PHARYNGEAL DIMENSIONS IN HEALTHY MEN AND WOMEN

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Carvalho, Newton Kara-José, Edméa Rita Temporini, Newton Kara-Junior" "autores" => array:4 [ 0 => array:2 [ "nombre" => "Regina de Souza" "apellidos" => "Carvalho" ] 1 => array:2 [ "nombre" => "Newton" "apellidos" => "Kara-José" ] 2 => array:2 [ "nombre" => "Edméa Rita" "apellidos" => "Temporini" ] 3 => array:2 [ "nombre" => "Newton" "apellidos" => "Kara-Junior" ] ] ] ] ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1807593222031490?idApp=UINPBA00004N" "url" => "/18075932/0000006200000001/v1_202212060743/S1807593222031490/v1_202212060743/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S1807593222031477" "issn" => "18075932" "doi" => "10.1590/S1807-59322007000100001" "estado" => "S300" "fechaPublicacion" => "2007-01-01" "aid" => "3147" "copyright" => "CLINICS" "documento" => "simple-article" "crossmark" => 0 "licencia" => "https://creativecommons.org/licenses/by-nc/3.0/" "subdocumento" => "edi" "cita" => "Clinics. 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=> "PHARYNGEAL DIMENSIONS IN HEALTHY MEN AND WOMEN" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "5" "paginaFinal" => "10" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "Mauro Miguel Daniel, Maria Cecília Lorenzi, Claudia da Costa Leite, Geraldo Lorenzi-Filho" "autores" => array:4 [ 0 => array:4 [ "nombre" => "Mauro Miguel" "apellidos" => "Daniel" "email" => array:1 [ 0 => "loredaniel@uol.com.br" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff1" ] ] ] 1 => array:3 [ "nombre" => "Maria Cecília" "apellidos" => "Lorenzi" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "b" "identificador" => "aff2" ] ] ] 2 => array:3 [ "nombre" => "Claudia da Costa" "apellidos" => "Leite" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "a" "identificador" => "aff1" ] ] ] 3 => array:3 [ "nombre" => "Geraldo" "apellidos" => "Lorenzi-Filho" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "c" "identificador" => "aff3" ] ] ] ] "afiliaciones" => array:3 [ 0 => array:3 [ "entidad" => "Department of Radiology, Neuroradiology Division, São Paulo University Medical School – São Paulo/SP, Brazil." "etiqueta" => "a" "identificador" => "aff1" ] 1 => array:3 [ "entidad" => "Department of Otorhinolaryngology, Pulmonary Division, São Paulo University Medical School – São Paulo/SP, Brazil." "etiqueta" => "b" "identificador" => "aff2" ] 2 => array:3 [ "entidad" => "Department of Cardio-Pneumology, Pulmonary Division, São Paulo University Medical School – São Paulo/SP, Brazil." "etiqueta" => "c" "identificador" => "aff3" ] ] ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig2" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 799 "Ancho" => 994 "Tamanyo" => 143113 ] ] "descripcion" => array:1 [ "en" => "(A and B) –Sagittal measurements" ] ] ] "textoCompleto" => "INTRODUCTIONObstructive sleep apnea syndrome is characterized by repetitive episodes of obstruction of the upper airway during sleep and is found more frequently in obese individuals, possibly due to fat deposition in some neck structures. Epidemiological studies reveal a high prevalence of the syndrome in men and obese people.Besides the existence of functional gender-related differences regarding the pharyngeal dilator muscle activity and, therefore, the collapsibility of the pharynx,<a class="elsevierStyleCrossRefs" href="#bib1">1,2</a> another possible explanation for the predominance of male obstructive sleep apnea syndrome patients is the existence of anatomical differences in the upper airway. Previous studies using the acoustic reflection technique to assess the pharyngeal cross-sectional area showed that this area is significantly larger in healthy men than in healthy women in the sitting position, whereas no difference was found in recumbent positions. Pharyngeal compliance was also found to be greater in men than in women.<a class="elsevierStyleCrossRef" href="#bib3">3</a> However, the mechanisms responsible for the increased susceptibility of men to obstructive sleep apnea syndrome are not yet completely understood.Imaging evaluation of pharyngeal structures has proven to be an important tool in the study of this obstructive syndrome, bringing insights into its pathophysiology and possible therapeutic approaches.<a class="elsevierStyleCrossRefs" href="#bib4">4–6</a> Regarding magnetic resonance imaging (MRI) of the necks of normal subjects, a larger overall soft tissue volume was found in men.<a class="elsevierStyleCrossRef" href="#bib7">7</a>In the present study, we sought to investigate upper airway anatomy of awake healthy men and women. We hypothesized that significant gender-related differences may at least in part explain the greater susceptibility of men to obstructive sleep apnea syndrome.MATERIALS AND METHODSTen healthy men and 10 healthy women were prospectively evaluated by MRI after they signed informed consent forms. The protocol was reviewed and approved by the Institutional Ethics Committee.All subjects underwent a clinical evaluation and verbally confirmed the absence of acute or chronic diseases, as well as the use of any medications. The absence of obstructive sleep apnea syndrome was assumed after observing the following criteria: a) absence of snoring; b) absence of daytime sleepiness (Epworth sleepiness scale < 10); c) absence of obstructive sleep apnea syndrome -associated conditions (hypertension, diabetes, or other cardiac diseases); and d) absence of obesity (body mass index - BMI < 30 kg/m2). Polysomnographic studies were not performed.Men and women enrolled in the study were similar regarding their mean age (32.9 ± 7.8 years and 36.2 ± 10.5 years, respectively; P = 0.430) and BMI (24.7 ± 1.3 kg/m2 and 23.7 ± 3.5 kg/m2, respectively; P = 0.350).The MRI studies were performed using the same equipment (General Electric Medical - Milwaukee, WI—1.5 Tesla). All patients were positioned in supine decubitus, with no head support, and were instructed to remain still and not to swallow, as well as to keep their mouths closed and to use soft nose breathing during the acquisition of the images. All study subjects remained awake during the exam.Twelve to 15 sagittal images (T1 weighted; 3.0 mm thickness; 1.0 mm gap) and 20 axial images (T1 and T2 weighted; 4.0 mm thickness; 2.5 mm gap) were obtained with a fast spin-echo (FSE) pulse sequence. The most cranial axial image was programmed cranial to the hard palate; the most caudal axial image was programmed at the glottic level (<a class="elsevierStyleCrossRef" href="#fig1">Figure 1</a>).<elsevierMultimedia ident="fig1"></elsevierMultimedia>Repetition time (TR) and echo time (TE) for T1 weighted images were 600 msec and 20 msec respectively. The TR and TE for T2 weighted images were 3,000 msec and 90 msec respectively (number of excitations = 2; field of view = 24 cm). A cervical neurovascular coil was used. The total examination time did not exceed 10 minutes in each case.For measuring purposes, the pharynx was schematically divided into 4 different regions: rhinopharynx, retropalatal oropharynx, retrolingual oropharynx, and hypopharynx.<a class="elsevierStyleCrossRefs" href="#bib8">8–10</a> The inferior limit of the rhinopharynx consisted of an imaginary horizontal line crossing the hard palate. The oropharynx was defined as the air space between the inferior limit of the rhinopharynx and an imaginary horizontal line tangential to the epiglottic tip. The hypopharynx extended from the inferior limit of the oropharynx to the esophageal transition.A median sagittal image in which the lingual septum and the odontoid process of the second cervical vertebra were distinguished was employed for sagittal measurements.The following sagittal measurements were obtained:<ul class="elsevierStyleList" id="celist10"><li class="elsevierStyleListItem" id="celistitem10">1.The anteroposterior length of the tongue (APtongue): defined as the distance between the tip of the tongue and its posterior border (<a class="elsevierStyleCrossRef" href="#fig2">Figure 2</a>).<elsevierMultimedia ident="fig2"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="celistitem20">2.The craniocaudal length of the soft palate (CCsoftpal): defined as the distance between the posterior nasal spine and the tip of the uvula (<a class="elsevierStyleCrossRef" href="#fig2">Figure 2</a>).</li><li class="elsevierStyleListItem" id="celistitem30">3.The anteroposterior dimension of the soft palate (APsoftpal): defined as the anteroposterior measurement of the soft palate in its thicker region (<a class="elsevierStyleCrossRef" href="#fig2">Figure 2</a>).</li><li class="elsevierStyleListItem" id="celistitem40">4.Thickness of the submentonian fat tissue (SubmentFat): defined as the craniocaudal measurement of the submentonian fat tissue in its thicker region (<a class="elsevierStyleCrossRef" href="#fig2">Figure 2</a>).</li><li class="elsevierStyleListItem" id="celistitem50">5.Hyoid bone-posterior nasal spine distance (H-PNS): defined as the distance between the superior border of the hyoid bone body and the posterior nasal spine (<a class="elsevierStyleCrossRef" href="#fig2">Figure 2</a>).</li><li class="elsevierStyleListItem" id="celistitem60">6.Distance between the hyoid bone and the posterior wall of the pharynx (H-Col): the smallest distance between the posterior border of the hyoid bone body and the posterior wall of the pharynx, near the vertebral column (<a class="elsevierStyleCrossRef" href="#fig2">Figure 2</a>).</li></ul>The following measurements were obtained from the axial images:<ul class="elsevierStyleList" id="celist20"><li class="elsevierStyleListItem" id="celistitem70">1.Laterolateral length of the tongue (LLtongue): defined as the distance between the lateral borders of the tongue in its thicker region, having as an anatomical landmark the hyoglossal muscles (<a class="elsevierStyleCrossRef" href="#fig3">Figure 3</a>).<elsevierMultimedia ident="fig3"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="celistitem80">2.Mandibular angle (MandAng): defined as the angle measured between 2 lines whose vertex lies in the internal border of the chin, following each mandibular branch in posterior and lateral directions to its most posterior internal border, near the third molar teeth (<a class="elsevierStyleCrossRef" href="#fig3">Figure 3</a>).</li><li class="elsevierStyleListItem" id="celistitem90">3.The space between the pharyngeal air column and the mandibular branch (LatWall): defined as the distance between the pharyngeal air column and the mandibular branch at the level of the retropalatal oropharynx, comprising the so-called lateral wall of the pharynx, the parapharyngeal space, and the pterygoid muscle (<a class="elsevierStyleCrossRef" href="#fig3">Figure 3</a>).</li></ul>The morphology of the pharyngeal air column was also observed. Linear laterolateral (LL) and anteroposterior (AP) axial measurements were obtained at the following levels (<a class="elsevierStyleCrossRef" href="#fig4">Figure 4</a>):<ul class="elsevierStyleList" id="celist30"><li class="elsevierStyleListItem" id="celistitem100">1.Rhinopharynx (Level 1): axial pharyngeal image at the hard palate level (<a class="elsevierStyleCrossRef" href="#fig5">Figure 5a</a>).<elsevierMultimedia ident="fig5"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="celistitem110">2.High retropalatal oropharynx (Level 2): pharyngeal measurements in a plane lying 1.0 cm below the inferior limit of the rhinopharynx (hard palate) (<a class="elsevierStyleCrossRef" href="#fig5">Figure 5b</a>).</li><li class="elsevierStyleListItem" id="celistitem120">3.Low retropalatal oropharynx (Level 3): pharyngeal measurements at the uvula level or at the narrowest air column point of the low retropalatal region (<a class="elsevierStyleCrossRef" href="#fig5">Figure 5c</a>).</li><li class="elsevierStyleListItem" id="celistitem130">4.Retrolingual oropharynx (Level 4): measurements obtained in an intermediate image between the uvula and the tip of the epiglottis (<a class="elsevierStyleCrossRef" href="#fig5">Figure 5d</a>).</li></ul><elsevierMultimedia ident="fig4"></elsevierMultimedia>Statistical analysis included descriptive statistics and the Student t test, after checking the assumptions for the use of parametric tests, using STATA® (Statistical Data Analysis) software, version 7.0. A P ≤ 0.05 in 2-tailed tests was considered significant.RESULTSSagittal pharyngeal measurementsThe mean anteroposterior length of the tongue was significantly greater in men (7.50 ± 0.48 cm) than in women (7.00 ± 0.39 cm) (P = 0.020). The anteroposterior soft palate dimension was also greater in men (0.99 ± 0.07 cm) compared to women (0.88 ± 0.09 cm) (P = 0.009). Men also showed significantly larger distances between the hyoid bone and the posterior nasal spine (6.50 ± 0.76 cm) and between the hyoid bone and the posterior pharyngeal wall (2.89 ± 0.34 cm) compared to women (5.67 ± 0.48 cm, P = 0.009, and 2.23 ± 0.31 cm, P = 0.0003, respectively).In summary, MR images of normal men showed a significantly greater mean sagittal pharyngeal structural dimensions compared to those obtained from MR images of normal women, with the exception of the craniocaudal length of the soft palate and the thickness of the submentonian fat (<a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>).<elsevierMultimedia ident="tbl1"></elsevierMultimedia>Axial pharyngeal measurementsRegarding the cross-sectional linear dimensions, men and women had similar mean measurements, with the exception of the laterolateral tongue length, which was greater in men (4.55 ± 0.40 cm) than in women (4.21 ± 0.30 cm) (P = 0.05) (<a class="elsevierStyleCrossRef" href="#tbl2">Table 2</a>).<elsevierMultimedia ident="tbl2"></elsevierMultimedia>Pharyngeal column cross-sectional linear measurementsAll mean linear measurements of the pharyngeal air column were similar in men and women at the 4 levels considered (<a class="elsevierStyleCrossRef" href="#tbl3">Table 3</a>).<elsevierMultimedia ident="tbl3"></elsevierMultimedia>DISCUSSIONSince obstructive sleep apnea syndrome is more predominant in men overall, analyzing data from both men and women without obstructive apnea is an important starting point for better understanding of the mechanisms of the disease. It is also an stablished fact that obstructive sleep apnea syndrome is more predominant in obese subjects. Moreover, we emphasise that our study population comprised nonobese men and women. Regarding the use of linear cross-sectional pharyngeal measurements instead of area determinations, obtaining linear measurements of the pharynx has the advantage of being totally reproducible on the MRI console, on a PC, or even using conventional film. After deciding to prioritize the development of standard evaluation procedures that could be easily performed, we chose these simpler linear measurements. The disadvantages of area and volume measurements have been mentioned previously,<a class="elsevierStyleCrossRef" href="#bib11">11</a> including the following: the need for time-consuming 3-dimensional reconstructions, high cost, and the necessity of specialized personnel for interpretation and manipulation of the data at workstations.Most of the pharyngeal measurements were found to be significantly greater in men compared to women. These anatomical differences can, at least in part, be explained by the more massive physical structures observed in the necks of men.The evaluation of the position of the hyoid bone is traditionally obtained via the cephalometric measurement of the distance between the most anterior and superior borders of this structure and an imaginary line that horizontally crosses the inferior border of the mandible. The so-called MP-H measurement is obtained routinely in the cephalometric evaluation of patients with obstructive sleep apnea syndrome. Neither CT scan nor MRI studies allow a direct determination of this distance. The visualization of the necessary anatomical repairs is not possible with these imaging techniques unless 3-dimensional reconstruction or a CT survey is employed. As we aimed to bring to MRI the possibility of determining the hyoid positioning in a simple and readily available manner, we have described a variation on this classical cephalometric measurement: the distance between the hyoid bone and the posterior nasal spine (H-PNS). This measurement can be easily obtained by direct sagittal MRI images and, like the MP-H value, is proportional to the size of the tongue. The greater mean distance between the hyoid bone and the posterior nasal spine observed in men possibly represents a compensatory hyoid positioning (lower and more anterior) to accommodate a larger tongue.Despite the fact that most anatomical structures were systematically larger in awake men, pharyngeal linear air column dimensions were similar in both awake genders. No difference was found in linear cross-sectional air column measurements at any level. These data may suggest the existence in women of an anatomical protective factor against possible upper airway collapse. Therefore, although awake men and women present pharyngeal air columns with similar dimensions, in women this column is subject to compression by smaller surrounding structures, which might require less effort to keep its patency.A previous MRI study found a greater mean cross-sectional area of the soft palate in healthy men compared to women.<a class="elsevierStyleCrossRef" href="#bib7">7</a> In our study, which is part of a general research project on obstructive apnea in out Institution<a class="elsevierStyleCrossRef" href="#bib12">12</a>, we measured not the palatal area, but its craniocaudal length and anteroposterior dimension. The former was similar in both sexes; however, the anteroposterior dimension of the soft palate (the palatal “thickness”) was found to be greater in men. Moreover, we found no gender-related differences regarding pharyngeal air column measurements, whereas in the aforementioned study, the mean infrapalatal cross-sectional area was found to be greater in men.We studied awake men and women, and we know the possibility of collapse of the upper airway when individuals with obstructive sleep apnea syndrome are sleeping. We did not study obese subjects without obstructive apnea, regardless of the fact that the syndrome affects predominantly those individuals. These factors could possibly have biased our study." 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A possible explanation for this male predominance is the existence of anatomical differences in the upper airway between men and women. METHODS:The upper airways of 10 male and 10 female healthy volunteers were prospectively evaluated by magnetic resonance imaging. Anatomical pharyngeal and column cross-sectional linear measurements were made in sagittal T1 and axial T1 and T2 weighted fast spin-echo images. RESULTS:Men had significantly greater mean sagittal pharyngeal structural dimensions compared to women for all structures with the exception of the craniocaudal length of the soft palate and the thickness of the submentonian fat. In contrast, cross-sectional linear dimensions were similar in men and women with the exception of the laterolateral tongue length, which was greater in men. All mean linear measurements of the pharyngeal air column were similar in men and women at all studied levels. CONCLUSIONS:Men and women present pharyngeal air columns with similar dimensions, but in women this column is surrounded by smaller structures, which might imply a smaller effort to keep its patency. Our data suggest the existence of an anatomical protective factor in women against the upper airway collapse." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "ceabs10" "titulo" => "INTRODUCTION:" ] 1 => array:2 [ "identificador" => "ceabs20" "titulo" => "METHODS:" ] 2 => array:2 [ "identificador" => "ceabs30" "titulo" => "RESULTS:" ] 3 => array:2 [ "identificador" => "ceabs40" "titulo" => "CONCLUSIONS:" ] ] ] "pt" => array:3 [ "titulo" => "RESUMO" "resumen" => "INTRODUÇÃO:Estudos epidemiológicos demonstram alta prevalência da síndrome da apnéia obstrutiva do sono no sexo masculino. Uma explicação plausível para esta predominância masculina é a existência de diferenças anatômicas nas vias aéreas superiores entre homens e mulheres. MÉTODOS:As vias aéreas superiores de 10 homens e 10 mulheres, voluntários saudáveis, foram avaliados prospectivamente através do exame de ressonância magnética. Foram realizadas medidas lineares das vias aéreas superiores e das estruturas da faringe através de imagens sagitais pesadas em T1 e imagens axiais pesadas em T1 e T2 com a técnica de fast spin-echo. RESULTADOS:Os homens mostraram dimensões significativamente maiores das estruturas da faringe em relação às mulheres em todas as medidas realizadas nas imagens sagitais, com exceção do diâmetro crânio-caudal do palato mole e da espessura da gordura submentoniana. Em contraste, as imagens axiais mostraram medidas similares entre os sexos, exceto o diâmetro látero-lateral da língua que foi maior nos homens. Todas as medidas da coluna aérea das vias aéreas superiores foram semelhantes nos dois sexos. CONCLUSÕES:Embora homens e mulheres apresentem vias aéreas superiores com dimensões similares, nas mulheres as estruturas anatômicas ao seu redor são menores, sugerindo um menor esforço para manter as vias aéreas superiores patentes no sexo feminino. Nossos resultados sugerem a existência de um fator de proteção anatômico contra o colapso das vias aéreas superiores nas mulheres." "secciones" => array:4 [ 0 => array:2 [ "identificador" => "ceabs50" "titulo" => "INTRODUÇÃO:" ] 1 => array:2 [ "identificador" => "ceabs60" "titulo" => "MÉTODOS:" ] 2 => array:2 [ "identificador" => "ceabs70" "titulo" => "RESULTADOS:" ] 3 => array:2 [ "identificador" => "ceabs80" "titulo" => "CONCLUSÕES:" ] ] ] ] "multimedia" => array:8 [ 0 => array:7 [ "identificador" => "fig1" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 781 "Ancho" => 748 "Tamanyo" => 89775 ] ] "descripcion" => array:1 [ "en" => "Axial images programming. The most superior image was programmed cranial to the hard palate, and the most inferior axial image was programmed at the glottic level" ] ] 1 => array:7 [ "identificador" => "fig2" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 799 "Ancho" => 994 "Tamanyo" => 143113 ] ] "descripcion" => array:1 [ "en" => "(A and B) –Sagittal measurements" ] ] 2 => array:7 [ "identificador" => "fig3" "etiqueta" => "Figure 3" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr3.jpeg" "Alto" => 606 "Ancho" => 992 "Tamanyo" => 98103 ] ] "descripcion" => array:1 [ "en" => "(A and B) – Axial measurements" ] ] 3 => array:7 [ "identificador" => "fig4" "etiqueta" => "Figure 4" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr4.jpeg" "Alto" => 918 "Ancho" => 730 "Tamanyo" => 100314 ] ] "descripcion" => array:1 [ "en" => "Planning of axial images for measurements of air column" ] ] 4 => array:7 [ "identificador" => "fig5" "etiqueta" => "Figure 5" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr5.jpeg" "Alto" => 1272 "Ancho" => 993 "Tamanyo" => 210352 ] ] "descripcion" => array:1 [ "en" => "(A, B, C, and D) – Morphology of the pharyngeal air column" ] ] 5 => array:7 [ "identificador" => "tbl1" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "APtongue: Anteroposterior length of the tongue; CCsofpal: Craniocaudal soft palate length; APsoftpal: Anteroposterior soft palate dimension; SubmentFat: Submentonian fat tissue thickness; H-PNS: Distance between the hyoid bone and the posterior nasal spine; H-Col: Distance between the hyoid bone and the posterior pharyngeal wall; n: number of subjects; P: 2-tailed value of the Student t test; *statistically significant." "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Women(n = 10) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Men(n = 10) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">P \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">APtongue \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.00 ± 0.39 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.50 ± 0.48 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.020* \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">minimum – maximum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.2 – 7.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">7.0 – 8.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">CCsofpal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.70 ± 0.33 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.80 ± 0.26 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.460 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">minimum – maximum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.0 – 4.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.5 – 4.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">APsoftpal \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.88 ± 0.09 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.99 ± 0.07 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.009* \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">minimum – maximum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.8 – 1.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.9 – 1.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">SubmentFat \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.21 ± 0.26 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.12 ± 0.36 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.530 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">minimum – maximum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.0 ± 1.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.6 ± 1.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">H-PNS \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.67 ± 0.48 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">6.50 ± 0.76 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.009* \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">minimum – maximum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.0 – 6.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">5.4 – 7.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">H-Col \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.23 ± 0.31 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.89 ± 0.34 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.0003* \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">minimum – maximum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.9 – 2.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.3 – 3.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] ] "descripcion" => array:1 [ "en" => "Sagittal pharyngeal measurements in healthy men and women (cm)" ] ] 6 => array:7 [ "identificador" => "tbl2" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "LLtongue: Laterolateral tongue length; LatWall: space between the air pharyngeal column and the mandibular branch; MandAng: mandibular angle; n: number of subjects; P: 2-tailed value of the Student t test; *statistically significant." "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Women(n = 10) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Men(n = 10) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">P \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">LLtongue (cm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.21 ± 0.30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.55 ± 0.40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.050* \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">minimum – maximum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.9 – 4.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">4.0 – 5.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">LatWall (cm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.25 ± 0.28 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.47 ± 0.31 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.110 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">minimum – maximum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.0 – 3.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">3.1 – 4.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">MandAng (grades) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">69.3 ± 3.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">71.0 ± 6.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.470 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">minimum – maximum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">60 – 81 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">66 – 76 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] ] "descripcion" => array:1 [ "en" => "Axial pharyngeal measurements in healthy men and women (cm)" ] ] 7 => array:7 [ "identificador" => "tbl3" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "LL1: Rhinopharynx; LL2: High retropalatal oropharynx; LL3: Low retropalatal oropharynx; LL4: Retrolingual oropharynx; AP1: Rhinopharynx; AP2: High retropalatal oropharynx; AP3: Low retropalatal oropharynx; AP4: Retrolingual oropharynx; n: number of subjects; P: 2-tailed value of the Student t test." "tablatextoimagen" => array:1 [ 0 => array:1 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col"> \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Women(n = 10) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">Men(n = 10) \t\t\t\t\t\t\n \t\t\t\t\t\t</th><th class="td" title="\n \t\t\t\t\ttable-head\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t" scope="col">P \t\t\t\t\t\t\n \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Laterolateral pharyngeal air column measurements (cm)</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">LL1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.21 ± 0.38 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.29 ± 0.25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.580 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">minimum – maximum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.5 – 3.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.0 – 2.7 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">LL2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.14 + 0.41 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.97 + 0.27 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.290 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">minimum – maximum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.4 – 2.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.4 – 2.4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">LL3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.80 + 0.51 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.79 + 0.54 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.970 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">minimum – maximum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.3 – 2.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.8 – 2.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">LL4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.21 ± 0.54 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.21 ± 0.75 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.000 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">minimum – maximum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.5 – 3.3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.2 – 4.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " colspan="4" align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t" style="border-bottom: 2px solid black">Anteroposterior pharyngeal air column measurements (cm)</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AP1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">2.02 ± 0.51 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.99 ± 0.59 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.900 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">minimum – maximum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.2 – 3.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.2 – 3.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AP2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.88 ± 0.19 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.86 ± 0.20 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.820 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">minimum – maximum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.5 – 1.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.5 – 1.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AP3 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.58 ± 0.22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.56 ± 0.15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.810 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">minimum – maximum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.4 – 1.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.4 – 0.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">AP4 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.19 ± 0.74 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">1.20 ± 0.25 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.960 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="left" valign="\n \t\t\t\t\ttop\n \t\t\t\t">minimum – maximum \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.4 – 2.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="center" valign="\n \t\t\t\t\ttop\n \t\t\t\t">0.9 – 1.5 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="\n \t\t\t\t\ttable-entry\n \t\t\t\t " align="" valign="\n \t\t\t\t\ttop\n \t\t\t\t"> \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] ] ] ] "descripcion" => array:1 [ "en" => "Pharyngeal column cross-sectional linear measurements in healthy men and women (cm)" ] ] ] "bibliografia" => array:2 [ "titulo" => "REFERENCES" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "cebibsec10" "bibliografiaReferencia" => array:12 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Upper airway muscle activity in normal women: influence of hormonal status" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => """ RM Popovic \n \t\t\t\t\t\t\t\t """ 1 => """ DP White \n 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CLINICAL SCIENCES

Mauro Miguel Daniela, Maria Cecília Lorenzib, Claudia da Costa Leitea, Geraldo Lorenzi-Filhoc

a Department of Radiology, Neuroradiology Division, São Paulo University Medical School – São Paulo/SP, Brazil.

b Department of Otorhinolaryngology, Pulmonary Division, São Paulo University Medical School – São Paulo/SP, Brazil.

c Department of Cardio-Pneumology, Pulmonary Division, São Paulo University Medical School – São Paulo/SP, Brazil.

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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="cesec10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle120">INTRODUCTION</span><p id="para10" class="elsevierStylePara elsevierViewall">Obstructive sleep apnea syndrome is characterized by repetitive episodes of obstruction of the upper airway during sleep and is found more frequently in obese individuals&#44; possibly due to fat deposition in some neck structures&#46; Epidemiological studies reveal a high prevalence of the syndrome in men and obese people&#46;</p><p id="para20" class="elsevierStylePara elsevierViewall">Besides the existence of functional gender-related differences regarding the pharyngeal dilator muscle activity and&#44; therefore&#44; the collapsibility of the pharynx&#44;<a class="elsevierStyleCrossRefs" href="#bib1"><span class="elsevierStyleSup">1&#44;2</span></a> another possible explanation for the predominance of male obstructive sleep apnea syndrome patients is the existence of anatomical differences in the upper airway&#46; Previous studies using the acoustic reflection technique to assess the pharyngeal cross-sectional area showed that this area is significantly larger in healthy men than in healthy women in the sitting position&#44; whereas no difference was found in recumbent positions&#46; Pharyngeal compliance was also found to be greater in men than in women&#46;<a class="elsevierStyleCrossRef" href="#bib3"><span class="elsevierStyleSup">3</span></a> However&#44; the mechanisms responsible for the increased susceptibility of men to obstructive sleep apnea syndrome are not yet completely understood&#46;</p><p id="para30" class="elsevierStylePara elsevierViewall">Imaging evaluation of pharyngeal structures has proven to be an important tool in the study of this obstructive syndrome&#44; bringing insights into its pathophysiology and possible therapeutic approaches&#46;<a class="elsevierStyleCrossRefs" href="#bib4"><span class="elsevierStyleSup">4&#8211;6</span></a> Regarding magnetic resonance imaging &#40;MRI&#41; of the necks of normal subjects&#44; a larger overall soft tissue volume was found in men&#46;<a class="elsevierStyleCrossRef" href="#bib7"><span class="elsevierStyleSup">7</span></a></p><p id="para40" class="elsevierStylePara elsevierViewall">In the present study&#44; we sought to investigate upper airway anatomy of awake healthy men and women&#46; We hypothesized that significant gender-related differences may at least in part explain the greater susceptibility of men to obstructive sleep apnea syndrome&#46;</p></span><span id="cesec20" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle130">MATERIALS AND METHODS</span><p id="para50" class="elsevierStylePara elsevierViewall">Ten healthy men and 10 healthy women were prospectively evaluated by MRI after they signed informed consent forms&#46; The protocol was reviewed and approved by the Institutional Ethics Committee&#46;</p><p id="para60" class="elsevierStylePara elsevierViewall">All subjects underwent a clinical evaluation and verbally confirmed the absence of acute or chronic diseases&#44; as well as the use of any medications&#46; The absence of obstructive sleep apnea syndrome was assumed after observing the following criteria&#58; a&#41; absence of snoring&#59; b&#41; absence of daytime sleepiness &#40;Epworth sleepiness scale &#60; 10&#41;&#59; c&#41; absence of obstructive sleep apnea syndrome -associated conditions &#40;hypertension&#44; diabetes&#44; or other cardiac diseases&#41;&#59; and d&#41; absence of obesity &#40;body mass index - BMI &#60; 30 kg&#47;m<span class="elsevierStyleSup">2</span>&#41;&#46; Polysomnographic studies were not performed&#46;</p><p id="para70" class="elsevierStylePara elsevierViewall">Men and women enrolled in the study were similar regarding their mean age &#40;32&#46;9 &#177; 7&#46;8 years and 36&#46;2 &#177; 10&#46;5 years&#44; respectively&#59; <span class="elsevierStyleItalic">P</span> &#61; 0&#46;430&#41; and BMI &#40;24&#46;7 &#177; 1&#46;3 kg&#47;m<span class="elsevierStyleSup">2</span> and 23&#46;7 &#177; 3&#46;5 kg&#47;m2&#44; respectively&#59; <span class="elsevierStyleItalic">P</span> &#61; 0&#46;350&#41;&#46;</p><p id="para80" class="elsevierStylePara elsevierViewall">The MRI studies were performed using the same equipment &#40;General Electric Medical - Milwaukee&#44; WI&#8212;1&#46;5 Tesla&#41;&#46; All patients were positioned in supine decubitus&#44; with no head support&#44; and were instructed to remain still and not to swallow&#44; as well as to keep their mouths closed and to use soft nose breathing during the acquisition of the images&#46; All study subjects remained awake during the exam&#46;</p><p id="para90" class="elsevierStylePara elsevierViewall">Twelve to 15 sagittal images &#40;T1 weighted&#59; 3&#46;0 mm thickness&#59; 1&#46;0 mm gap&#41; and 20 axial images &#40;T1 and T2 weighted&#59; 4&#46;0 mm thickness&#59; 2&#46;5 mm gap&#41; were obtained with a fast spin-echo &#40;FSE&#41; pulse sequence&#46; The most cranial axial image was programmed cranial to the hard palate&#59; the most caudal axial image was programmed at the glottic level &#40;<a class="elsevierStyleCrossRef" href="#fig1">Figure 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig1"></elsevierMultimedia><p id="para100" class="elsevierStylePara elsevierViewall">Repetition time &#40;TR&#41; and echo time &#40;TE&#41; for T1 weighted images were 600 msec and 20 msec respectively&#46; The TR and TE for T2 weighted images were 3&#44;000 msec and 90 msec respectively &#40;number of excitations &#61; 2&#59; field of view &#61; 24 cm&#41;&#46; A cervical neurovascular coil was used&#46; The total examination time did not exceed 10 minutes in each case&#46;</p><p id="para110" class="elsevierStylePara elsevierViewall">For measuring purposes&#44; the pharynx was schematically divided into 4 different regions&#58; rhinopharynx&#44; retropalatal oropharynx&#44; retrolingual oropharynx&#44; and hypopharynx&#46;<a class="elsevierStyleCrossRefs" href="#bib8"><span class="elsevierStyleSup">8&#8211;10</span></a> The inferior limit of the rhinopharynx consisted of an imaginary horizontal line crossing the hard palate&#46; The oropharynx was defined as the air space between the inferior limit of the rhinopharynx and an imaginary horizontal line tangential to the epiglottic tip&#46; The hypopharynx extended from the inferior limit of the oropharynx to the esophageal transition&#46;</p><p id="para120" class="elsevierStylePara elsevierViewall">A median sagittal image in which the lingual septum and the odontoid process of the second cervical vertebra were distinguished was employed for sagittal measurements&#46;</p><p id="para130" class="elsevierStylePara elsevierViewall">The following sagittal measurements were obtained&#58;<ul class="elsevierStyleList" id="celist10"><li class="elsevierStyleListItem" id="celistitem10"><span class="elsevierStyleLabel">1&#46;</span><p id="para140" class="elsevierStylePara elsevierViewall">The anteroposterior length of the tongue &#40;APtongue&#41;&#58; defined as the distance between the tip of the tongue and its posterior border &#40;<a class="elsevierStyleCrossRef" href="#fig2">Figure 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig2"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="celistitem20"><span class="elsevierStyleLabel">2&#46;</span><p id="para150" class="elsevierStylePara elsevierViewall">The craniocaudal length of the soft palate &#40;CCsoftpal&#41;&#58; defined as the distance between the posterior nasal spine and the tip of the uvula &#40;<a class="elsevierStyleCrossRef" href="#fig2">Figure 2</a>&#41;&#46;</p></li><li class="elsevierStyleListItem" id="celistitem30"><span class="elsevierStyleLabel">3&#46;</span><p id="para160" class="elsevierStylePara elsevierViewall">The anteroposterior dimension of the soft palate &#40;APsoftpal&#41;&#58; defined as the anteroposterior measurement of the soft palate in its thicker region &#40;<a class="elsevierStyleCrossRef" href="#fig2">Figure 2</a>&#41;&#46;</p></li><li class="elsevierStyleListItem" id="celistitem40"><span class="elsevierStyleLabel">4&#46;</span><p id="para170" class="elsevierStylePara elsevierViewall">Thickness of the submentonian fat tissue &#40;SubmentFat&#41;&#58; defined as the craniocaudal measurement of the submentonian fat tissue in its thicker region &#40;<a class="elsevierStyleCrossRef" href="#fig2">Figure 2</a>&#41;&#46;</p></li><li class="elsevierStyleListItem" id="celistitem50"><span class="elsevierStyleLabel">5&#46;</span><p id="para180" class="elsevierStylePara elsevierViewall">Hyoid bone-posterior nasal spine distance &#40;H-PNS&#41;&#58; defined as the distance between the superior border of the hyoid bone body and the posterior nasal spine &#40;<a class="elsevierStyleCrossRef" href="#fig2">Figure 2</a>&#41;&#46;</p></li><li class="elsevierStyleListItem" id="celistitem60"><span class="elsevierStyleLabel">6&#46;</span><p id="para190" class="elsevierStylePara elsevierViewall">Distance between the hyoid bone and the posterior wall of the pharynx &#40;H-Col&#41;&#58; the smallest distance between the posterior border of the hyoid bone body and the posterior wall of the pharynx&#44; near the vertebral column &#40;<a class="elsevierStyleCrossRef" href="#fig2">Figure 2</a>&#41;&#46;</p></li></ul></p><p id="para200" class="elsevierStylePara elsevierViewall">The following measurements were obtained from the axial images&#58;<ul class="elsevierStyleList" id="celist20"><li class="elsevierStyleListItem" id="celistitem70"><span class="elsevierStyleLabel">1&#46;</span><p id="para210" class="elsevierStylePara elsevierViewall">Laterolateral length of the tongue &#40;LLtongue&#41;&#58; defined as the distance between the lateral borders of the tongue in its thicker region&#44; having as an anatomical landmark the hyoglossal muscles &#40;<a class="elsevierStyleCrossRef" href="#fig3">Figure 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig3"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="celistitem80"><span class="elsevierStyleLabel">2&#46;</span><p id="para220" class="elsevierStylePara elsevierViewall">Mandibular angle &#40;MandAng&#41;&#58; defined as the angle measured between 2 lines whose vertex lies in the internal border of the chin&#44; following each mandibular branch in posterior and lateral directions to its most posterior internal border&#44; near the third molar teeth &#40;<a class="elsevierStyleCrossRef" href="#fig3">Figure 3</a>&#41;&#46;</p></li><li class="elsevierStyleListItem" id="celistitem90"><span class="elsevierStyleLabel">3&#46;</span><p id="para230" class="elsevierStylePara elsevierViewall">The space between the pharyngeal air column and the mandibular branch &#40;LatWall&#41;&#58; defined as the distance between the pharyngeal air column and the mandibular branch at the level of the retropalatal oropharynx&#44; comprising the so-called lateral wall of the pharynx&#44; the parapharyngeal space&#44; and the pterygoid muscle &#40;<a class="elsevierStyleCrossRef" href="#fig3">Figure 3</a>&#41;&#46;</p></li></ul></p><p id="para240" class="elsevierStylePara elsevierViewall">The morphology of the pharyngeal air column was also observed&#46; Linear laterolateral &#40;LL&#41; and anteroposterior &#40;AP&#41; axial measurements were obtained at the following levels &#40;<a class="elsevierStyleCrossRef" href="#fig4">Figure 4</a>&#41;&#58;<ul class="elsevierStyleList" id="celist30"><li class="elsevierStyleListItem" id="celistitem100"><span class="elsevierStyleLabel">1&#46;</span><p id="para250" class="elsevierStylePara elsevierViewall">Rhinopharynx &#40;Level 1&#41;&#58; axial pharyngeal image at the hard palate level &#40;<a class="elsevierStyleCrossRef" href="#fig5">Figure 5a</a>&#41;&#46;</p><elsevierMultimedia ident="fig5"></elsevierMultimedia></li><li class="elsevierStyleListItem" id="celistitem110"><span class="elsevierStyleLabel">2&#46;</span><p id="para260" class="elsevierStylePara elsevierViewall">High retropalatal oropharynx &#40;Level 2&#41;&#58; pharyngeal measurements in a plane lying 1&#46;0 cm below the inferior limit of the rhinopharynx &#40;hard palate&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig5">Figure 5b</a>&#41;&#46;</p></li><li class="elsevierStyleListItem" id="celistitem120"><span class="elsevierStyleLabel">3&#46;</span><p id="para270" class="elsevierStylePara elsevierViewall">Low retropalatal oropharynx &#40;Level 3&#41;&#58; pharyngeal measurements at the uvula level or at the narrowest air column point of the low retropalatal region &#40;<a class="elsevierStyleCrossRef" href="#fig5">Figure 5c</a>&#41;&#46;</p></li><li class="elsevierStyleListItem" id="celistitem130"><span class="elsevierStyleLabel">4&#46;</span><p id="para280" class="elsevierStylePara elsevierViewall">Retrolingual oropharynx &#40;Level 4&#41;&#58; measurements obtained in an intermediate image between the uvula and the tip of the epiglottis &#40;<a class="elsevierStyleCrossRef" href="#fig5">Figure 5d</a>&#41;&#46;</p></li></ul></p><elsevierMultimedia ident="fig4"></elsevierMultimedia><p id="para290" class="elsevierStylePara elsevierViewall">Statistical analysis included descriptive statistics and the Student <span class="elsevierStyleItalic">t</span> test&#44; after checking the assumptions for the use of parametric tests&#44; using STATA&#174; &#40;<span class="elsevierStyleItalic">Statistical Data Analysis</span>&#41; software&#44; version 7&#46;0&#46; A <span class="elsevierStyleItalic">P</span> &#8804; 0&#46;05 in 2-tailed tests was considered significant&#46;</p></span><span id="cesec30" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle140">RESULTS</span><span id="cesec40" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle150">Sagittal pharyngeal measurements</span><p id="para300" class="elsevierStylePara elsevierViewall">The mean anteroposterior length of the tongue was significantly greater in men &#40;7&#46;50 &#177; 0&#46;48 cm&#41; than in women &#40;7&#46;00 &#177; 0&#46;39 cm&#41; &#40;<span class="elsevierStyleItalic">P</span> &#61; 0&#46;020&#41;&#46; The anteroposterior soft palate dimension was also greater in men &#40;0&#46;99 &#177; 0&#46;07 cm&#41; compared to women &#40;0&#46;88 &#177; 0&#46;09 cm&#41; &#40;<span class="elsevierStyleItalic">P</span> &#61; 0&#46;009&#41;&#46; Men also showed significantly larger distances between the hyoid bone and the posterior nasal spine &#40;6&#46;50 &#177; 0&#46;76 cm&#41; and between the hyoid bone and the posterior pharyngeal wall &#40;2&#46;89 &#177; 0&#46;34 cm&#41; compared to women &#40;5&#46;67 &#177; 0&#46;48 cm&#44; <span class="elsevierStyleItalic">P</span> &#61; 0&#46;009&#44; and 2&#46;23 &#177; 0&#46;31 cm&#44; <span class="elsevierStyleItalic">P</span> &#61; 0&#46;0003&#44; respectively&#41;&#46;</p><p id="para310" class="elsevierStylePara elsevierViewall">In summary&#44; MR images of normal men showed a significantly greater mean sagittal pharyngeal structural dimensions compared to those obtained from MR images of normal women&#44; with the exception of the craniocaudal length of the soft palate and the thickness of the submentonian fat &#40;<a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>&#41;&#46;</p><elsevierMultimedia ident="tbl1"></elsevierMultimedia></span><span id="cesec50" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle160">Axial pharyngeal measurements</span><p id="para320" class="elsevierStylePara elsevierViewall">Regarding the cross-sectional linear dimensions&#44; men and women had similar mean measurements&#44; with the exception of the laterolateral tongue length&#44; which was greater in men &#40;4&#46;55 &#177; 0&#46;40 cm&#41; than in women &#40;4&#46;21 &#177; 0&#46;30 cm&#41; &#40;<span class="elsevierStyleItalic">P</span> &#61; 0&#46;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#tbl2">Table 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl2"></elsevierMultimedia></span><span id="cesec60" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle170">Pharyngeal column cross-sectional linear measurements</span><p id="para330" class="elsevierStylePara elsevierViewall">All mean linear measurements of the pharyngeal air column were similar in men and women at the 4 levels considered &#40;<a class="elsevierStyleCrossRef" href="#tbl3">Table 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl3"></elsevierMultimedia></span></span><span id="cesec70" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle180">DISCUSSION</span><p id="para340" class="elsevierStylePara elsevierViewall">Since obstructive sleep apnea syndrome is more predominant in men overall&#44; analyzing data from both men and women without obstructive apnea is an important starting point for better understanding of the mechanisms of the disease&#46; It is also an stablished fact that obstructive sleep apnea syndrome is more predominant in obese subjects&#46; Moreover&#44; we emphasise that our study population comprised nonobese men and women&#46; Regarding the use of linear cross-sectional pharyngeal measurements instead of area determinations&#44; obtaining linear measurements of the pharynx has the advantage of being totally reproducible on the MRI console&#44; on a PC&#44; or even using conventional film&#46; After deciding to prioritize the development of standard evaluation procedures that could be easily performed&#44; we chose these simpler linear measurements&#46; The disadvantages of area and volume measurements have been mentioned previously&#44;<a class="elsevierStyleCrossRef" href="#bib11"><span class="elsevierStyleSup">11</span></a> including the following&#58; the need for time-consuming 3-dimensional reconstructions&#44; high cost&#44; and the necessity of specialized personnel for interpretation and manipulation of the data at workstations&#46;</p><p id="para350" class="elsevierStylePara elsevierViewall">Most of the pharyngeal measurements were found to be significantly greater in men compared to women&#46; These anatomical differences can&#44; at least in part&#44; be explained by the more massive physical structures observed in the necks of men&#46;</p><p id="para360" class="elsevierStylePara elsevierViewall">The evaluation of the position of the hyoid bone is traditionally obtained via the cephalometric measurement of the distance between the most anterior and superior borders of this structure and an imaginary line that horizontally crosses the inferior border of the mandible&#46; The so-called MP-H measurement is obtained routinely in the cephalometric evaluation of patients with obstructive sleep apnea syndrome&#46; Neither CT scan nor MRI studies allow a direct determination of this distance&#46; The visualization of the necessary anatomical repairs is not possible with these imaging techniques unless 3-dimensional reconstruction or a CT survey is employed&#46; As we aimed to bring to MRI the possibility of determining the hyoid positioning in a simple and readily available manner&#44; we have described a variation on this classical cephalometric measurement&#58; the distance between the hyoid bone and the posterior nasal spine &#40;H-PNS&#41;&#46; This measurement can be easily obtained by direct sagittal MRI images and&#44; like the MP-H value&#44; is proportional to the size of the tongue&#46; The greater mean distance between the hyoid bone and the posterior nasal spine observed in men possibly represents a compensatory hyoid positioning &#40;lower and more anterior&#41; to accommodate a larger tongue&#46;</p><p id="para370" class="elsevierStylePara elsevierViewall">Despite the fact that most anatomical structures were systematically larger in awake men&#44; pharyngeal linear air column dimensions were similar in both awake genders&#46; No difference was found in linear cross-sectional air column measurements at any level&#46; These data may suggest the existence in women of an anatomical protective factor against possible upper airway collapse&#46; Therefore&#44; although awake men and women present pharyngeal air columns with similar dimensions&#44; in women this column is subject to compression by smaller surrounding structures&#44; which might require less effort to keep its patency&#46;</p><p id="para380" class="elsevierStylePara elsevierViewall">A previous MRI study found a greater mean cross-sectional area of the soft palate in healthy men compared to women&#46;<a class="elsevierStyleCrossRef" href="#bib7"><span class="elsevierStyleSup">7</span></a> In our study&#44; which is part of a general research project on obstructive apnea in out Institution<a class="elsevierStyleCrossRef" href="#bib12"><span class="elsevierStyleSup">12</span></a>&#44; we measured not the palatal area&#44; but its craniocaudal length and anteroposterior dimension&#46; The former was similar in both sexes&#59; however&#44; the anteroposterior dimension of the soft palate &#40;the palatal &#8220;thickness&#8221;&#41; was found to be greater in men&#46; Moreover&#44; we found no gender-related differences regarding pharyngeal air column measurements&#44; whereas in the aforementioned study&#44; the mean infrapalatal cross-sectional area was found to be greater in men&#46;</p><p id="para390" class="elsevierStylePara elsevierViewall">We studied awake men and women&#44; and we know the possibility of collapse of the upper airway when individuals with obstructive sleep apnea syndrome are sleeping&#46; We did not study obese subjects without obstructive apnea&#44; regardless of the fact that the syndrome affects predominantly those individuals&#46; These factors could possibly have biased our study&#46;</p></span></span>"
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          "titulo" => "UNITERMOS&#58;"
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          "titulo" => "INTRODUCTION"
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              "titulo" => "Sagittal pharyngeal measurements"
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              "titulo" => "Axial pharyngeal measurements"
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              "titulo" => "Pharyngeal column cross-sectional linear measurements"
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          "clase" => "keyword"
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            0 => "Obstructive sleep apnea syndrome"
            1 => "Sleep apnea"
            2 => "MRI"
            3 => "Pharynx"
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          "clase" => "keyword"
          "titulo" => "UNITERMOS&#58;"
          "identificador" => "xpalclavsec1584844"
          "palabras" => array:4 [
            0 => "S&#237;ndrome da apn&#233;ia obstrutiva do sono"
            1 => "Apn&#233;ia do sono"
            2 => "Resson&#226;ncia magn&#233;tica"
            3 => "Faringe"
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        "resumen" => "<span id="ceabs10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle10">INTRODUCTION&#58;</span><p id="spara120" class="elsevierStyleSimplePara elsevierViewall">Epidemiological studies reveal a high male prevalence of obstructive sleep apnea syndrome&#46; A possible explanation for this male predominance is the existence of anatomical differences in the upper airway between men and women&#46;</p></span> <span id="ceabs20" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle20">METHODS&#58;</span><p id="spara130" class="elsevierStyleSimplePara elsevierViewall">The upper airways of 10 male and 10 female healthy volunteers were prospectively evaluated by magnetic resonance imaging&#46; Anatomical pharyngeal and column cross-sectional linear measurements were made in sagittal T1 and axial T1 and T2 weighted fast spin-echo images&#46;</p></span> <span id="ceabs30" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle30">RESULTS&#58;</span><p id="spara140" class="elsevierStyleSimplePara elsevierViewall">Men had significantly greater mean sagittal pharyngeal structural dimensions compared to women for all structures with the exception of the craniocaudal length of the soft palate and the thickness of the submentonian fat&#46; In contrast&#44; cross-sectional linear dimensions were similar in men and women with the exception of the laterolateral tongue length&#44; which was greater in men&#46; All mean linear measurements of the pharyngeal air column were similar in men and women at all studied levels&#46;</p></span> <span id="ceabs40" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle40">CONCLUSIONS&#58;</span><p id="spara150" class="elsevierStyleSimplePara elsevierViewall">Men and women present pharyngeal air columns with similar dimensions&#44; but in women this column is surrounded by smaller structures&#44; which might imply a smaller effort to keep its patency&#46; Our data suggest the existence of an anatomical protective factor in women against the upper airway collapse&#46;</p></span>"
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            "titulo" => "INTRODUCTION&#58;"
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            "titulo" => "METHODS&#58;"
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            "titulo" => "RESULTS&#58;"
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        "resumen" => "<span id="ceabs50" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle60">INTRODU&#199;&#195;O&#58;</span><p id="spara160" class="elsevierStyleSimplePara elsevierViewall">Estudos epidemiol&#243;gicos demonstram alta preval&#234;ncia da s&#237;ndrome da apn&#233;ia obstrutiva do sono no sexo masculino&#46; Uma explica&#231;&#227;o plaus&#237;vel para esta predomin&#226;ncia masculina &#233; a exist&#234;ncia de diferen&#231;as anat&#244;micas nas vias a&#233;reas superiores entre homens e mulheres&#46;</p></span> <span id="ceabs60" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle70">M&#201;TODOS&#58;</span><p id="spara170" class="elsevierStyleSimplePara elsevierViewall">As vias a&#233;reas superiores de 10 homens e 10 mulheres&#44; volunt&#225;rios saud&#225;veis&#44; foram avaliados prospectivamente atrav&#233;s do exame de resson&#226;ncia magn&#233;tica&#46; Foram realizadas medidas lineares das vias a&#233;reas superiores e das estruturas da faringe atrav&#233;s de imagens sagitais pesadas em T1 e imagens axiais pesadas em T1 e T2 com a t&#233;cnica de fast spin-echo&#46;</p></span> <span id="ceabs70" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle80">RESULTADOS&#58;</span><p id="spara180" class="elsevierStyleSimplePara elsevierViewall">Os homens mostraram dimens&#245;es significativamente maiores das estruturas da faringe em rela&#231;&#227;o &#224;s mulheres em todas as medidas realizadas nas imagens sagitais&#44; com exce&#231;&#227;o do di&#226;metro cr&#226;nio-caudal do palato mole e da espessura da gordura submentoniana&#46; Em contraste&#44; as imagens axiais mostraram medidas similares entre os sexos&#44; exceto o di&#226;metro l&#225;tero-lateral da l&#237;ngua que foi maior nos homens&#46; Todas as medidas da coluna a&#233;rea das vias a&#233;reas superiores foram semelhantes nos dois sexos&#46;</p></span> <span id="ceabs80" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle90">CONCLUS&#213;ES&#58;</span><p id="spara190" class="elsevierStyleSimplePara elsevierViewall">Embora homens e mulheres apresentem vias a&#233;reas superiores com dimens&#245;es similares&#44; nas mulheres as estruturas anat&#244;micas ao seu redor s&#227;o menores&#44; sugerindo um menor esfor&#231;o para manter as vias a&#233;reas superiores patentes no sexo feminino&#46; Nossos resultados sugerem a exist&#234;ncia de um fator de prote&#231;&#227;o anat&#244;mico contra o colapso das vias a&#233;reas superiores nas mulheres&#46;</p></span>"
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          "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">Axial images programming&#46; The most superior image was programmed cranial to the hard palate&#44; and the most inferior axial image was programmed at the glottic level</p>"
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          "leyenda" => "<p id="spara70" class="elsevierStyleSimplePara elsevierViewall">APtongue&#58; Anteroposterior length of the tongue&#59; CCsofpal&#58; Craniocaudal soft palate length&#59; APsoftpal&#58; Anteroposterior soft palate dimension&#59; SubmentFat&#58; Submentonian fat tissue thickness&#59; H-PNS&#58; Distance between the hyoid bone and the posterior nasal spine&#59; H-Col&#58; Distance between the hyoid bone and the posterior pharyngeal wall&#59; n&#58; number of subjects&#59; <span class="elsevierStyleItalic">P</span>&#58; 2-tailed value of the Student <span class="elsevierStyleItalic">t</span> test&#59; &#42;statistically significant&#46;</p>"
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                  \t\t\t\t\tvoid\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Women&#40;n &#61; 10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t" scope="col">Men&#40;n &#61; 10&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">APtongue&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#46;00 &#177; 0&#46;39&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t">7&#46;50 &#177; 0&#46;48&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t">0&#46;020&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>minimum &#8211; maximum&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t">6&#46;2 &#8211; 7&#46;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t">7&#46;0 &#8211; 8&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">CCsofpal&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">3&#46;70 &#177; 0&#46;33&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#46;80 &#177; 0&#46;26&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>minimum &#8211; maximum&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">SubmentFat&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t">1&#46;0 &#177; 1&#46;9&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">H-PNS&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t">5&#46;67 &#177; 0&#46;48&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t">6&#46;50 &#177; 0&#46;76&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t">0&#46;009&#42;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t">5&#46;0 &#8211; 6&#46;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5&#46;4 &#8211; 7&#46;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">0&#46;0003&#42;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t">1&#46;9 &#8211; 2&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttable-entry\n
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                  """
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          "leyenda" => "<p id="spara90" class="elsevierStyleSimplePara elsevierViewall">LLtongue&#58; Laterolateral tongue length&#59; LatWall&#58; space between the air pharyngeal column and the mandibular branch&#59; MandAng&#58; mandibular angle&#59; n&#58; number of subjects&#59; <span class="elsevierStyleItalic">P</span>&#58; 2-tailed value of the Student <span class="elsevierStyleItalic">t</span> test&#59; &#42;statistically significant&#46;</p>"
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                  \t\t\t\t" scope="col">Women&#40;n &#61; 10&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t">LatWall &#40;cm&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#46;25 &#177; 0&#46;28&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#46;47 &#177; 0&#46;31&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">3&#46;0 &#8211; 3&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">MandAng &#40;grades&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t">69&#46;3 &#177; 3&#46;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">71&#46;0 &#177; 6&#46;3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">0&#46;470&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>minimum &#8211; maximum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60 &#8211; 81&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66 &#8211; 76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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        "descripcion" => array:1 [
          "en" => "<p id="spara80" class="elsevierStyleSimplePara elsevierViewall">Axial pharyngeal measurements in healthy men and women &#40;cm&#41;</p>"
        ]
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        "identificador" => "tbl3"
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          "leyenda" => "<p id="spara110" class="elsevierStyleSimplePara elsevierViewall">LL1&#58; Rhinopharynx&#59; LL2&#58; High retropalatal oropharynx&#59; LL3&#58; Low retropalatal oropharynx&#59; LL4&#58; Retrolingual oropharynx&#59; AP1&#58; Rhinopharynx&#59; AP2&#58; High retropalatal oropharynx&#59; AP3&#58; Low retropalatal oropharynx&#59; AP4&#58; Retrolingual oropharynx&#59; n&#58; number of subjects&#59; <span class="elsevierStyleItalic">P</span>&#58; 2-tailed value of the Student <span class="elsevierStyleItalic">t</span> test&#46;</p>"
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                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Women&#40;n &#61; 10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Men&#40;n &#61; 10&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col"><span class="elsevierStyleItalic">P</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Laterolateral pharyngeal air column measurements &#40;cm&#41;</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LL1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;21 &#177; 0&#46;38&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;29 &#177; 0&#46;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;580&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>minimum &#8211; maximum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;5 &#8211; 3&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;0 &#8211; 2&#46;7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LL2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;14 &#43; 0&#46;41&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;97 &#43; 0&#46;27&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;290&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>minimum &#8211; maximum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;4 &#8211; 2&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;4 &#8211; 2&#46;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LL3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;80 &#43; 0&#46;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;79 &#43; 0&#46;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;970&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>minimum &#8211; maximum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;3 &#8211; 2&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;8 &#8211; 2&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">LL4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;21 &#177; 0&#46;54&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;21 &#177; 0&#46;75&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>minimum &#8211; maximum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;5 &#8211; 3&#46;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;2 &#8211; 4&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Anteroposterior pharyngeal air column measurements &#40;cm&#41;</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AP1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#46;02 &#177; 0&#46;51&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;99 &#177; 0&#46;59&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;900&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>minimum &#8211; maximum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;2 &#8211; 3&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;2 &#8211; 3&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AP2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;88 &#177; 0&#46;19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;86 &#177; 0&#46;20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
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                  \t\t\t\t">0&#46;820&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>minimum &#8211; maximum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;5 &#8211; 1&#46;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;5 &#8211; 1&#46;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AP3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;58 &#177; 0&#46;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;56 &#177; 0&#46;15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;810&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>minimum &#8211; maximum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;4 &#8211; 1&#46;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;4 &#8211; 0&#46;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">AP4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;19 &#177; 0&#46;74&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#46;20 &#177; 0&#46;25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;960&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>minimum &#8211; maximum&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;4 &#8211; 2&#46;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="center" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#46;9 &#8211; 1&#46;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
            ]
          ]
        ]
        "descripcion" => array:1 [
          "en" => "<p id="spara100" class="elsevierStyleSimplePara elsevierViewall">Pharyngeal column cross-sectional linear measurements in healthy men and women &#40;cm&#41;</p>"
        ]
      ]
    ]
    "bibliografia" => array:2 [
      "titulo" => "REFERENCES"
      "seccion" => array:1 [
        0 => array:2 [
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Article information

ISSN: 18075932
Original language: English

DOI:10.1590/S1807-59322007000100002

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Year/Month	Html	Pdf	Total

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2024 October	49	45	94
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2024 August	36	41	77
2024 July	49	35	84
2024 June	38	27	65
2024 May	42	13	55
2024 April	33	17	50
2024 March	45	20	65
2024 February	50	15	65
2024 January	47	11	58
2023 December	35	25	60
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2023 October	33	25	58
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2023 August	11	10	21
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2023 May	35	2	37
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