogram in sleep apnea patients versus normal controls (a neuromuscular compensatory mechanism). J. Clin. Invest. 89: 1571-1579, 1992.
25. Morrison, D. L., S. H. Launois, S. Isono, T. R. Feroah, W. A. Whitelaw, and J. E. Remmers. Pharyngeal narrowing and closing pressures in patients with obstructive sleep apnea. Am. Rev. Respir. Din. 148: 606-611, 1993.
26. Permutt, S., B. Bromberger-Barnea, and H. N. Bane. Alveolar pressure, pulmonary venous pressure, and the vascular waterfall. Med. Thorac. 19: 239-260, 1962.
27. Remmers, J. E., W. J. Degroot, E. K. Sauerland, and A. M. Anch. Pathogenesis of upper airway occlusion during sleep. J Appl. Physiol. 44: 931-938, 1978.
28. Rodenstein, D. O., G. Dooms, Y. Thomas, G. Liistro, D. C. Stanescu, C. Culee, and G. Aubert-Tulkins. Pharyngeal shape and dimensions in healthy subjects, snorers, and patients with obstructive sleep apnoea. Thorax 45: 722-727, 1990.
29. Ryan, C. R, A. A. Lowe, D. Li, and J. A. Fleetham. Three-dimensional upper airway computed tomography in obstructive sleep apnea. Am. Rev. Respir. Dis. 144: 428-432, 1991.
30. Schwab, R. J., K. B. Gupta, W. B. Gefter, L. J. Metzger, E. A. Hoffman, and A. I. Pack. Upper airway and soft tissue anatomy in normal subjects and patients with sleep-disordered breathing. Am. J. Respir. Crit. Care Med. 152: 1673-1689, 1995.
31. Schwartz, A. R., P. L. Smith, A. R. Gold, R. A. Wise, and S. Permutt. Induction of upper airway occlusion in sleeping normal humans. J. Appl. Physiol. 64: 535-542, 1988.
32. Schwartz, A. R., P. L. Smith, R. A. Wise, I. Bankman, and S. Permutt. Effect of positive nasal pressure on upper airway pressure-flow relationships. J. Appl. Physiol. 64: 1626-1634, 1989.
33. Schwartz, A. R., D. C. Thut, B. Russ, M. Seelagy, X. Yuan, R. G. Brower, S. Permutt, R. A. Wise, and P. L. Smith. Effect of electrical stimulation of the hypoglossal nerve on airflow mechanics in the isolated upper airway. Am. Rev. Respir. Dis. 147: 1144-1150, 1993.
34. Series, F., Y. Cormier, and M. Desmeules. Influence of passive changes of lung volume on upper airways. J. Appl. Physiol. 68: 2159-2164, 1990.
35. Shelton, K. E., S. B. Gay, D. E. Hollowell, H. Woodson, and P. M. Suratt. Mandible enclosure of upper airway and weight in obstructive sleep apnea. Am. Rev. Respir. Dis. 148: 195-200, 1993.
36. Shelton, K. E., S. B. Gay, H. Woodson, and P. M. Suratt. Pharyngeal fat in obstructive sleep apnea. Am. Rev. Respir. Dis. 148: 462-466, 1993.
37. Shepard, J. W., Jr., and S. E. Thawley. Localization of upper airway collapse during sleep in patients with obstructive sleep apnea. Am. Rev. Respir. Dis. 141: 1350-1355, 1990.
38. Smith, P. L., R. A. Wise, and S. Permutt. Upper airway pressure-flow relationships in patients with obstructive sleep apnea. J. Appl. Physiol. 64: 789-795, 1988.
39. Suratt, P. M., R. F. McTier, and S. C. Wilhoit. Upper airway muscle activation is augmented in patients with obstructive sleep apnea compared with that in normal subjects. Am. Rev. Respir. Dis. 137: 889-894, 1988.
40. Thut, D. C., A. R. Schwartz, D. Roach, A. Wise, S. Permutt, and P. L. Smith. Tracheal and neck position influence upper airway airflow dynamics by altering airway length. J. Appl. Physiol. 75: 2084-2090, 1993.
41. Van de Graaff, W. Thoracic influences on upper airway patency. J. Appl. Physiol. 65: 2124-2131, 1988.
42. Venables, W. N., and B. D. Ripley. Modern Applied Statistics with S-Plus. New York: Springer-Verlag, 1994.
43. Wilson, T. A., J. R. Rodarte, and J. P. Butler. Wave-speed and viscous flow limitation. In: Handbook of Physiology. The Respiratory System. Mechanics of Breathing. Bethesda, MD: Am. Physiol. Soc., 1986, sect. 3, vol. III, pt. 1., chapt. 5, p. 55-61.