Efficacy of dynamic MRI sleep study in the management of obstructive sleep apnea: an observational study

Authors

  • Sanjeev Mohanty Institute of ENT, Head and Neck Surgery, MGM Healthcare, Chennai, Tamil Nadu, India
  • Dharani Thiruvengadam Institute of ENT, Head and Neck Surgery, MGM Healthcare, Chennai, Tamil Nadu, India
  • Haripriya Gopinathan Rajam Institute of ENT, Head and Neck Surgery, MGM Healthcare, Chennai, Tamil Nadu, India
  • Deepthi Padmanabhan Institute of ENT, Head and Neck Surgery, MGM Healthcare, Chennai, Tamil Nadu, India
  • Balaji Kumaragurubaran Institute of ENT, Head and Neck Surgery, MGM Healthcare, Chennai, Tamil Nadu, India
  • Guna Keerthana Ramesh Institute of ENT, Head and Neck Surgery, MGM Healthcare, Chennai, Tamil Nadu, India

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20250116

Keywords:

Obstructive sleep apnea, Dynamic MRI, Apnea hypopnea index, Retropalatal collapse, Lateral pharyngeal wall collapse

Abstract

Background: Obstructive sleep apnea has become a more common health problem owing to a more sedentary lifestyle and work culture. Dynamic MRI in the preoperative evaluation of these patients aims at diagnosing the actual cause, level and pattern of obstruction and guides the surgeon in decision making among the various treatment options established.

Methods: In this retrospective study, Dynamic MRI was performed in 66 patients who were previously diagnosed with polysomnography. The levels and pattern of obstruction were analysed with the severity of AHI grading and their significance in planning the treatment protocol is discussed.

Results: 62 patients had significant retropalatal collapse and 53 had lateral pharyngeal wall collapse in the Dynamic MRI. Retroglossal collapse is usually presenting with the retropalatal collapse and are found in six patients. Collapse at all three levels namely retropalatal, retroglossal and hypopharyngeal are present in three patients. 48 patients were advised for surgical management after pre-operative evaluation with MRI and 30 patients who underwent surgery had promising results at the six month follow up visit.

Conclusion: This study shows that lateral pharyngeal wall collapse is majorly contributory to the AHI severity although multilevel collapse is seen in both mild and severe OSA patients. Hence, Dynamic MRI is suggested before proceeding with the management of the OSA patients.

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References

Abbasi A, Gupta SS, Sabharwal N, Meghrajani V, Sharma S, Kamholz S, et al. A comprehensive review of obstructive sleep apnea. Sleep Sci. 2021;14(2):142-54.

Rundo JV, Downey R 3rd. Polysomnography. Handb Clin Neurol. 2019;160:381-92. DOI: https://doi.org/10.1016/B978-0-444-64032-1.00025-4

Li Y, Ji C, Sun W, Xiong H, Li Z, Huang X, et al. Characteristics and mechanism of upper airway collapse revealed by dynamic mri during natural sleep in patients with severe obstructive sleep apnea. Nat Sci Sleep. 2023;15:885-902. DOI: https://doi.org/10.2147/NSS.S423303

Chung F, Abdullah HR, Liao P. STOP-Bang questionnaire: a practical approach to screen for obstructive sleep apnea, Chest. 2016;149(3):631-8. DOI: https://doi.org/10.1378/chest.15-0903

Scharf MT. Reliability and Efficacy of the Epworth Sleepiness Scale: Is There Still a Place for It. Nat Sci Sleep. 2022;14:2151-6. DOI: https://doi.org/10.2147/NSS.S340950

Torre C. Anatomy of obstructive sleep apnea: an evolutionary and developmental perspective. Int J Head and Neck Surg. 2019;10(4):98-101. DOI: https://doi.org/10.5005/jp-journals-10001-1382

Cunningham J, Hunter M, Budgeon C. The prevalence and comorbidities of obstructive sleep apnea in middle-aged men and women: the Busselton Healthy Ageing Study. J Clin Sleep Med. 2021;17(10):2029–39. DOI: https://doi.org/10.5664/jcsm.9378

Bajpai J, Pradhan A, Bajaj D, Verma AK, Kant S, Pandey AK, et al. Prevalence of dyslipidaemia in OSA patients at a tertiary care center. Am J Cardiovasc Di, 2023;13(1):1-9.

A Han S, Cha H, Yang SK, Kim SY, Han DH, Kim DY, et al. Sleep parameter characteristics of patients with OSA who have retropalatal circumferential narrowing and the clinical significance of lateral pharyngeal wall collapse during sleep. Sleep Breath, 2023;27(6):2165-73.

Abreu AR. Pathophysiology of obstructive sleep apnoea: the role of physiologic phenotypes. Int J of Head and Neck Surg. 2021;12(2):71-3. DOI: https://doi.org/10.5005/jp-journals-10001-1428

Huang T, Lin BM, Markt SC, Stampfer MJ, Laden F, Hu FB, et al. Sex differences in the associations of obstructive sleep apnoea with epidemiological factors. Eur Respir J. 2018;51:1702421. DOI: https://doi.org/10.1183/13993003.02421-2017

Franklin KA, Lindberg E. Obstructive sleep apnea is a common disorder in the population— a review on the epidemiology of sleep apnea. J Thorac Dis. 2015;7(8):1311-22.

Dong Z. Association of overweight and obesity with obstructive sleep apnoea: A systematic review and meta-analysis. Obesity Med. 2020;17:100185. DOI: https://doi.org/10.1016/j.obmed.2020.100185

Kuna ST. Effects of weight loss on obstructive sleep apnea severity. Ten-year sleep AHEAD study. Am J Respir Crit Care Med, 2021;203(2):221–9. DOI: https://doi.org/10.1164/rccm.201912-2511OC

Lombardi C, Pengo MF, Parati G. Systemic hypertension in obstructive sleep apnea. J Thorac Dis. 2018;10(34):4231-3. DOI: https://doi.org/10.21037/jtd.2018.12.57

Altay S, Fırat S, Peker Y. The TURCOSACT Collaborators. A narrative review of the association of obstructive sleep apnea with hypertension: how to treat both when they coexist. J Clin Med. 2023;12(12):4144. DOI: https://doi.org/10.3390/jcm12124144

Yeghiazarians. Obstructive sleep apnea and cardiovascular disease- a scientific statement from the American heart association. Circulation. 2021;144:56–67. DOI: https://doi.org/10.1161/CIR.0000000000000988

Alshaer H, Hummel R, Mendelson M, Marshal T, Bradley TD. Objective relationship between sleep apnea and frequency of snoring assessed by machine learning. J Clin Sleep Med. 2019;15(3):463–70. DOI: https://doi.org/10.5664/jcsm.7676

Chiang JK, Lin YC, Lu CM, Kao YH. Correlation between snoring sounds and obstructive sleep apnea in adults: a meta-regression analysis. Sleep Sci. 2022;15(4):463-70. DOI: https://doi.org/10.5935/1984-0063.20220068

Gamaleldin O. Role of dynamic sleep MRI in obstructive sleep apnea syndrome. Oral Radiol. 2020;37(12).

Han S, Cha H, Yang SK. Sleep parameter characteristics of patients with OSA who have retropalatal circumferential narrowing and the clinical significance of lateral pharyngeal wall collapse during sleep. Sleep Breath. 2023;27:2165–73. DOI: https://doi.org/10.1007/s11325-023-02808-1

Volner K, Chao S, Camacho M. Dynamic sleep MRI in obstructive sleep apnea: a systematic review and meta-analysis. Eur Arch Otorhinolaryngol. 2022;279(2):595-607. DOI: https://doi.org/10.1007/s00405-021-06942-y

Izolde B, Daskalaki E, Mavroudi E, Moniaki V. A dietary and lifestyle intervention improves treatment adherence and clinical outcomes in overweight and obese patients with obstructive sleep apnea: a randomized, controlled trial. Life. 2023;13(8):1755. DOI: https://doi.org/10.3390/life13081755

Yeom SW, Kim MG, Lee EJ, Chung SK, Kim DH, Noh SJ, et al. Association between septal deviation and OSA diagnoses: a nationwide 9-year follow-up cohort study. J Clin Sleep Med. 2021;17(10):2099-106. DOI: https://doi.org/10.5664/jcsm.9352

Gamaleldin O, Bahgat A, Anwar O. Role of dynamic sleep MRI in obstructive sleep apnea syndrome. Oral Radiol. 2021;37:376–84. DOI: https://doi.org/10.1007/s11282-020-00455-w

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Published

2025-01-27

How to Cite

Mohanty, S., Thiruvengadam, D., Rajam, H. G., Padmanabhan, D., Kumaragurubaran, B., & Ramesh, G. K. (2025). Efficacy of dynamic MRI sleep study in the management of obstructive sleep apnea: an observational study . International Journal of Otorhinolaryngology and Head and Neck Surgery, 11(1), 34–41. https://doi.org/10.18203/issn.2454-5929.ijohns20250116

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Original Research Articles