Skip to main content

Abstract

Cephalometry, Computed Tomography (CT), and Magnetic Resonance (MR) are the main imaging modalities applied in the assessment of OSA patients, providing insights into pathophysiology, evaluation, and treatment planning of OSA. Two more issues of increasing importance in TORS area are the possibility to detect vessels close to the surgical area in order to prevent inadvertent injury during dissection and the capability from simple linear and angular measures to obtain a sound predictor index about the exposure difficulties in TORS. In this chapter we review the role of different imaging modalities in the diagnostic assessment of the upper airway in OSA patients, with specific attention to the hypopharynx.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 119.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. The Report of an American Academy of Sleep Medicine Task Force. Sleep-related breathing disordered in adults: recommendations for syndrome definition and measurement techniques in clinical research. Sleep. 1999;22:667–89.

    Google Scholar 

  2. Goldberg AN, Schwab RJ. Identifying the patient with sleep apnea. Upper airway assessment and physical examination. Otolaryngol Clin North Am. 1998;31(6):919–30.

    Article  CAS  PubMed  Google Scholar 

  3. Patel NP, Schwab RJ. Upper airway imaging. In: Kushida CA, editor. Sleep disorders/vol. 4 obstructive sleep apnea. Diagnosis and treatment; 2007. Chapter 4. p. 61–88.

    Google Scholar 

  4. Luginbuhl A, Baker A, Curry J, Drejet S, Miller M, Cognetti D. Preoperative cephalometric analysis to predict transoral robotic surgery exposure. J Robot Surg. 2014;8(4):313–7 [Epub 2014 Jun 24].

    Article  PubMed  PubMed Central  Google Scholar 

  5. Chiffer RC, Schwab RJ, Keenan BT, Borek RC, Thaler ER. Volumetric MRI analysis pre- and post-transoral robotic surgery for obstructive sleep apnea. Laryngoscope. 2015;125(8):1988–95.

    Article  PubMed  Google Scholar 

  6. Ryu HH, Kim CH, Cheon SM, et al. The usefulness of cephalometric measurement as a diagnostic tool for obstructive sleep apnea syndrome: a retrospective study. Oral Surg Oral Med Oral Pathol Oral Radiol. 2015;119(1):20–31.

    Article  PubMed  Google Scholar 

  7. Shepard JW, Gefter WB, Guilleminault C, et al. Evaluation of the upper airway in patients with obstructive sleep apnea. Sleep. 1991;14(4):361–71.

    PubMed  Google Scholar 

  8. Nelson S, Hans M. Contribution of craniofacial risk factors in increasing apneic activity among obese and non-obese habitual snorers. Chest. 1997;111(1):154–62.

    Article  CAS  PubMed  Google Scholar 

  9. Waite PD, Vilos GA. Surgical changes of posterior airway space in obstructive sleep apnea. Oral Maxillofac Surg Clin North Am. 2002;14:385–99.

    Article  PubMed  Google Scholar 

  10. Guarda-Nardini L, Manfredini D, Mion M, et al. Anatomically based outcome predictors of treatment for obstructive sleep apnea with intraoral splint devices: a systematic review of cephalometric studies. J Clin Sleep Med. 2015; Apr 10.

  11. Horiuchi A, Suzuki M, Ookubo M, et al. Measurement techniques predicting the effectiveness of an oral appliance for obstructive sleep apnea hypopnea syndrome. Angle Orthod. 2005;75:1003–11.

    PubMed  Google Scholar 

  12. Skinner MA, Robertson CJ, Kingshott RN, et al. The efficacy of mandibular advancement splint in relation to cephalometric variables. Sleep Breath. 2002;63:315–24.

    Google Scholar 

  13. Aksoz T, Akan H, Celebi M, Sakan BB. Does the oropharyngeal fat tissue influence the oropharyngeal airway in snorers? Dynamic CT study. Korean J Radiol. 2004;5(2):102–6.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Akan H, Aksoz T, Belet U, Sesen T. Dynamic upper airway soft-tissue and caliber changes in healthy subjects and snoring patients. AJNR Am J Neuroradiol. 2004;25(10):1846–50.

    PubMed  Google Scholar 

  15. Burger CD, Stanson AW, Daniels BK, Sheedy II PF, Shepard Jr JW. Fast-CT evaluation of the effect of lung volume on upper airway size and function in normal men. Am Rev Respir Dis. 1992;146(2):335–9.

    Article  CAS  PubMed  Google Scholar 

  16. Burger CD, Stanson AW, Sheedy II PF, Daniels BK, Shepard Jr JW. Fast-computed tomography evaluation of age-related changes in upper airway structure and function in normal men. Am Rev Respir Dis. 1992;145(4 Pt 1):846–52.

    Article  CAS  PubMed  Google Scholar 

  17. Caballero P, Alvarez-Sala R, Garcia-Rio F, et al. CT in the evaluation of the upper airway in healthy subjects and in patients with obstructive sleep apnea syndrome. Chest. 1998;113(1):111–6.

    Article  CAS  PubMed  Google Scholar 

  18. Ell SR, Jolles H, Galvin JR. Cine CT demonstration of nonfixed upper airway obstruction. AJR Am J Roentgenol. 1986;146(4):669–77.

    Article  CAS  PubMed  Google Scholar 

  19. Ell SR, Jolles H, Keyes WD, Galvin JR. Cine CT technique for dynamic airway studies. AJR Am J Roentgenol. 1985;145(1):35–6.

    Article  CAS  PubMed  Google Scholar 

  20. Galvin JR, Rooholamini SA, Stanford W. Obstructive sleep apnea: diagnosis with ultrafast CT. Radiology. 1989;171(3):775–8.

    Article  CAS  PubMed  Google Scholar 

  21. Haponik EF, Smith PL, Bohlman ME, Allen RP, Goldman SM, Bleecker ER. Computerized tomography in obstructive sleep apnea. Correlation of airway size with physiology during sleep and wakefulness. Am Rev Respir Dis. 1983;127(2):221–6.

    CAS  PubMed  Google Scholar 

  22. Fleetham JA. Upper airway imaging in relation to obstructive sleep apnea. Clin Chest Med. 1992;13(3):399–416.

    CAS  PubMed  Google Scholar 

  23. Ryan CF, Lowe AA, Li D, Fleetham JA. Three-dimensional upper airway computed tomography in obstructive sleep apnea. A prospective study in patients treated by uvulopalatopharyngoplasty. Am Rev Respir Dis. 1991;144(2):428–32.

    Article  CAS  PubMed  Google Scholar 

  24. Li HY, Chen NH, Wang CR, Shu YH, et al. Use of 3-dimensional computed tomography scan to evaluate upper airway patency for patients undergoing sleep-disordered breathing surgery. Otolaryngol Head Neck Surg. 2003;129(4):336–42.

    Article  PubMed  Google Scholar 

  25. Kim EJ, Choi JH, Kim YS, et al. Upper airway changes in severe obstructive sleep apnea: upper airway length and volumetric analyses using 3D MDCT. Acta Otolaryngol. 2011;131(5):527–32.

    Article  PubMed  Google Scholar 

  26. Li S1, Qin Y, Wu D. Lingual-occlusal surface position predicts retroglossal obstruction in patients with obstructive sleep apnea hypopnea syndrome. Acta Otolaryngol. 2015; June 24:1–6 [Epub ahead of print].

    Google Scholar 

  27. Wu D, Qin J, Guo X, et al. Analysis of the difference in the course of the lingual arteries caused by tongue position change. Laryngoscope. 2015;125(3):762–6.

    Article  PubMed  Google Scholar 

  28. Mortimore IL, Marshall I, Wraith PK. Neck and total body fat deposition in nonobese and obese patients with sleep apnea compared with that in control subjects. Am J Respir Crit Care Med. 1998;157:280–3.

    Article  CAS  PubMed  Google Scholar 

  29. Sittitavornwong S, Waite PD. Imaging the upper airway in patients with sleep disordered breathing. Oral Maxillofac Surg Clin North Am. 2009;21:389–402.

    Article  PubMed  Google Scholar 

  30. Razek AAKA. Diagnostic role of magnetic resonance imaging in obstructive sleep apnea syndrome. J Comput Assist Tomogr. 2015;39(4):565–71.

    Article  PubMed  Google Scholar 

  31. Schwab RJ, Pasirstein M, Pierson R, et al. Identification of upper airway anatomic risk factors for obstructive sleep apnea with volumetric magnetic resonance imaging. Am J Respir Crit Care Med. 2003;168(5):522–30.

    Article  PubMed  Google Scholar 

  32. Ciscar MA, Juan G, Martinez V, et al. Magnetic resonance imaging of the pharynx in OSA patients and healthy subjects. Eur Respir J. 2001;17(1):79–86.

    Article  CAS  PubMed  Google Scholar 

  33. Schwab RJ. Upper airway imaging. Clin Chest Med. 1998;19(1):33–54.

    Article  CAS  PubMed  Google Scholar 

  34. Kami YN, Chikui T, Shiraushi T, et al. A new method for displaying the lingual artery using high-resolution three-dimensional phase-contrast magnetic resonance angiography. IJOM. 2013;42(11):1494–8.

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Andrea De Vito M.D., Ph.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2016 Springer International Publishing Switzerland

About this chapter

Cite this chapter

De Vito, A., Frasconi, P.C., Bazzocchi, O., Tenti, G. (2016). Imaging. In: Vicini, C., Hoff, P., Montevecchi, F. (eds) TransOral Robotic Surgery for Obstructive Sleep Apnea. Springer, Cham. https://doi.org/10.1007/978-3-319-34040-1_5

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-34040-1_5

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-34038-8

  • Online ISBN: 978-3-319-34040-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics