Cephalometric Variables Significantly Associated with Apnea Hypopnea Index in Suspected Obstructive Sleep Apnea Patients : A Preliminary Study

폐쇄성수면무호흡 의심환자에서 무호흡-저호흡 지수와 연관이 있는 두개골 계측 변수 : 예비연구

  • Park, Suyoung (Department of Radiology, Gil Medical Center, Gachon University School of Medicine) ;
  • Hwang, Hee Young (Department of Radiology, Gil Medical Center, Gachon University School of Medicine) ;
  • Kim, Eung Yeop (Department of Radiology, Gil Medical Center, Gachon University School of Medicine) ;
  • Kang, Seung-Gul (Department of Psychiatry, Gil Medical Center, Gachon University School of Medicine) ;
  • Kim, Seon Tae (Department of Otolaryngology, Gil Medical Center, Gachon University School of Medicine) ;
  • Park, Kee Hyung (Department of Neurology, Gil Medical Center, Gachon University School of Medicine)
  • 박수영 (가천대학교 의학전문대학원 길병원 영상의학교실) ;
  • 황희영 (가천대학교 의학전문대학원 길병원 영상의학교실) ;
  • 김응엽 (가천대학교 의학전문대학원 길병원 영상의학교실) ;
  • 강승걸 (가천대학교 의학전문대학원 길병원 정신건강의학교실) ;
  • 김선태 (가천대학교 의학전문대학원 길병원 이비인후과학교실) ;
  • 박기형 (가천대학교 의학전문대학원 길병원 신경과학교실)
  • Received : 2014.11.13
  • Accepted : 2015.02.03
  • Published : 2015.02.28

Abstract

Objectives The purpose of this study is to find the cephalometric variables which are significantly correlated with the apnea-hypopnea index (AHI) in suspected Korean obstructive sleep apnea (OSA) patients. Methods We examined lateral cephalogram and attended-full night laboratory polysomnography of the 40 participants who complained of OSA symptoms. The correlation analysis was conducted to find the cephalometric variables which are significantly correlated with the AHI. Results The correlation analysis showed that the higher AHI was associated with the longer distance between hyoid and mandibular plane (p = 0.023), the longer distance between C3 and hyoid (p = 0.014), the longer tongue length (p = 0.003), the larger inferior tongue area (p = 0.008), the larger anterior displacement of the hyoid bone (p = 0.024), the longer distance between posterior nasal spine and the tip of the soft palate (p = 0.021), and the larger cross-sectional area of soft palate (p = 0.001) of cephalogram in erect position. The higher AHI was correlated with the longer distance between hyoid and mandibular plane (p = 0.008), the longer tongue length (p = 0.037), the larger inferior tongue area (p = 0.013), the thicker uvula (p = 0.004), the longer distance between retrognathion and hyoid (p = 0.025), and larger cross-sectional area of soft palate (p = 0.001) of cephalogram in supine position. Conclusions The present preliminary results showed the candidate measurements of cephalogram which are significantly correlated with the AHI in suspected OSA.

Keywords

References

  1. Bresnitz EA, Goldberg R, Kosinski RM. Epidemiology of obstructive sleep apnea. Epidemiol Rev 1994;16:210-227. https://doi.org/10.1093/oxfordjournals.epirev.a036151
  2. Ono T, Lowe AA, Ferguson KA, Fleetham JA. Associations among upper airway structure, body position, and obesity in skeletal Class I male patients with obstructive sleep apnea. Am J Orthod Dentofacial Orthop 1996;109:625-634. https://doi.org/10.1016/S0889-5406(96)70074-4
  3. Riley R, Guilleminault C, Herran J, Powell N. Cephalometric analyses and flow-volume loops in obstructive sleep apnea patients. Sleep 1983;6:303-311. https://doi.org/10.1093/sleep/6.4.303
  4. Tangugsorn V, Krogstad O, Espeland L, Lyberg T. Obstructive sleep apnea: a canonical correlation of cephalometric and selected demographic variables in obese and nonobese patients. Angle Orthod 2001;71:23-35.
  5. Ong KC, Clerk AA. Comparison of the severity of sleep-disordered breathing in Asian and Caucasian patients seen at a sleep disorders center. Respir Med 1998;92:843-848. https://doi.org/10.1016/S0954-6111(98)90386-9
  6. Iber C, Ancoli-Israel S, Chesson ALJ, Quan SF. The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications. Westchester: American Academy of Sleep Medicine;2007.
  7. Park J, Wang D, Kim WI, Lee SD, Nam SY, Lee YB. Clinical evaluation of polysomnography in snoring and obstructive sleep apnea syndrome (OSA) patients. Korean J Otorhinolaryngol-Head Neck Surg 1994;37:369-376.
  8. Kwon TG, Cho YW, Ahn BH, Suh YS. Cephalometric predictors of obstructive sleep apnea. J Korean Assoc Oral Maxillofac Surg 2003; 29:338-345.
  9. Li KK, Powell NB, Kushida C, Riley RW, Adornato B, Guilleminault C. A comparison of Asian and white patients with obstructive sleep apnea syndrome. Laryngoscope 1999;109:1937-1940. https://doi.org/10.1097/00005537-199912000-00007
  10. Tsuchiya M, Lowe AA, Pae EK, Fleetham JA. Obstructive sleep apnea subtypes by cluster analysis. Am J Orthod Dentofacial Orthop 1992;101:533-542. https://doi.org/10.1016/0889-5406(92)70128-W
  11. Hwang SH, Park IS, Nam KY, Kim JB, Cho YW, Suh YS, et al. Cephalometric differences in obstructive sleep apnea between obese and non-obese Korean male patients. Korean J Orthod 2008;38:202-213. https://doi.org/10.4041/kjod.2008.38.3.202