P089 The Predictive Value of an Omegoid Epiglottis in Upper Airway Reconstruction Surgery for Obstructive Sleep Apnea

BACKGROUND: Obstructive sleep apnea is a serious medical issue with significant cardiovascular health associated complications. Surgical intervention is indicated for patients who are refractory to medical management. It’s efficacy was demonstrated in SAMS Trial in 2019. Surgery in this trial predominantly widened the airway in an anterior-posterior plane. An omegoid epiglottis has been hypothesized to be indicative of chronic lateral airway collapse, which hypothetically would be less responsive to the surgical protocol used in SAMS trial.. Our aim is to determine whether an omegoid epiglottis is therefore a poor predictor of surgical success. METHOD: Following ethics approval, 53 OSA patients MRI images, Apnoea-hypopnea index’s (AHI) and Epworth sleepiness scale’s (ESS) who fell into the surgical arm of the SAMS trial were de-identified and retrospectively analyzed. Two independent researchers measured the width: depth ratio and alpha angle of patient epiglottises on MRI and used this data to separate patients into omegoid and non-omegoid epiglottis cohorts. The difference between pre-operative and post-operative AHI and ESS scores were tabulated and statistically analyzed between the 2 cohorts to determine the effectiveness of surgery. Intra-rater measurement assessments were undertaken to ensure reliability of data-collection. Result: Epiglottis shape will be correlated with the effectiveness of multilevel OSA surgery based on qualitative, Epworth Sleepiness Scale (ESS), and quantitative, apnoea-hypoapnoea index (AHI) data collection prior and post-surgery (On going). CONCLUSIONS: This study aims to determine whether an omegoid epiglottis acts as a predictor of poor outcome following SAM trial soft tissue reconstructive protocol.