Sixty male patients with polysomnographically documented OSA were included in this study. A pair of cephalograrns were obtained in the upright and supine positions. In the supine position, the ANB angle, lower facial height and the cross-sectional area of soft palate increased and there was a decrease in the vertical airway length and oropharynx cross-sectional area. Positional changes did not affect the cross-sectional area of tongue, but the cross-sectional area of the oropharynx decreased in the supine position. The obese group had higher AI and RDI. Maxillary unit length, C3-H, the cross-sectional areas of tongue, soft palate and oropharynx were significantly greater in the group Obese than in non-obese group. No correlation was noted between the mandibular unit length and OSA severity. The group of small mandibular unit length showed shorter lower facial height and maxillary unit length, and smaller cross-sectional area of tongue than the long mandibular unit length group. Hyold bone positioned more inferiorly and cross-sectional area of nasopharynx decreased as the OSA severity increased.
Cephalometry ; Humans ; Male ; Nasopharynx ; Obesity ; Oropharynx ; Palate, Soft ; Sleep Apnea Syndromes ; Sleep Apnea, Obstructive* ; Supine Position* ; Tongue

The sybmental region in patients with Obstructive Sleep Apnea (OSA) is perceived to be larger than normal. Therefore, neck thickness has become a variable routinely measured during clinical screening of OSA subjects. In general, OSA patients are believed to have a large tongue and a narrow airway. To test if OSA patients have a larger face and tongue than non-alneics, eighty pairs of upright and supine cephalograms were obtained from four groups of subjects subclassified in accirdance with severity. The sum of distances between pairs of landmarks was calculated for each subjects and employed as a pure size variable for the face and tongue. Only tongue size become larger in accordance with apnea severity in both body positions (P<.01). Tongue size reflects apnea seveity, yet it provides only a small fraction of the explanation with regard to apnea severity. We conclude that size may be one factor of many which are significantly related to OSA seberity.
Apnea ; Cephalometry ; Humans ; Mass Screening ; Neck ; Sleep Apnea, Obstructive* ; Supine Position ; Tongue

OBJECTIVES: Noonan syndrome is a rare disease presenting with phenotypic features. Over two-thirds of patients with Noonan Syndrome have congenital heart defects with pulmonic stenosis as the most common cardiac abnormality. As a means of focusing on these complications, we report three patients with stigmata of Noonan Syndrome, each of whom had a combination of pulmonic stenosis and other cardiac abnormalities.

PATIENTS AND METHODS: The clinical features and cardiac abnormalities of three patients with Noonan Syndrome were studied, and a literature review on cardiovascular manifestations of this syndrome was undertaken.

RESULTS: The three patients we report had physical features compatible with Noonan Syndrome. Pulmonic stenosis is common among three cases and other cardiac abnormalities were also noted with the aid of 2D-echocardiogram.

CONCLUSION: The existence of several types of cardiac abnormalities within one syndrome is unusual and requires further investigation. Thorough history and physical examination is of utmost importance in diagnosing a rare condition with associated cardiac abnormalities. Recognition of common abnormalities in patients with Noonan Syndrome would aid both clinical course and management of this rare condition.

Human ; Female ; Adult ; Noonan Syndrome ; Craniofacial Abnormalities ; Pulmonary Valve Stenosis ; Heart Septal Defects, Atrial