The effect of pharyngeal soft tissue components on snoring Ersin Ozturk a, 4 , Deniz Dalayman b , Guner Sonmez a , Hakan Mutlu a , H. Onur Sildiroglu a , C. Cinar Basekim a , Esref Kizilkaya a a Department of Radiology, GATA Haydarpasa Teaching Hospital, Istanbul, Turkey b Department of Radiology, German Hospital, Istanbul, Turkey Received 24 January 2007; accepted 17 February 2007 Abstract Objective: To determine the effect of oropharyngeal air column area, parapharyngeal fatpad thickness, pterygoid muscle thickness, and parapharyngeal wall thickness on snoring. Materials and Methods: Fifty-six individuals (35 men, 21 women) complaining of snoring in a questionnaire administered to pati attending the MR unit for cervical MR imaging were enrolled as the study group, and 39 (23 men, 16 women) individuals of snoring were enrolled as the control group. Firstly, patients’ body mass index (BMI) was determined. Then turbo spin e MR imaging in the axial plane was performed, from the nasopharynx to the hyoid bone level, in both groups. From the MR images, oropharyngeal air column area, parapharyngeal fat pad thickness, pterygoid muscle thicknessand parapharyngeal wall thickness measurements were made. Finally, the results were statistically analysed using SPSS (Statistical Package for Social Scien 10.0.Student’s t-testwasused asa complementary method in the analysis of the study data. The correlations between BMIand parapharyngeal wall thickness, and BMI and oropharyngeal air column area were determined by Pearson’s correlation analysis. Results:No statistically significant difference was found between study and control groups in terms of mean age, pterygoid muscle thickness, or pharyngeal fat pad thickness ( P N.05). Snorers’ BMI levels ( P b.01) and average parapharyngeal wall thick statistically significantly higher than those of the control subjects. Snorers’ oropharyngeal air column area was significantly narrower t that of the control subjects, statistically ( P b.01). Conclusion: As a result of the study, it was concluded that only oropharyngeal air column area and parapharyngeal musc effect on snoring. D 2007 Elsevier Inc. All rights reserved. Keywords: Snoring; Magnetic resonance imaging; Oropharyngeal air column area; Parapharyngeal fat pad; Pterygoid muscle; Parapharyng 1. Introduction Snoring is a disturbing sound produced by vibrations of the soft tissues in the upper respiratory passages as a result of partial narrowing of these soft tissues during sleep [1]. It is a problem frequently encountered in adults and may be observed in any person, but particularly in males and overweight individuals, smokers, and alcohol users.Al- though snoring may be regarded as a trivial condition by some,it is a disorder thataffects sleep patterns and may sometimes preventhe sufferer from receiving sufficient oxygen during sleep. The determination of the site ofthe obstruction in the upperrespiratory passages causing snoring is particularly important for surgical treatment. Various methods may be used to analyze the structures of the bones and soft tissu constitute these regions. These methods are fluoroscopy, nasopharyngoscopy, cephalometry, computed tomography (CT), and magnetic resonance (MR) imaging. The ideal imaging modality should be a method that is economical, noninvasive, in which the patient can be in a supine posi and that does not involve radiation. In addition, it must s anatomical structures at high resolution. Although such a modality does not yet exist, MR imaging is a relatively go method for examining the upper respiratory passages. Our aims in this study were to determine, using MR, which of the soft tissue components surrounding the airw that mightcauseobstruction in the upperrespiratory 0899-7071/07/$ – see front matter D 2007 Elsevier Inc. All rights reserved. doi:10.1016/j.clinimag.2007.02.024 4 Corresponding author. GATA Haydarpasa Egitim Hastanesi, Usku- dar,Istanbul, Turkey.Tel.:+90 212 2797578 (home), +90 216 5422879 (work); fax: +90 216 5422808. E-mail address: drersini@yahoo.com (E. Ozturk). Clinical Imaging 31 (2007) 259 – 263