Anatomical Optical Coherence Tomography of the Human Upper Airway
Endoscopic visualization of the internal surface of hollow organ systems is widely used in medical practice. Examples include endoscopy of the urinary tract, gastrointestinal tract, and upper and lower respiratory tracts. Although valuable for visualizing the internal anatomy, a limitation of endoscopy has been the inability, to date, to easily quantify internal dimensions during these examinations. Such objective measurements would be particularly valuable in understanding the behavior of the human airway.
Repetitive collapse of the upper airway during sleep is the hallmark of obstructive sleep apnea, a common condition affecting 2%–4% of middle-aged adults . Despite three decades of research, the pathogenesis of obstructive sleep apnea remains incompletely understood. The prevailing view is that patients with obstructive sleep apnea have smaller pharyngeal airways and higher pharyngeal resistances, requiring a compensatory increase in pharyngeal muscle activity to maintain upper airway patency during wakefulness. When such patients sleep, state-related reductions in pharyngeal muscle activity remove this essential compensatory mechanism and airway collapse ensues. These episodes of partial or complete upper airway obstruction are terminated by brief arousals from sleep, often lasting only seconds and not consciously perceived by the patient but enough to disrupt sleep and be responsible for the excessive daytime sleepiness that characterizes the obstructive sleep apnea–hypopnea syndrome.
KeywordsObstructive Sleep Apnea Optical Coherence Tomography Compute Tomogra Airway Collapse Mandibular Advancement
Unable to display preview. Download preview PDF.
- 1.T. Young, M. Palta, J. Dempsey, J. Skatrud, S. Weber, S. Badr, N. Engl. J. Med. 328, 1230 (1993)Google Scholar
- 16.D.D. Sampson, T.R. Hillman, in Lasers and Current Optical Techniques in Biol-ogy, ed. by G. Palumbo, R. Pratesi. Comprehensive Series in Photochemistry and Photobiology, vol. 4, 1st edn. (Royal Society of Chemistry, Cambridge, UK, 2004), p. 481Google Scholar
- 24.. Polysomnography Task Force of the American Sleep Disorders Association Standards of Practice Committee, Sleep 20, 406 (1997)Google Scholar
- 28.. American Academy of Sleep Medicine Task Force, Sleep 22, 667 (1999)Google Scholar
- 35. J.H. Walsh, M.S. Leigh, A. Paduch, K.J. Maddison, D.L. Philippe, J.J. Armstrong, D.D. Sampson, D.R. Hillman, P.R. Eastwood, J. Sleep Res. (in press)Google Scholar
- 38.E.F. Haponik, P.L. Smith, M.E. Bohlman, R.P. Allen, S.M. Goldman, E.R. Bleecker, Am. J. Respir. Crit. Care Med. 127, 221 (1983)Google Scholar
- 45.J. Williamson, A.R. West, P.B. Noble, J.J. Armstrong, S. Becker, M.S. Leigh, D.D. Sampson, H.W. Mitchell, D.R. Hillman, P.R. Eastwood, Regional airway compliance measured by anatomical optical coherence tomography in isolated bronchial segments of the pig. Paper presented at 12th Congress of the AsiaPacific Society of Respirology, Gold coast, Australia, 2007Google Scholar