Systematic head and neck physical examination as a predictor of obstructive sleep apnea in class III obese patients

Systematic head and neck physical examination as a predictor of obstructive sleep apnea in class III obese patients

Author Martinho, Fernanda Louise Autor UNIFESP Google Scholar
Tangerina, Rodrigo de Paiva Autor UNIFESP Google Scholar
Togeiro, Sonia Maria Autor UNIFESP Google Scholar
Gregório, Luiz Carlos Autor UNIFESP Google Scholar
Tufik, Sergio Autor UNIFESP Google Scholar
Bittencourt, Lia Rita Azeredo Autor UNIFESP Google Scholar
Institution Universidade Federal de São Paulo (UNIFESP)
Abstract Our aim was to determine if anatomical abnormalities of the upper airway (UA) and facial skeleton of class III severely obese patients are related to the presence and severity of obstructive sleep apnea syndrome (OSAS). Forty-five patients (69% females, mean age 46.5 ± 10.8 years) with a body mass index (BMI) over 40 kg/m² underwent UA and facial skeletal examinations as well as polysomnography. Mean BMI was 49 ± 7 kg/m² and mean neck circumference was 43.4 ± 5.1 cm. Polysomnographic findings showed that 22% had a normal apnea-hypopnea index (AHI) and 78% had an AHI over 5. The presence of OSAS was associated with younger age (P = 0.02), larger neck circumference (P = 0.004), presence of a voluminous lateral wall (P = 0.0002), posteriorized soft palate (P = 0.0053), thick soft palate (P = 0.0014), long uvula (P = 0.04), thick uvula (P = 0.0052), and inferior turbinate hypertrophy (P = 0.04). A larger neck circumference (P = 0.02), presence of a voluminous lateral wall (P = 0.04), posteriorized soft palate (P = 0.03), and thick soft palate (P = 0.04) were all associated with OSAS severity. The prevalence of OSAS in this group was high. A larger neck circumference and soft tissue abnormalities of the UA were markers for both the presence and severity of OSAS. Conversely, no abnormalities in the facial skeleton were associated with OSAS in patients with morbid obesity.
Keywords Obesity
Obstructive sleep apnea syndrome
Physical examination
Language English
Date 2008-12-01
Published in Brazilian Journal of Medical and Biological Research. Associação Brasileira de Divulgação Científica, v. 41, n. 12, p. 1093-1097, 2008.
ISSN 0100-879X (Sherpa/Romeo, impact factor)
Publisher Associação Brasileira de Divulgação Científica
Extent 1093-1097
Access rights Open access Open Access
Type Article
Web of Science ID WOS:000262580300008
SciELO ID S0100-879X2008001200008 (statistics in SciELO)

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