Oropharyngeal Exam Confirms Obstructive Sleep Apnea

Friedman tongue position score associated with obstructive sleep apnea severity

THURSDAY, Oct. 20 (HealthDay News) -- The Friedman tongue position (FTP) score on oropharyngeal examination confirms obstructive sleep apnea syndrome (OSAS) and is associated with its severity, according to a study published in the October issue of the Archives of Otolaryngology -- Head & Neck Surgery.

Xavier Barceló, M.D., from the Hospital de l'Esperit Sant de Santa Coloma in Barcelona, Spain, and colleagues investigated whether oropharyngeal examination by FTP was useful in confirming OSAS and its severity in 301 patients (mean age, 51 years; 75 percent male) admitted to the sleep disorders unit with suspicion of OSAS. Patients underwent neck perimeter measurements, body mass index (BMI) calculation, oropharyngeal examination, rhinomanometry, fiberendoscopy, and a sleep study.

The investigators found that the apnea-hypopnoea index (AHI) was at least 5.0/hour in 94 percent of the patients. A total of 74.1, 14.3, and 11.6 percent of the patients had FTP scores of 2 and 3, 1, and 4, respectively. The AHI values were normal in 6 percent of patients, of which 16 and two patients had FTP scores of 1 and 2, respectively. BMI, cervical perimeter, tonsil size score, uvula score, nasal flow at 150 Pa, and age were associated with OSAS severity. Patients with tonsillectomy had AHI values higher than those who had tonsils inside the tonsillar fossa, and similar to those who had tonsils that extended beyond the tonsillar pillars. Only FTP had a relevant association with OSAS severity on multiple regression analysis.

"Our results suggest that a patient with an FTP score of 3 or 4 is unlikely to have an AHI value within the normal range," the authors write.

Two authors disclosed financial relationships with the pharmaceutical industry.

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