Maxillofacial Plastic and Reconstructive Surgery

Korean Association of Maxillofacial Plastic and Reconstructive Surgeons (대한악안면성형재건외과학회)
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Cephalometric Predisposing Factors of the Snoring and Obstructive Sleep Apnea

코골이 및 폐쇄성 수면 무호흡증의 두부 규격 방사선 계측학적 기여 인자

  • Seo, Eun-Woo (Department of Oral and Maxillofacial Surgery, Section of Dentistry, Ajou University School of Medicine) ;
  • Lee, Ho-Kyung (Department of Oral and Maxillofacial Surgery, Section of Dentistry, Ajou University School of Medicine) ;
  • Han, Min-Woo (Department of Oral and Maxillofacial Surgery, Section of Dentistry, Ajou University School of Medicine) ;
  • Seo, Mi-Hyun (Department of Oral and Maxillofacial Surgery, Section of Dentistry, Ajou University School of Medicine) ;
  • Kim, Hyun-Jun (Department of Otorhinolaryngology, Ajou University School of Medicine) ;
  • Song, Seung-Il (Department of Oral and Maxillofacial Surgery, Section of Dentistry, Ajou University School of Medicine)
  • 서은우 (아주대학교 의과대학 치과학교실 구강악안면외과) ;
  • 이호경 (아주대학교 의과대학 치과학교실 구강악안면외과) ;
  • 한민우 (아주대학교 의과대학 치과학교실 구강악안면외과) ;
  • 서미현 (아주대학교 의과대학 치과학교실 구강악안면외과) ;
  • 김현준 (아주대학교 의과대학 이비인후과학교실) ;
  • 송승일 (아주대학교 의과대학 치과학교실 구강악안면외과)
  • Received : 2013.02.25
  • Accepted : 2013.05.20
  • Published : 2013.05.31
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Abstract

Purpose: This study was intended to perform a cephalometric comparison between the patients with and without obstructive sleep apnea (OSA). The factors influencing the OSA in the lateral cephalogram were also investigated. Methods: Fifty patients who had visited the Sleep Disorder Clinic at the Ajou University Hospital and evaluated with the polysomnograph (PSG) and cephalogram, were included in the study. The patients had the apnea-hypopnea episode over 5 times per hour (apnea-hypopnea index $[AHI]{\geq}5$) were diagnosed as OSA after the overnight PSG. To evaluate the hard and soft tissue profiles, the cephalometric radiograms were taken at the maximal intercuspation. The correlation between the patient's age, height, weight, body mass index (BMI) and AHI was inspected in the OSA and control group. The difference between the OSA and control group was evaluated (Mann-Whitney U Test). The cephalometric influencing factors to OSA were analyzed (Pearson's correlation coefficient) statistically using SPSS statistics. Results: The OSA Group had a significantly higher BMI than the control group. The mean lower facial height (ANS-Me) was longer in the OSA group; however, statistically significant difference was not detected in the anteroposterior craniofacial measurements. The distance between mandibular plane and hyoid bone of the OSA group was significantly longer than that of the control group. The hyoid position (MP-Hyoid) had a positive correlation between AHI (P<0.001). However, the measurements of oropharyngeal airway were not different between the two groups. The hypothesis, that the antero-posteriorly narrow oropharyngeal airway may aggravate the airway resistance and give rise to a higher AHI, was rejected in the study. Conclusion: We suggest that the lateral cephalogram may be utilized as a useful method to evaluate OSA. The patients with a lower hyoid position can be expected to have higher risks of OSA. However, a comprehensive intraoral inspection, including the soft palate and tonsilar hypertrophy, is emphasized, as the lateral cepahlogram cannot visualize the oropharyngeal status completely.

Keywords

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