Tongue scalloping as a sign of obstructive sleep apnea syndrome: Clinical and polysomnographic insights.
Level 4 - case-series / case-control
Observational cross-sectional diagnostic accuracy study
PubMed 40569396 · doi:10.4103/lungindia.lungindia_110_25
What was done
An observational cross-sectional study evaluated 1,261 individuals with obesity and high-risk features for sleep-disordered breathing, of whom 250 were diagnosed with obstructive sleep apnea syndrome (OSAS) by polysomnography (PSG). The study compared OSAS and non-OSAS cohorts to assess diagnostic metrics (sensitivity, specificity, predictive values) for tongue scalloping (TS), snoring, and daytime somnolence, and used multivariable logistic regression to identify independent predictors.
What was found
Tongue scalloping occurred in 39.6% of OSAS patients compared to 20.5% of non-OSAS participants (P < 0.001). For OSAS diagnosis, TS demonstrated a specificity of 79.5% and a negative predictive value of 84.2%. For nocturnal desaturation, TS showed a specificity of 84% and a positive predictive value of 90%. Multivariable logistic regression identified TS, smoking, snoring, daytime somnolence, higher neck circumference, body mass index, and waist-to-height ratio as independent predictors of OSAS.
Why it matters
Tongue scalloping provides a fast, non-invasive physical examination sign that can aid in clinical risk stratification and prioritization of patients for formal polysomnography.
Limits
The cross-sectional design was conducted in a high-risk, obese population, limiting generalizability to the general public or unselected primary care cohorts. The abstract does not report overall sensitivity or positive predictive value for OSAS diagnosis as a whole, nor does it describe inter-rater reliability for assessing tongue scalloping.
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