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Upper airway modifications after weight loss: a systematic review
Carolina Ferraz de Paula Soares1, Michel Burihan Cahali1
1Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (HC-FMUSP), Departamento de Otorrinolaringologia, São Paulo, SP, Brazil.
Brazilian Journal of Otorhinolaryngology
|December 6, 2022
Summary
Weight loss improves sleep apnea by increasing upper airway space. This occurs through reduced parapharyngeal fat and hyoid bone repositioning, particularly in the retropalatal region.
Area of Science:
- Anatomy and Physiology
- Sleep Medicine
- Bariatric Medicine
Background:
- Weight loss is a primary treatment for sleep apnea severity.
- Objective assessment of airway changes post-weight loss is a recent area of research.
- Understanding these anatomical alterations is crucial for effective sleep apnea management.
Purpose of the Study:
- To systematically review and evaluate literature on upper airway alterations following weight loss.
- To synthesize findings on how these changes impact obstructive sleep apnea.
Main Methods:
- A comprehensive literature search was conducted across major medical databases (PubMed, Web of Science, Scopus, Embase).
- Initial search yielded 681 articles.
- 10 studies were selected for detailed data extraction and analysis.
Main Results:
- Weight loss generally increases retropalatal airway area, often in the lateral pharyngeal region.
- Volumetric studies show reduced parapharyngeal and tongue fat, and decreased pharyngeal soft tissue volume.
- Craniofacial analysis indicates reduced airway height due to hyoid bone repositioning.
Conclusions:
- Limited high-quality evidence exists on weight loss-induced upper airway changes and their effect on obstructive sleep apnea.
- Current evidence suggests weight loss expands airway space by reducing parapharyngeal structures.
- Key findings include lateral airway area gain and hyoid bone relocation.
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