MRI analysis of tissue and airway volumes following upper airway surgery for Obstructive Sleep Apnoea

A. Lowth, K. Sutherland, N. Antic, S. Carney, P. G. Catcheside, C. L. Chai-Coetzer, M. Chia, J. C. Hodge, A. Jones, R. Lewis, S. MacKay, N. McArdle, R. D. McEvoy, E. Ooi, A. Pinczel, G. Rees, B. Singh, N. Stow, E. Weaver, C. WoodsA. Yeo, P. A. Cistulli

Research output: Contribution to journalMeeting Abstractpeer-review


Primary analysis of data from the Sleep Apnea Multilevel Surgery (SAMS) trial has shown significant improvement in Obstructive Sleep Apnoea (OSA) severity in patients undergoing modified uvulopalatopharyngoplasty and minimally invasive tongue volume reduction. However, the anatomical effects of this surgery and relationship to OSA improvement have not been investigated. We aimed to quantify pharyngeal changes following surgery.

51 OSA patients were randomised to surgical intervention. Upper airway MRI (T1-weighted) was performed at baseline and 6 months post-surgery. Scans were used to create 3-dimensional volumetric models of the tongue (genioglossus muscle), soft palate, and pharyngeal airway space by manual segmentation. Volume changes were compared by paired t-test, and relationship with AHI change assessed using Spearman's correlation.

Preliminary analysis of 15 subjects has been completed to date (Age: 41.5 ± 11.0 years [mean ± SD]); BMI: 31.9 ± 4.2 kg.m-2; 73.3% male). AHI was confirmed to improve in this subset (baseline:50.7 ± 23/hr, 6-month:17.6 ± 9.0/hr, p < 0.001) with no weight change observed (p = 0.85). No change was observed in MRI volumetric models of the tongue (baseline:97.2 ± 18.2 cm3, 6-month:98.1 ± 17.5 cm3, p = 0.90), soft palate (baseline:9.5 ± 2.3 cm3, 6-month:7.9 ± 1.7 cm3, p = 0.058), or airway space (baseline:19.0 ± 5.9 cm3, 6-month:16.1 ± 4.5 cm3, p = 0.12). Correlation analysis showed no relationship between changes in these volumes and AHI change. Analysis was performed by a single operator, blind to pre- or post-operative status, with good intra-rater reliability (ICC 0.85–0.99, N = 5).

Preliminary analysis did not identify significant changes in 3D MRI modelled pharyngeal volumes 6 months after multilevel upper airway surgery. Work is ongoing to complete volumetric analysis, 3D mandibular dimensions, and measurement of craniofacial structures.
Original languageEnglish
Article number0074
Pages (from-to)34-35
Number of pages2
JournalJournal of Sleep Research
Issue numberS1
Publication statusPublished - Oct 2019
EventSleep Down Under 2019: 31st ASM of Australasian Sleep Technologists Association - Sydney, Australia
Duration: 16 Oct 201919 Oct 2019
Conference number: 31


  • Obstructive sleep apnoea
  • Sleep Apnea Multilevel Surgery (SAMS) trial
  • Airway
  • Volume


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