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Epidemiology and Population Health

Relations between body mass index, laryngeal fat pads, and laryngeal airway configuration in adult men population

International Journal of Obesity volume 45, pages 288–295 (2021)Cite this article

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Abstract

Background

The impact of body mass index (BMI) on pharyngeal fat pads has been well studied, yet no study has assessed its associations on laryngeal morphology.

Objectives

To study the associations of BMI differences on laryngeal morphology in adult males using computed tomography angiography (CTA) scans.

Methods

All adult male patients who underwent head and neck CTAs between 2011 and 2018 were initially included and categorized according to their BMI: (1) BMI < 20; (2) 20 ≤ BMI < 25; (3) 25 ≤ BMI < 30; (4) 30 ≤ BMI < 35; and (5) BMI ≥ 35. Anatomical measurements included pre-epiglottic and paraglottic fat-pad dimensions, airway width at the epiglottis tip and base, and epiglottis angle. For statistical analysis, BMI was regarded both as a categorical and continuous variable.

Results

One hundred and five scans were included. BMI ranged from 15.90 to 44.40 kg/m2. Significant differences were found in pre-epiglottic and paraglottic fat measurements between BMI subgroups 1–5 (Pre-epiglottic fat depth: 17.75, 17.74, 19.04, 20.73, and 21.09 mm, respectively, P = 0.005, correlation 0.343, and P < 0.001 in continuous measurement; Paraglottic space average width: 3.5, 5.4, 5.46, 6.85, and 7.38 mm, P < 0.001, correlation 0.532, and P < 0.001 in continuous measurement). As BMI increased, the epiglottis-hard-palate angle increased (56.4°, 55.3°, 65.2°, 64°, and 68.4°, P = 0.001, correlation 0.354, and P < 0.001 in continuous measurement). No significant difference was found in airway width between subgroups at the epiglottis tip or base. Yet, in continuous variables analysis, a significant negative correlation was found between BMI scores and the airway width at the epiglottis base (−0.226, P = 0.02).

Conclusions

In adult males, BMI is correlated with laryngeal fat-pad volume, affecting its morphology and airway width. Clinical implications regarding obstructive sleep apnea and voice quality should be further investigated.

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Fig. 1: Anatomic measurements of the study.
Fig. 2: Comparison of the study’s measurements divided into the BMI subgroups.
Fig. 3: Association of BMI with anatomic measurements of the study—continuous variable analysis.
Fig. 4: Impact of body mass index (BMI) on the epiglottis-hard-palate angle.

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Author notes

  1. These authors contributed equally: Yonatan Lahav, Meital Adi

Authors and Affiliations

  1. Department of Otolaryngology, Head and Neck Surgery, Kaplan Medical Center, Rehovot, Israel

    Yonatan Lahav, Doron Halperin & Oded Cohen

  2. Hadassah Medical School, Hebrew University, Jerusalem, Israel

    Yonatan Lahav, Meital Adi, Eden Arberboy, Doron Halperin & Oded Cohen

  3. Department of Radiology, Kaplan Medical Center, Rehovot, Israel

    Meital Adi

  4. Department of Otolaryngology, Head and Neck Surgery, Rabin Medical Center, Petah Tikva, Israel

    Hagit Shoffel-Havakuk

  5. Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    Hagit Shoffel-Havakuk

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Correspondence to Oded Cohen.

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Lahav, Y., Adi, M., Arberboy, E. et al. Relations between body mass index, laryngeal fat pads, and laryngeal airway configuration in adult men population. Int J Obes 45, 288–295 (2021). https://doi.org/10.1038/s41366-020-0631-6

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