CHIN-CHUNG SHUPEI-LIN LEEJOU-WEI LINCHUN-TA HUANGYEUN-CHUNG CHANGCHONG-JEN YUHAO-CHIEN WANG2020-07-202020-07-2020131932-6203https://www.scopus.com/inward/record.uri?eid=2-s2.0-84877623012&doi=10.1371%2fjournal.pone.0062848&partnerID=40&md5=9a51a8a64c526e5ae5f125952c741efbhttps://scholars.lib.ntu.edu.tw/handle/123456789/510210Objective:This study aimed to explore the association between obstructive sleep apnea (OSA) severity and pharyngeal parameters using sub-mental ultrasonography (US), and investigate the accuracy of US for identifying severe OSA patients.Methods:One hundred and five consecutive referrals for suspected OSA were enrolled. The diameters of the retro-glossal (RG) and retro-palatal (RP) regions were measured via sub-mental US upon expiration during tidal breathing, forced inspiration, and M?ller maneuver (MM). Independent factors associated with severe OSA identified from two-thirds of randomly-selected patients (model-development group) were used to construct a model for predicting severe OSA. The accuracy of the model was validated in the remaining one-third of patients (validation group).Results:Fifty severe OSA patients, 30 with mild-moderate OSA, and 25 without OSA were enrolled. Compared to non-OSA and mild-moderate OSA patients, those with severe OSA had narrower RP diameter in all three maneuvers. Using the prediction model constructed with changes of RP diameters at MM and neck circumference, the independent predictors of severe OSA in the model-development group had 100% sensitivity and 65% specificity.Conclusion:Sub-mental US can accurately discriminate the severity of OSA and be used to identify patients with severe OSA. ? 2013 Shu et al.[SDGs]SDG3adult; article; controlled study; diagnostic accuracy; diagnostic test accuracy study; disease severity; echography; female; forced expiration; human; inspiratory capacity; major clinical study; male; Muller maneuver; neck circumference; patient identification; polysomnography; prediction; randomized controlled trial; respiratory tract parameters; sensitivity and specificity; sleep disordered breathing; tidal volume; Adult; Body Mass Index; Female; Humans; Male; Middle Aged; Odds Ratio; Pharynx; Polysomnography; Reproducibility of Results; Risk Factors; ROC Curve; Severity of Illness Index; Sleep Apnea, Obstructivejournal article10.1371/journal.pone.0062848236754332-s2.0-84877623012