ORAL RADIOLOGY, 2026 (SCI-Expanded, Scopus)
Objective This study aimed to investigate the relationship between the severity of obstructive sleep apnea (OSA) and stiffness of the genioglossus (GG) and geniohyoid (GH) muscles using shear wave elastography (SWE), a non-invasive ultrasonographic technique. Methods A total of 102 participants were enrolled, including 51 patients with OSA and 51 healthy controls. Muscle stiffness of the GG and GH was measured using SWE. OSA severity was determined according to the Apnea-Hypopnea Index (AHI) from full-night polysomnography. Comparative and correlation analyses were performed between groups and across severity levels. Results GH muscle stiffness was significantly higher in the OSA group than in controls (p = 0.017), whereas GG stiffness showed a non-significant trend (p = 0.061). Among OSA subgroups, GH stiffness was significantly greater in moderate cases than in mild cases, (p = 0.017), but no significant difference was found in GG stiffness across severity levels. Measurement reliability for both muscles was excellent (ICC > 0.95). No significant correlation was observed between stiffness values and daytime sleepiness. Conclusion This study demonstrates that GH stiffness increases with OSA and may reflect compensatory muscular adaptations, particularly at moderate disease stages. SWE appears to be a reliable and non-invasive method for assessing upper airway muscle characteristics, offering potential as a supportive tool in OSA evaluation.