Histological evaluation of soft palate tissues in patients with sleep-disordered breathing

Introduction: Sleep is a physiological state essential for the proper functioning of the body. One of the reasons for its disturbance is obstructive sleep apnea syndrome (OSAS). Aim: The aim of this research is the histological evaluation of the soft palate in patients who suffered from various types of OSAS. Material and method: The study group consisted of patients with sleep-disordered breathing (SDB) in the form of primary snoring or OSAS. Patients with chronic tonsillitis, without a history of SDB, were included in the comparative group. Fragments of the mucous of the uvula (study group) and the palatoglossal pillar (comparative group) were obtained during surgery for histological evaluation. Using histological, histochemical and immunohistochemical methods, we assessed the inflammation and its severity (CD3, CD20, CD68), the structure of nerve fibers (S-100) and the size of blood vessels (CD34) in the examined tissue. Results: Patients with OSAS developed a local inflammatory process in the palatal tissues (stronger expression of CD3, CD20, CD68 in patients with OSAS). The severity of the immunohistochemical reaction with CD3 correlated with the stage of OSAS. A higher degree of fibrosis and a higher expression of CD34 and S-100 receptors were observed in patients with OSAS compared to snoring patients and patients from the comparative group. Conclusion: Most likely, snoring due to chronic tissue vibration leads to damage to the nerve fibers in the soft palate, which can intensify episodes of hypopneas during and increase the chance for sleep apneas.