The korean journal of orthodontics (대한치과교정학회지)

The Korean Association Of Orthodontists (대한치과교정학회)
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Cephalometric differences in obstructive sleep apnea between obese and non-obese Korean male patients

한국인 성인 남성 폐쇄성수면무호흡 환자의 측모 두부 방사선계측학적 비교

  • Hwang, Sang-Hee (Department of Dentistry, College of Medicine, Keimyung University) ;
  • Park, In-Suk (Department of Dentistry, College of Medicine, Keimyung University) ;
  • Nam, Ki-Young (Department of Dentistry, College of Medicine, Keimyung University) ;
  • Kim, Jong-Bae (Department of Dentistry, College of Medicine, Keimyung University) ;
  • Cho, Yong-Won (Department of Neurology, College of Medicine, Keimyung University) ;
  • Suh, Young-Sung (Department of Family Medicine, College of Medicine, Keimyung University) ;
  • Ahn, Byung-Hoon (Department of Otolaryngology, College of Medicine, Keimyung University) ;
  • Park, Shin-Goo (Department of Occupational & Environmental Medicine, College of Medicine, Inha University) ;
  • Park, Hyo-Sang (Department of Orthodontics, College of Dentistry, Kyungpook National University)
  • 황상희 (계명대학교 의과대학 치과학교실) ;
  • 박인숙 (계명대학교 의과대학 치과학교실) ;
  • 남기영 (계명대학교 의과대학 치과학교실) ;
  • 김종배 (계명대학교 의과대학 치과학교실) ;
  • 조용원 (계명대학교 의과대학 신경과학교실) ;
  • 서영성 (계명대학교 의과대학 가정의학교실) ;
  • 안병훈 (계명대학교 의과대학 이비인후과학교실) ;
  • 박신구 (인하대학교 의과대학 산업의학교실) ;
  • 박효상 (경북대학교 치과대학 교정학교실)
  • Published : 2008.06.30
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Abstract

Objective: The purpose of this study was to compare the cephalometric measurements of obese and non-obese Korean male patients with obstructive sleep apnea syndrome (OSA). Methods: Eighty-seven adults who had visited the Sleep Disorder Clinic Center in Keimyung University, Daegu, Korea were examined and evaluated with polysomnography (PSG) and lateral cephalogram. They were divided into 4 groups (non-obese simple snorers, obese simple snorers, non-obese OSA patients, obese OSA patients) according to AHI (Apnea-Hypopnea Index) and BMI (Body Mass Index). Results: The obese OSA group had the highest AHI among the 4 groups. The non-obese OSA group had a significantly steeper mandibular angle and shorter tongue length than the obese OSA group. The hyoid bone of the obese OSA group was positioned anterior and inferior as compared with the non-obese OSA group. Multiple regression analysis showed that tongue length in the obese OSA group and retroposition of hyoid bone in the non-obese OSA group were significant determinants for the severity of AHI. Conclusions: From a cephalometric point of view, the obese and non-obese pateints with OSA may be characterized by different pathogeneses. Therefore, they have to be managed by individualized treatment. For the obese OSA patients, weight control must be advised as a first choice and for the non-obese OSA patients, oral appliance, nasal CPAP, UPPP and others could be chosen according to the obstructive sites.

본 연구는 비만도에 따른 한국인 남성 폐쇄성수면무호흡 환자의 측모 두부 방사선계측학적 특성을 파악하기 위하여 시행되었다. 이를 위하여 계명대학교 의과대학 동산의료원 수면클리닉에 수면장애를 주소로 내원하여 수면다원검사 후 치과에서 측모 두부방사선계측사진 촬영을 한 87명의 성인 환자들을 체질량지수(BMI)와 수면무호흡지수(AHI)에 따라 비비만 단순코골이군(Non-obese, simple snorers), 비만 단순코골이군(Obese, simple snorers), 비비만 수면무호흡군(Non-obese, OSA patients), 비만 수면무호흡군(Obese, OSA patients)의 4군으로 나누어 비교하였다. 그 결과, 4군 중 비만 수면무호흡군의 수면무호흡지수가 가장 컸으며, 비만 수면무호흡군보다 비비만 수면무호흡군의 하악각이 더 크고 혀 길이는 더 작았다. 또한, 비비만 수면무호흡군보다 비만수면무호흡군의 설골이 더 전하방에 위치하였고, 수면무호흡지수에 영향을 미치는 기여 인자는 비만 수면무호흡군에서는 혀 길이, 비비만 수면무호흡군에서는 설골의 후방위치였다. 이처럼 비만 수면무호흡 환자와 비비만 수면무호흡 환자의 측모 두부방사선계측학적 특성과 기여 인자가 다르게 나타나므로, 치료방법도 따라서 다르게 선택해야 할 것이다. 비만 수면무호흡 환자들에게는 먼저 체중감량이 권고되어야 할 것이고, 비비만 수면무호흡 환자들은 폐쇄부위에 따라 구강 내 장치나 Nasal CPAP(continuous positive airway pressure), UPPP (uvulopalatopharyngoplasty) 등이 추천될 수 있을 것이다.

Keywords

References

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