The impacts of open-mouth breathing on upper airway space in obstructive sleep apnea: 3-D MDCT analysis

Eun Joong Kim, Ji Ho Choi, Kang Woo Kim, Tae Hoon Kim, Sang Hag Lee, Heung Man Lee, Chol Shin, Ki Yeol Lee, Seung Hoon Lee

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Open-mouth breathing during sleep is a risk factor for obstructive sleep apnea (OSA) and is associated with increased disease severity and upper airway collapsibility. The aim of this study was to investigate the effect of open-mouth breathing on the upper airway space in patients with OSA using three-dimensional multi-detector computed tomography (3-D MDCT). The study design included a case - control study with planned data collection. The study was performed at a tertiary medical center. 3-D MDCT analysis was conducted on 52 patients with OSA under two experimental conditions: mouth closed and mouth open. Under these conditions, we measured the minimal cross-sectional area of the retropalatal and retroglossal regions (mXSA-RP, mXSA-RG), as well as the upper airway length (UAL), defined as the vertical dimension from hard palate to hyoid. We also computed the volume of the upper airway space by 3-D reconstruction of both conditions. When the mouth was open, mXSARP and mXSA-RG significantly decreased and the UAL significantly increased, irrespective of the severity of OSA. However, between the closed- and open-mouth states, there was no significant change in upper airway volume at any severity of OSA. Results suggest that the more elongated and narrow upper airway during open-mouth breathing may aggravate the collapsibility of the upper airway and, thus, negatively affect OSA severity.

Original languageEnglish
Pages (from-to)533-539
Number of pages7
JournalEuropean Archives of Oto-Rhino-Laryngology
Volume268
Issue number4
DOIs
Publication statusPublished - 2011 Apr

Keywords

  • Computed tomography
  • Mouth breathing
  • Obstructive sleep apnea
  • Three-dimensional imaging

ASJC Scopus subject areas

  • Otorhinolaryngology

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