• Maxillofacial Plastic and Reconstructive Surgery
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• v.41
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• pp.58.1-58.8
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• 2019

Background: The aim of this study is to investigate the relationship between gender-specific and obesity-related airway anatomy in patients with obstructive sleep apnea (OSA) by using cephalometric analyses. Methods: We retrospectively evaluated 206 patients with suspected OSA undergoing polysomnography and anthropometric measurements such as body mass index, neck circumference, and waist-hip ratio. We checked lateral cephalometry to measure tissue landmarks including angle from A point to nasion to B point (ANB), soft palate length (SPL), soft palate thickness (SPT), retropalatal space (RPS), retrolingual space (RLS), and mandibular plane to hyoid (MPH). Results: Male with OSA showed significantly increased SPL (P = .006) compared with controls. SPL and MPH had significant correlation with apnea-hypopnea index (AHI) and central obesity. Female with OSA showed significantly increased ANB (P = .013) and SPT (P = .004) compared with controls. The receiver operating characteristic curves revealed that SPT in male and ANB and SPT in female were significant in model 1 (AHI ≥ 5) and model 2 (AHI ≥ 15). MPH was also significant for male in model 2. Conclusion: Male and female with OSA had distinct anatomic features of the upper airway and different interactions among soft palate, mandible, and hyoid bone.

• Journal of Dental Anesthesia and Pain Medicine
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• v.17 no.1
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• pp.71-76
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• 2017

Drug-induced sleep endoscopy (DISE) is used to identify areas of upper airway obstruction, which occurs when patients with obstructive sleep apnea (OSA) snore. DISE enables effective diagnosis and appropriate treatment of the obstruction site. Among surgical treatment methods for OSA, maxillomandibular advancement surgery (MMA) is performed to move a jaw forward; the surgery has a high success rate for OSA treatment. In DISE, anesthetics such as propofol and midazolam must be administered to induce snoring while the patient is deeply sedated for an accurate diagnosis to be made. When inducing deep sedation in a patient with OSA, airway obstruction may increase, causing oxygen saturation to drop; airway interventions are necessary in such cases. Effective DISE and MMA surgery can be performed by administering propofol through target-controlled infusion while monitoring the bispectral index (BIS).

• Sleep Medicine and Psychophysiology
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• v.27 no.2
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• pp.77-81
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• 2020

Obstructive sleep apnea (OSA) is a sleep-related breathing disorder in which narrowing and obstruction of the upper airway lead to frequent arousal and decreased arterial oxygenation during sleep. OSA is more common in children with genetic disorders like achondroplasia compared to children without genetic disorders. Achondroplasia is genetic disorder characterized by hypoplasia of the facial bone and skull base with foramen magnum stenosis, resulting in exceedingly high frequency of OSA. The authors present a case of a patient with achondroplasia diagnosed with severe OSA through polysomnography after adenectomy showed little therapeutic effect and who was treated with continuous positive airway pressure.

• Tuberculosis and Respiratory Diseases
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• v.87 no.2
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• pp.165-175
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• 2024

Background: The prevalence of small airway dysfunction (SAD) in patients with chronic obstructive pulmonary disease (COPD) across different ethnicities is poorly understood. This study aimed to estimate the prevalence of SAD in stable COPD patients. Methods: We conducted a cross-sectional study of 196 consecutive stable COPD patients. We measured pre- and post-bronchodilator (BD) lung function and respiratory impedance. The severity of COPD and lung function abnormalities was graded in accordance with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. SAD was defined as either difference in whole-breath resistance at 5 and 19 Hz > upper limit of normal or respiratory system reactance at 5 Hz < lower limit of normal. Results: The cohort consisted of 95.9% men, with an average age of 66.3 years. The mean forced expiratory volume 1 second (FEV₁) % predicted was 56.4%. The median COPD assessment test (CAT) scores were 14. The prevalence of post-BD SAD across the GOLD grades 1 to 4 was 14.3%, 51.1%, 91%, and 100%, respectively. The post-BD SAD and expiratory flow limitation at tidal breath (EFL_T) were present in 62.8% (95% confidence interval [CI], 56.1 to 69.9) and 28.1% (95% CI, 21.9 to 34.2), respectively. COPD patients with SAD had higher CAT scores (15.5 vs. 12.8, p<0.01); poor lung function (FEV₁% predicted 46.6% vs. 72.8%, p<0.01); lower diffusion capacity for CO (4.8 mmol/min/kPa vs. 5.6 mmol/min/kPa, p<0.01); hyperinflation (ratio of residual volume to total lung capacity % predicted: 159.7% vs. 129%, p<0.01), and shorter 6-minute walk distance (367.5 m vs. 390 m, p=0.02). Conclusion: SAD is present across all severities of COPD. The prevalence of SAD increases with disease severity. SAD is associated with poor lung function and higher symptom burden. Severe SAD is indicated by the presence of EFL_T.

• The korean journal of orthodontics
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• v.36 no.3 s.116
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• pp.228-236
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• 2006

To evaluate the cephalometric and dental characteristics of obstructive sleep apnea (OSA) patients, 23 OSA patients and 15 control, non-OSA, patients who visited the Sleep Disorder Clinic Center, Keimyung University were investigated. Patients who suffered from apnea-hypopnea episodes over 10times per hour were diagnosed as having OSA after polysomnograph testing, Impressions were taken with alginate. Cephalometric radiographs were taken at maximum intercuspation. The dental cast measurements, including transpalatal width, intercanine width, intermolar width and palatal depth did not differ between the control and OAS groups and did not have a positive correlation with the apnea-hypopnea index (AHI). Upper airway width was statistically narrower than the control group. Upper airway width had a low negative correlation with AHI, but, lower airway width had a low positive correlation, and, the higher the AHI score, the longer the mandibular border to hyoid distance.

• The Journal of the Convergence on Culture Technology
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• v.10 no.5
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• pp.453-458
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• 2024

If you are unable to get comfortable sleep to maintain and recover your health, it will cause a lot of disruption to your daily life. Among the intraoral devices used to resolve snoring, obstructive sleep apnea, bruxism, teeth clenching, and mouth breathing, which interfere with a comfortable sleep, devices that stabilize the lower jaw by moving it forward are a treatment that replaces surgical therapy and positive airway pressure. It is showing effect. During use of the device, a force is generated that causes the lower jaw to return to its original position, so a device that fixes it with screws, rubber bands, etc. is used. To see the effect of the device, you must bite your upper and lower teeth. In order to eliminate the inconvenience of having to stay closed while sleeping, the device is manufactured only in the upper jaw and creates a vertical guideway in the lingual embarasure of the lower jaw in the shape of a key & key way structure, allowing twisting movements and allowing forward and lateral movements. It is about the development of a device that has a blocking function that allows the mouth to be opened while wearing the device and has a function that solves sleep apnea by inducing airway expansion during sleep.

• The Journal of Korea Assosiation for Disability and Oral Health
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• v.12 no.2
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• pp.87-91
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• 2016

Pierre Robin syndrome (PRS) is characterized by the triad of congenital mandibular hypoplasia, glossoptosis and cleft palate. Infant PRS patients are frequently suffering from upper airway obstruction, gastroesophageal reflux and growth retardation caused by above mentioned problems. We report a dental caries treatment of 3-year old girl with Pierre Robin syndrome with multiple caries. The cause of multiple caries was mainly presumed as patient's eating habit caused by her general condition. She had some feeding problems and had history of gastric tube. She was still using milk bottle and took more than an hour to finish a meal. The treatment was performed under general anesthesia considering patient's condition; mild autism, poor cooperation and respiratory problem due to micrognathia. Severely affected upper incisors were treated with pulp treatment and restored with zirconia crown for esthetic purpose. Lower incisors were treated with pulp treatment and restored with composite resin. Upper right first primary molar was restored with stainless steel crown and other primary molars were treated with composite resin. There were no postoperative complications. According to her parents, the patient's compliance to oral hygiene management was greatly improved after the treatment since she was very pleased with the esthetic result and highly motivated by her looks. The treatment without sedation or general anesthesia would be possible once the airway is improved as the mandible grows.

• The korean journal of orthodontics
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• v.30 no.5 s.82
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• pp.591-598
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• 2000

This study was designed to analysis the airway which affects to breathing, speech and facial growth pattern in unilateral cleft lip and palate patients. Upper airway and the position of hyoid bone pattern were analyzed on the lateral cephalometric radiographs of the 78 subjects of complete unilateral cleft lip and palate group and each group was divided two sub-groups by circumpubertal growth peak and gender. These data were statistically analyzed to examine the difference between pre-circumpubertal growth peak group and post-circumpubertal growth peak one, and between male and female group. The results of this study were as follows: 1. After circumpubertal growth peak stage, the position of hyoid bone was lower than before in both male and female group. 2. After circumpubertal growth peak stage, the measurement were increased in CV3ia-APH, PNS-ad which related to the volume of pharyngeal space. This was due to the decrease of adenoid and anteroiferior growth of mandible and affected to breathing and speech after circumpubertal growth peak. 3. During circumpubertal growth peak stage, all measurements increased more in male than female group, which due to the different amount of growth in different gender. 4. The position of hyoid bone was lower in male than female group in all age group. 5. After circumpubertal growth peak stage, CV3ia-APH increased more in male. This was due to the more growth in madible of male which resulted in the activation of digastric muscle.

• Korean Journal of Clinical Laboratory Science
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• v.51 no.1
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• pp.119-123
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• 2019

Obstructive sleep apnea (OSA) is a sleep disorder with no breathing symptoms due to repetitive upper airway resistance. OSA is a disease that can have significant effects on the cerebral cardiovascular system. Active treatment is needed to prevent these complications. The use of continuous positive airway pressure (CPAP), the standard therapy of OSA, has comparative therapeutic effects. On the other hand, there is no comparison report of the polysomnography (PSG) results before and after CPAP therapy without using a mask. This paper reports a patient who was diagnosed as OSA and used CPAP every night for more than 2 years. The patient showed a decrease in the apnea-hypopnea index from 64.7/h to 12.9/h. In addition, other sleep-related indicators improved significantly. The daily use of CPAP as a treatment for OSA for more than 2 years may improve the PSG results. Constant follow up of PSG will be needed to adjust the appropriate CPAP pressure to patients because there might be a change in the Apnea-Hypopnea Index and other sleep-related indicators for constant CPAP users for at least 2 years.

• Journal of The Korean Dental Society of Anesthesiology
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• v.10 no.1
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• pp.27-33
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• 2010

The gag reflex is a physiologic reaction which safeguards the airway from foreign bodies. But, an exaggerated gag reflex can be a severe limitation to a patient's ability to accept dental care and for a clinician's ability to provide it. The overactive gag reflex can be due to psychological factors or physiological factors, or both. Psychological factors can include fear of loss of control and past traumatic experiences. A 58-year-old man, scheduled for extraction of left upper second molar, left lower second and third molar and implantation of left upper second molar, and left lower second molar had no specific underlying medical problems. He had exaggerated gag reflex. Dental treatment was successfully performed using intravenous sedation. Intravenous sedation with midazolam and propofol was a useful management technique for reflex control during dental treatment extended to the posterior regions in the oral cavity.