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Scientific Oral Presentations

Laryngology/Broncho-Esophagology

Session: Scientific Oral Presentation 2 - Laryngology/Broncho-Esophagology

What Is the Role of Laryngeal Morphology in Obstructive Sleep Apnea? A Retrospective Analysis

Sunday, October 12, 2025

10:24 AM - 10:30 AM EDT

Location: 138

Introduction: Laryngeal morphological features may contribute to airway obstruction in obstructive sleep apnea (OSA), but standardized evaluation protocols are lacking. This study investigated specific laryngeal findings in OSA patients while assessing the reliability of current evaluation methods.

Methods: We conducted a retrospective analysis of fiberoptic laryngoscopy videos from 145 patients (88 OSA, 54 non-OSA controls, 3 incomplete assessments) between 2022-2023. Two board-certified otolaryngologists independently evaluated videos for laryngomalacia, arytenoid position, epiglottic shape/prolapse, and post-cricoid redundancy. We assessed inter-rater reliability using Cohen's kappa and analyzed associations between disease exposures (OSA, obesity, COPD, GERD) and laryngeal morphology using multiple regression.

Results: Assessment reliability varied significantly across features. Epiglottic prolapse showed the highest inter-rater agreement (κ=0.318, p< 0.001), followed by laryngomalacia (κ=0.174, p=0.035), while post-cricoid redundancy demonstrated minimal consensus (κ=0.0848, p=0.283). Traditional OSA risk factors including severity, obesity, GERD, and COPD did not predict laryngeal morphology outcomes. Age showed a significant negative correlation with epiglottic prolapse score (β=–0.089, p=0.035), suggesting age-related changes in laryngeal morphology.

Conclusions: Our findings reveal varying reliability in laryngeal assessment methods, with epiglottic prolapse being most consistently evaluated. The significant inverse relationship between age and epiglottic prolapse, combined with independence from traditional OSA risk factors, indicates that laryngeal morphology represents a distinct consideration in OSA evaluation. These results highlight the need for standardized assessment protocols and age-specific considerations in surgical planning.

Presenting Author(s)

AH

Alexandria L. Harris, MS, MD

Resident Physician
University of Pittsburgh Medical Center - Medical Education Program
Pittsburgh, PA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.

Co-Author(s)

KC

Katie M. Carlson, MPH

Epidemiologist
University of Pittsburgh
Pittsburgh, PA, United States

Disclosure information not submitted.
Thomas M. Kaffenberger, MD

Assistant Professor of Otolaryngology
University of Pittsburgh Medical Center
Pittsburgh, PA, United States

Disclosure(s):
faculty for this accredited education activity has no relationship(s) with ineligible companies to disclose.
AM

Angela L. Mazul, PhD

Assistant Professor
University of Pittsburgh
Pittsburgh, PA, United States

Disclosure information not submitted.

Senior Author(s)

SS

Sandra Stinnett, MD

Clinical Assistant Professor
University of Pittsburgh Department of Otolaryngology-Head & Neck Surgery, United States

Disclosure information not submitted.