Journal of the Korean Association of Oral and Maxillofacial Surgeons

The Korean Association of Oral and Maxillofacial Surgeons (대한구강악안면외과학회)
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CEPHALOMETRIC PREDICTORS OF OBSTRUCTIVE SLEEP APNEA

폐쇄성 수면 무호흡증에 있어 두부 규격 방사선 계측학적 기여 인자

  • Kwon, Tae-Geon (Dept. of Oral & Maxillofacial Surgery, College of Dentistry, Kyungpook National University) ;
  • Cho, Yong-Won (Dept. of Neurology, College of Medicine, Keimyung University) ;
  • Ahn, Byung-Hoon (Dept. of Otolaryngology, College of Medicine, Keimyung University) ;
  • Suh, Young-Sung (Dept. of Family Medicine, College of Medicine, Keimyung University)
  • 권대근 (경북대학교 치과대학 구강악안면외과학 교실) ;
  • 조용원 (계명대학교 의과대학 신경과학 교실) ;
  • 안병훈 (계명대학교 의과대학 이비인후과학 교실) ;
  • 서영성 (계명대학교 의과대학 가정의학 교실)
  • Published : 2003.10.30
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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, $R^2$ = 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 & 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.

Keywords

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