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Identify Patients at Risk of Moderate or Severe OSAHS During ENT Examination.
Nicolas Lenay1, Bruno Toussaint1, Phi Linh Nguyen-Thi2
1Department of Ear, Nose, Throat-Head and Neck Surgery University Hospital of Nancy, Hospitals of Brabois Vandoeuvre-les-Nancy France.
Laryngoscope Investigative Otolaryngology
|June 12, 2026
Summary
Routine ENT exams can identify patients at risk for moderate/severe obstructive sleep apnea-hypopnea syndrome (OSAHS). Key predictors include age over 45, retrovelar narrowing, and mega-epiglottis, aiding early OSAHS screening.
Area of Science:
- Otolaryngology and Sleep Medicine
- Anatomical Predictors of Sleep Apnea
- Upper Airway Imaging and Analysis
Background:
- Obstructive sleep apnea-hypopnea syndrome (OSAHS) significantly impacts patient health.
- Identifying anatomical risk factors during routine otolaryngology (ENT) examinations is crucial for early OSAHS detection.
- Current diagnostic methods for OSAHS can be resource-intensive.
Purpose of the Study:
- To identify specific anatomical features identifiable during awake ENT examinations that predict moderate to severe OSAHS.
- To develop a screening model based on these anatomical factors for OSAHS risk assessment.
- To correlate ENT findings with polysomnographic results for OSAHS severity.
Main Methods:
- Prospective study of 110 patients with snoring or suspected OSAHS.
- Standardized ENT examination including nasofibroscopy and sleep recording.
- Independent anatomical assessment of the epiglottis, retro-pharyngeal space, and tongue base by two examiners.
- Multivariate logistic regression analysis to identify independent predictors of moderate/severe OSAHS.
Main Results:
- Excellent interobserver agreement was achieved for key anatomical assessments (e.g., epiglottis shape, retro-pharyngeal space).
- Significant associations with moderate/severe OSAHS included age > 45 years, male sex, retrovelar narrowing < 1 cm, mega-epiglottis, and modified Cormack-Lehane score.
- Independent predictors identified were age > 45 years (aOR=4), retrovelar narrowing < 1 cm (aOR=2.8), and mega-epiglottis (aOR=4.1).
Conclusions:
- Routine anatomical assessment of the upper airway during ENT consultations is a valuable tool for identifying patients at risk of moderate/severe OSAHS.
- Specific anatomical factors like age, retrovelar narrowing, and epiglottis morphology can effectively predict OSAHS severity.
- This approach facilitates targeted screening and management of OSAHS patients.
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