Cephalometric predictors of obstructive sleep apnea.
- Author:
Tae Geon KWON
1
;
Yong Won CHO
;
Byung Hoon AHN
;
Young Sung SUH
Author Information
1. Dept. of Oral and Maxillofacial Surgery, College of Dentistry, Kyungpook National University, Korea. kwondk@wmail.knu.ac.kr
- Publication Type:Original Article
- Keywords:
Obstructive sleep apnea;
Cephalogram;
AHI
- MeSH:
Airway Resistance;
Humans;
Hypertrophy;
Palate, Soft;
Sleep Apnea, Obstructive*
- From:Journal of the Korean Association of Oral and Maxillofacial Surgeons
2003;29(5):338-345
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: This study was intended to perform cephalometric comparison between the patients with and without obstructive sleep apnea (OSA). The factors influencing the OSA in the lateral cephalogram was also investigated. PATIENT AND METHOD: Twenty four patients who visited Sleep Disorder Clinic in Dongsan Medical Center, Keimyung University and evaluated with polysomnograph(PSG) and cephalogram were included in the study. The patients had apnea-hypopnea episode(AHI) over 10 times per hour was diagnosed as OSA after overnight PSG. To evaluate hard and soft tissue profile, cephalometric radiogram were taken at maximal intercuspation(P1) and mandibular protruding position(P2). The diffefence between the OSA and normal group were evaluated statistically and the stepwise regression analysis was applied to analyse the cephalometric influencing factors to OSA. RESULT: The OSA Group(n=14) had significantly higher Body Mass Index(BMI) than control group(n=10). Lower facial height(ANSGn) was longer in OSA group. However statistically significant difference was not detected in other anteroposterior craniofacial measurements. The soft palate lenth (PNS-P), hyoid position (MP-Hyoid) had positive correlation between AHI (r=0.496, r=0.413, respectively, p<0.05). However, the measurements of oropharyngeal airway was not different between the two groups. The hypothesis, the antero-posteriorly narrow oropharyngeal airway might aggravate the airway resistance and can give rise to higher AHI, was not accepted in the study. This can be attributed by inclusion of the patients performed uvulopalatopharyngoplasty because of the tonsilar or soft palate hypertrophy in the present study. The results of regression analysis revealed that PNS-P, upper airway width(Nph1), upper facial heght(N-ANS), and lower facial height(ANS-Gn) could influence the degree of AHI (F value < 0.0001, R2 = 0.829). CONCLUSION: We suggest lateral cephalogram may utilized as a useful method to evaluate OSA. The patient with long soft palate, narrow upper airway width, long upper and lower facial height can be expected to have high risk of OSA. However, it should be emphasized the comphrehensive intraoral inspection including soft palate and tonsilar hypertrophy because lateral cepahlogram cannot visualize oropharyngeal status completely.
