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Massachusetts Chapter of the American College of Surgeons Massachusetts Chapter of the American College of Surgeons Massachusetts Chapter of the American College of Surgeons Massachusetts Chapter of the American College of Surgeons Massachusetts Chapter of the American College of Surgeons
Normative Soft Palate Dimensions: Correlation with Obstructive Sleep Apnea

William Innis, MD, Jeffrey H. Spiegel, MD, FACS, Osamu Sakai, PhD
Boston Medical Center- Department of Otolaryngology


PURPOSE OF STUDY
(1) To determine if soft palate length, thickness, and volume correlate with degree of obstructive sleep apnea, and (2) identify normative palatal dimensions for adults.

METHODS USED:
Retrospective review of 101 patients with both a recent MRI and polysomnogram. MRI data from these patients was reviewed to obtain soft palate length, thickness and volume for each. Patient Apnea/Hypopnea Index (AHI) was obtained from polysomnogram. Patients were then divided into four groups based on AHI (none, mild, moderate, and severe). The differences in mean palatal length, thickness, and volume between these groups were compared using ANOVA. Where differences were significant, we used t-tests to make multiple comparisons.

SUMMARY OF RESULTS:
Normative data for palatal length, thickness, and volume is presented stratified for degree of obstructive sleep apnea. Statistically significant differences were found in the three measured palatal dimensions for those without sleep apnea versus those with severe sleep apnea (p=0.014 for volume, p=0.038 for thickness, and p=0.036 for length).

CONCLUSIONS:
(1) Contrary to prior publications, we found a true and statistically significant variation in multiple palatal dimensions in patients stratified for degree of obstructive sleep apnea on polysomnogram. (2) Normative palatal data tables are presented, permitting greater anatomic understanding when undertaking surgical manipulation of the palate (such as to reduce snoring or sleep apnea). (3) Palatal volume is higher amongst patients with significant sleep apnea, possibly supporting the appropriateness of palatal reduction procedures for obstructive sleep apnea.

TABLES AND CHARTS:
  None
(AHI <5)
Mild
(AHI 5-10)
Moderate
(AHI 10-15)
Severe
(AHI >15)
All Subjects
Length (mm) 38.2 +/- 0.9 * 41.0 +/- 0.8 40.1 +/- 1.2 42.5 +/- 1.3 * 40.1 +/- 0.5
Thickness (mm) 9.8 +/- 0.3 * 10.6 +/- 0.3 10.3 +/- 0.4 11.3 +/- 0.5 * 10.4 +/- 0.2
Volume (cubic mm) 4160 +/- 210 * 4790 +/- 200 4600 +/- 290 5350 +/- 330 * 4630 +/- 130

Table 1 - Mean length of the soft palate measured as a curve in the midline, the mean thickness of the soft palate and the mean volume (+/- standard deviation) for patients with none, mild, moderate, and severe sleep apnea.
*Significant difference between groups (p<0.05).

 

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