Submental Ultrasonography in Diagnosing Severe Obstructive Sleep Apnea Syndrome

Abstract

Background: The aim of this study was to compare multiple ultrasound parameters in diagnosing patients with severe obstructive sleep apnea syndrome (OSAS). Methods: A submental ultrasonography was performed to measure the distance between the lingual arteries, the diameter of the retropalatal space in the transverse dimension, and the tongue base thickness in the sagittal plane. The diameter of the retropalatal space and tongue base thickness were measured in the resting state and under Müller's maneuver. Analyses were based on the means of the triplicate measurements and the severity of OSAS. Results: Based on ultrasound data, patients with severe OSAS had a significantly larger mean tongue base thickness in the resting state and under Müller's maneuver and a larger mean distance between the lingual arteries. The mean tongue base thickness (≥60 mm, odds ratio 5.18; 1.07–25.0) is the sole independent predictor for severe OSAS. The resting tongue base thickness (≥60 mm) had a diagnostic performance of 84.9% sensitivity, 59.3% specificity, 75.0% positive predictive value, 72.7% negative predictive value, and 74.2% accuracy for severe OSAS. Conclusion: Submental ultrasonography is a noninvasive, convenient, and effective tool in diagnosing severe OSAS.

Keywords

• obstructive
• sleep apnea
• sleep disorders
• ultrasound