대한치과교정학회지 (The korean journal of orthodontics)

  • 제53권5호
  • /
  • Pages.317-327
  • /
  • 2023
  • /
  • 2234-7518(pISSN)
  • /
  • 2005-372X(eISSN)
대한치과교정학회 (The Korean Association Of Orthodontists)
권호 표지
DOI QR코드

DOI QR Code

Three-dimensional evaluation of the association between tongue position and upper airway morphology in adults: A cross-sectional study

  • Yuchen Zheng (Department of Orthodontics, School of Dentistry, Chonnam National University) ;
  • Hussein Aljawad (Department of Orthodontics, School of Dentistry, Chonnam National University) ;
  • Min-Seok Kim (Department of Oral Anatomy, School of Dentistry, Dental Science Research Institute, Chonnam National University) ;
  • Su-Hoon Choi (Department of Mathematics and Statistics, Chonnam National University) ;
  • Min-Soo Kim (Department of Mathematics and Statistics, Chonnam National University) ;
  • Min-Hee Oh (Department of Orthodontics, School of Dentistry, Dental 4D Research Institute, Dental Science Research Institute, Chonnam National University) ;
  • Jin-Hyoung Cho (Department of Orthodontics, School of Dentistry, Dental 4D Research Institute, Dental Science Research Institute, Chonnam National University)
  • 투고 : 2023.02.02
  • 심사 : 2023.08.13
  • 발행 : 2023.09.25
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

Objective: This study aimed to evaluate the association between low tongue position (LTP) and the volume and dimensions of the nasopharyngeal, retropalatal, retroglossal, and hypopharyngeal segments of the upper airway. Methods: A total of 194 subjects, including 91 males and 103 females were divided into a resting tongue position (RTP) group and a LTP group according to their tongue position. Subjects in the LTP group were divided into four subgroups (Q1, Q2, Q3, and Q4) according to the intraoral space volume. The 3D slicer software was used to measure the volume and minimum and average cross-sectional areas of each group. Airway differences between the RTP and LTP groups were analyzed to explore the association between tongue position and the upper airway. Results: No significant differences were found in the airway dimensions between the RTP and LTP groups. For both retropalatal and retroglossal segments, the volume and average cross-sectional area were significantly greater in the patients with extremely low tongue position. Regression analysis showed that the retroglossal airway dimensions were positively correlated with the intraoral space volume and negatively correlated with A point-nasion-B point and palatal plane to mandibular plane. Males generally had larger retroglossal and hypopharyngeal airways than females. Conclusions: Tongue position did not significantly influence upper airway volume or dimensions, except in the extremely LTP subgroup.

키워드

참고문헌

  1. Lowe AA, Fleetham JA, Adachi S, Ryan CF. Cephalometric and computed tomographic predictors of obstructive sleep apnea severity. Am J Orthod Dentofacial Orthop 1995;107:589-95. https://doi.org/10.1016/s0889-5406(95)70101-x
  2. Miles PG, Vig PS, Weyant RJ, Forrest TD, Rockette HE Jr. Craniofacial structure and obstructive sleep apnea syndrome--a qualitative analysis and meta-analysis of the literature. Am J Orthod Dentofacial Orthop 1996;109:163-72. https://doi.org/10.1016/s0889-5406(96)70177-4
  3. Oktay H, Ulukaya E. Maxillary protraction appliance effect on the size of the upper airway passage. Angle Orthod 2008;78:209-14. https://doi.org/10.2319/122806-535.1
  4. Golchini E, Rasoolijazi H, Momeni F, Shafaat P, Ahadi R, Jafarabadi MA, et al. Investigation of the relationship between mandibular morphology and upper airway dimensions. J Craniofac Surg 2020;31:1353-61. https://doi.org/10.1097/SCS.0000000000006341
  5. Okubo M, Suzuki M, Horiuchi A, Okabe S, Ikeda K, Higano S, et al. Morphologic analyses of mandible and upper airway soft tissue by MRI of patients with obstructive sleep apnea hypopnea syndrome. Sleep 2006;29:909-15. https://doi.org/10.1093/sleep/29.7.909
  6. Kirjavainen M, Kirjavainen T. Upper airway dimensions in Class II malocclusion. Effects of headgear treatment. Angle Orthod 2007;77:1046-53. https://doi.org/10.2319/081406-332
  7. Alfawzan AA. Assessment of airway dimensions in skeletal Class I malocclusion patients with various vertical facial patterns: a cephalometric study in a sample of the Saudi population. J Orthod Sci 2020;9:12. https://doi.org/10.4103/jos.JOS_10_20
  8. Tarkar JS, Parashar S, Gupta G, Bhardwaj P, Maurya RK, Singh A, et al. An evaluation of upper and lower pharyngeal airway width, tongue posture and hyoid bone position in subjects with different growth patterns. J Clin Diagn Res 2016;10:ZC79-83. https://doi.org/10.7860/JCDR/2016/16746.7158
  9. Juge L, Knapman FL, Humburg P, Burke PGR, Lowth AB, Brown E, et al. The relationship between mandibular advancement, tongue movement, and treatment outcome in obstructive sleep apnea. Sleep 2022;45:zsac044. https://doi.org/10.1093/sleep/zsac044
  10. Chan AS, Sutherland K, Schwab RJ, Zeng B, Petocz P, Lee RW, et al. The effect of mandibular advancement on upper airway structure in obstructive sleep apnoea. Thorax 2010;65:726-32. https://doi.org/10.1136/thx.2009.131094
  11. Ferguson KA, Cartwright R, Rogers R, Schmidt-Nowara W. Oral appliances for snoring and obstructive sleep apnea: a review. Sleep 2006;29:244-62. https://doi.org/10.1093/sleep/29.2.244
  12. Aljawad H, Lee KM, Lim HJ. Three-dimensional evaluation of upper airway changes following rapid maxillary expansion: a retrospective comparison with propensity score matched controls. PLoS One 2021;16:e0261579. https://doi.org/10.1371/journal.pone.0261579
  13. Iwasaki T, Saitoh I, Takemoto Y, Inada E, Kakuno E, Kanomi R, et al. Tongue posture improvement and pharyngeal airway enlargement as secondary effects of rapid maxillary expansion: a cone-beam computed tomography study. Am J Orthod Dentofacial Orthop 2013;143:235-45. https://doi.org/10.1016/j.ajodo.2012.09.014
  14. Hsieh YJ, Liao YF, Chen NH, Chen YR. Changes in the calibre of the upper airway and the surrounding structures after maxillomandibular advancement for obstructive sleep apnoea. Br J Oral Maxillofac Surg 2014;52:445-51. https://doi.org/10.1016/j.bjoms.2014.02.006
  15. Gurani SF, Di Carlo G, Cattaneo PM, Thorn JJ, Pin-holt EM. Effect of head and tongue posture on the pharyngeal airway dimensions and morphology in three-dimensional imaging: a systematic review. J Oral Maxillofac Res 2016;7:e1. https://doi.org/10.5037/jomr.2016.7101
  16. Izuka EN, Feres MF, Pignatari SS. Immediate impact of rapid maxillary expansion on upper airway dimensions and on the quality of life of mouth breathers. Dental Press J Orthod 2015;20:43-9. https://doi.org/10.1590/2176-9451.20.3.043-049.oar
  17. Gurani SF, Cattaneo PM, Rafaelsen SR, Pedersen MR, Thorn JJ, Pinholt EM. The effect of altered head and tongue posture on upper airway volume based on a validated upper airway analysis-an MRI pilot study. Orthod Craniofac Res 2020;23:102-9. https://doi.org/10.1111/ocr.12348
  18. Hwang HS, Lee KM, Uhm GS, Cho JH, McNamara JA Jr. Use of Reference Ear Plug to improve accuracy of lateral cephalograms generated from cone-beam computed tomography scans. Korean J Orthod 2013;43:54-61. https://doi.org/10.4041/kjod.2013.43.2.54
  19. Lee K, Hwang SJ. Change of the upper airway after mandibular setback surgery in patients with mandibular prognathism and anterior open bite. Maxillofac Plast Reconstr Surg 2019;41:51. https://doi.org/10.1186/s40902-019-0230-4
  20. Hiyama S, Suda N, Ishii-Suzuki M, Tsuiki S, Ogawa M, Suzuki S, et al. Effects of maxillary protraction on craniofacial structures and upper-airway dimension. Angle Orthod 2002;72:43-7. https://pubmed.ncbi.nlm.nih.gov/11843272/
  21. Staudt CB, Gnoinski WM, Peltomaki T. Upper airway changes in Pierre Robin sequence from childhood to adulthood. Orthod Craniofac Res 2013;16:202-13. https://doi.org/10.1111/ocr.12019
  22. Zheng ZH, Yamaguchi T, Kurihara A, Li HF, Maki K. Three-dimensional evaluation of upper airway in patients with different anteroposterior skeletal patterns. Orthod Craniofac Res 2014;17:38-48. https://doi.org/10.1111/ocr.12029
  23. Zhong Z, Tang Z, Gao X, Zeng XL. A comparison study of upper airway among different skeletal craniofacial patterns in nonsnoring Chinese children. Angle Orthod 2010;80:267-74. https://pubmed.ncbi.nlm.nih.gov/19905851/ https://doi.org/10.2319/030809-130.1
  24. Ingman T, Nieminen T, Hurmerinta K. Cephalometric comparison of pharyngeal changes in subjects with upper airway resistance syndrome or obstructive sleep apnoea in upright and supine positions. Eur J Orthod 2004;26:321-6. https://doi.org/10.1093/ejo/26.3.321
  25. Pae EK, Lowe AA, Sasaki K, Price C, Tsuchiya M, Fleetham JA. A cephalometric and electromyographic study of upper airway structures in the upright and supine positions. Am J Orthod Dentofacial Orthop 1994;106:52-9. https://doi.org/10.1016/S0889-5406(94)70021-4
  26. Moon IJ, Han DH, Kim JW, Rhee CS, Sung MW, Park JW, et al. Sleep magnetic resonance imaging as a new diagnostic method in obstructive sleep apnea syndrome. Laryngoscope 2010;120:2546-54. https://doi.org/10.1002/lary.21112
  27. Martin SE, Mathur R, Marshall I, Douglas NJ. The effect of age, sex, obesity and posture on upper airway size. Eur Respir J 1997;10:2087-90. https://doi.org/10.1183/09031936.97.10092087
  28. Kim S, Park E. Differences in height, weight, BMI, and obesity rate between 2018 Community Health and Korea National Health and Nutrition Examination Surveys. J Health Info Stat 2020;45:281-7. https://doi.org/10.21032/jhis.2020.45.3.281