Relationship between Epiglottis and Severity of Obstructive Sleep Apnea

Abstract

Objectives:

The aim of this retrospective case-control study was to define epiglottis morphologies and to investigate the relationship between the angle of the laryngeal surface of the epiglottis (ALSE) and the severity of obstructive sleep apnea (OSA) using flexible optic laryngoscopy (FOL) images.

Methods:

Eighty-three patients with OSA (Group 1) and 87 patients with no complaints of OSA (Group 2) were evaluated. The ALSE was measured using ImageJ through FOL images. ALSE measurements were compared between the two groups. The correlation of ALSE measurements to the respiratory disturbance index (RDI) was analyzed.

Results:

Group 1 comprised 79 male and 4 female patients with a mean age of 43 years. Group 2 comprised 72 male and 15 female patients with a mean age of 39 years. The mean ALSE measurement was 139.7 degrees in Group 1 and 140.08 degrees in Group 2 and was not significantly different between the two groups (P value greater than 0.05). The mean RDI in Group 1 was 28.83, showing evidence of a low correlation between ALSE measurements and RDI. Epiglottis morphology revealed three different shapes: concave epiglottis and slightly observed petiole, minimally concave epiglottis with petiole dominancy, and severe concave epiglottis (omega epiglottis).

Conclusions:

Three different morphologies were observed through FOL examinations. The ALSE measurements were not significantly different between patients with OSA (Group 1) and control subjects (Group 2). This might indicate that the ALSE cannot be used as a predictive factor in OSA pathophysiology.