Pharyngeal cross-sectional area in normal men and women

Pharyngeal size and the dynamic behavior of the upper airway may be important factors in modulating respiratory airflow. Patients with obstructive sleep apnea are known to have reduced pharyngeal cross-sectional area. However, no systematic measurements of pharyngeal area in healthy asymptomatic subjects are available, in part due to the lack of simple, rapid, and noninvasive measurement techniques. We utilized the acoustic reflection technique to measure pharyngeal cross-sectional area in 24 healthy volunteers (14 males, 10 females). Pharyngeal area was measured during a continuous slow expiration from total lung capacity (TLC) to residual volume (RV). We compared pharyngeal cross-sectional areas in males and females at three lung volumes: TLC, 50% of vital capacity (VC), and RV. In males, pharyngeal areas (means +/- SD) were 6.4 +/- 1.3 cm2 at TLC, 5.4 +/- 0.9 cm2 at 50% VC, and 4.1 +/- 0.8 cm2 at RV. In females, pharyngeal areas were 4.8 +/- 0.6 cm2 at TLC, 4.2 +/- 0.5 cm2 at 50% VC, and 3.7 +/- 0.6 cm2 at RV. The difference in area between males and females was statistically significant at TLC and 50% VC but not at RV. However, when the pharyngeal cross-sectional area was normalized for body surface area, this difference was not significant. In males there was a negative correlation of pharyngeal area with age. We conclude that sex differences in pharyngeal area are related to body size, pharyngeal area shows a similar variation with lung volumes in males and females, and in males pharyngeal area reduces with age.