Abstract

Aim of the study: To assess if the modified Mallampati score (MMS) can predict the presence and the severity of obstructive sleep apnea syndrome (OSA) in a group
of patients who had snoring and witnessed apnea from Al-Azhar university hospitals, Cairo, Egypt and Almoosa Hospital, Alhasa, Saudi Arabia.

Methods: A retrospective study was done for patients who had snoring and witnessed apnea referred to a sleep lab for the diagnosis of OSA by overnight full polysomnogram from January 2017 to November 2020. Apnea-hypopnea index (AHI) was used to categorize the severity of sleep apnea. Age, sex, MMS, body mass
index (BMI), comorbidities, sleep and laboratory parameters were recorded. Also, full Otorhinolaryngological, Neurological and Internal medicine examinations were recorded.

Results: The study was carried out on 350 patients fulfilling the inclusion criteria with a mean age 51.3 ± 14.3 years ranging from 14 to 81 years. More than half of them (58.6%) were males, the mean BMI was 35.1 ± 8.8 kg/m2 and the mean MMS was 4.7 ± 1.6 with about 65% of patients grouped in classes III and IV. OSA
(AHI>5) was diagnosed in 278 (79.4%) patients. Significantly, OSA was more detected among males, those with increased age, BMI, MMS, and those with type 2 diabetes mellitus (T2DM). Further evaluation showed a significant positive correlation between both BMI and MMS with the severity of OSA (ρ =0.23, P<0.001 and
ρ =0.36, P<0.001) respectively.

Conclusion: MMS is a useful tool to predict the presence as well as the severity of OSA in snoring patients. BMI and male gender are independent predictors.

Keywords: Snoring; Modified Mallampati Score; Body Mass Index; Obstructive Sleep Apnea