{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,15]],"date-time":"2026-05-15T03:37:42Z","timestamp":1778816262348,"version":"3.51.4"},"reference-count":39,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2024,4,12]],"date-time":"2024-04-12T00:00:00Z","timestamp":1712880000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Positive airway pressure (PAP) titration during drug\u2010induced sleep endoscopy (DISE) provides objective measures of upper airway collapsibility. While skeletal measurements relate to collapsibility measures on DISE, the influence of soft tissue dimensions on upper airway collapsibility is not known. We analyzed the relationship of measures of upper airway soft tissue volumes, specifically soft palate, pharyngeal lateral walls, and tongue, with metrics of collapsibility.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Cross\u2010sectional analysis from a prospective cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Academic medical center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Patients seeking PAP alternative therapies for obstructive sleep apnea (OSA) underwent standardized supine computed tomography (CT) acquisition and DISE protocols. The CT analysis primarily focused on soft tissue volumes and, secondarily, on airway and skeletal volumetric measures. DISE with PAP administration (DISE\u2010PAP) enabled the determination of the pressure at which inspiratory airflow first commenced (pharyngeal critical pressure, Pcrit<jats:sub>A<\/jats:sub>) and the pressure at which inspiratory flow limitation was abolished (pharyngeal opening pressure, PhOP). Both unadjusted and adjusted correlation analyses were performed to understand the relationship between upper airway anatomy and either Pcrit<jats:sub>A<\/jats:sub> or PhOP.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>One hundred thirty\u2010nine subjects completed both CT and DISE\u2010PAP. On average, patients were male (70.5%), white (84.2%), middle\u2010aged (56.6\u2009\u00b1\u200913.5 years), and overweight (29.6\u2009\u00b1\u20094.7\u2009kg\/m<jats:sup>2<\/jats:sup>), with moderate\u2010severe apnea\u2010hypopnea index (29.7\u2009\u00b1\u200921.3\u2009events\/h). Adjusted for age, sex, body mass index, and skeletal volumes, soft palate, and lateral pharyngeal wall volumes were not associated with PhOP or Pcrit<jats:sub>A<\/jats:sub>, but a larger tongue was associated with more positive PhOP (<jats:italic>\u2374\u2009<\/jats:italic>=\u20090.20, <jats:italic>P<\/jats:italic>\u2009=\u2009.02), and more positive Pcrit<jats:sub>A<\/jats:sub> (<jats:italic>\u2374<\/jats:italic>\u2009=\u20090.16, <jats:italic>P<\/jats:italic>\u2009=\u2009.07). Exploratory analyses revealed smaller minimum cross\u2010sectional retropalatal area and intramandibular volume were also associated with increased collapsibility measures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>After controlling for clinical factors and skeletal volume, greater tongue volume was associated with more severe collapsibility during DISE. These results, in concert with previous work, suggest that greater tongue volume in a smaller skeletal dimensions contribute to the severity of airway collapsibility, a key driver of OSA pathogenesis.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ohn.772","type":"journal-article","created":{"date-parts":[[2024,4,13]],"date-time":"2024-04-13T02:53:32Z","timestamp":1712976812000},"page":"578-587","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Association Between Soft Tissue Measures From Computed Tomography and Upper Airway Collapsibility on Drug\u2010Induced Sleep Endoscopy"],"prefix":"10.1002","volume":"171","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4670-4399","authenticated-orcid":false,"given":"Eric R.","family":"Thuler","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Division of Sleep Surgery University of Pennsylvania Perelman School of Medicine Philadelphia Pennsylvania 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