Iked N, Hazime N, Dekeister C, Folia M, Tiberge M, Paoli J R
Service de Stomatologie et Chirurgie Maxillo-Faciale, Hôpital Rangueil, CHU Toulouse, 1 avenue Jean Poulhes, 31 403 Toulouse.
Rev Stomatol Chir Maxillofac. 2001 Nov;102(6):305-11.
The purpose of our study was to compare cephalometric analysis of craniofacial features in normal weight or obese subjects who are habitual snorers or apneic. We conducted a retrospective comparison of their clinical and cephalometric features by degree of obesity.
One hundred and sixty two male subjects with obstructive sleep apnea syndrome (OSAS) diagnosed by conventional polysomnography were included in the study. Patients were divided into four groups according to their body mass index (BMI) and their apnea/hypopnea index (AHI: Group 1 = normal-weight snorers (34 patients), Group 2 = normal-weight apneic subjects (40 patients), Group 3 = obese snorers (20 patients), Group 4 = obese apneic subjects (68 patients). Lateral cephalometry was performed in all patients. Intergroup comparisons (2/4, 1/2, 3/4) were made using 32 parameters to study the influence of the size of bone structures, their relationships, and size of the upper airways.
The four groups were comparable for age. AHI was higher for group 4 (obese apneic) compared with group 1 (normal-weight snorers). Compared with group 3 (obese snorers), group 1 (normal-weight snorers) had a retroposition of the mandible (smaller SNB and ANB angle), an accentuated facial divergence and a narrower pharyngeal space at the hyoid bone level. Compared with group 1 (normal-weight snorers), group 2 (normal-weight apneic) had a narrower pharyngeal space at different levels. Compared with group 3 (obese snorers), group 4 (obese apneic) had a lower hyoid bone evaluated with different cephalometric variables.
This study mainly shows that apneic patients exhibit craniofacial differences when divided into two groups according to their body mass index. Our findings are consistent with previous reports and could suggest a dual etiology of OSAS.
我们研究的目的是比较正常体重或肥胖的习惯性打鼾者或呼吸暂停者的颅面特征的头影测量分析。我们按肥胖程度对他们的临床和头影测量特征进行了回顾性比较。
本研究纳入了162名经传统多导睡眠图诊断为阻塞性睡眠呼吸暂停综合征（OSAS）的男性受试者。根据体重指数（BMI）和呼吸暂停/低通气指数（AHI）将患者分为四组：第1组 = 正常体重打鼾者（34例患者），第2组 = 正常体重呼吸暂停者（40例患者），第3组 = 肥胖打鼾者（20例患者），第4组 = 肥胖呼吸暂停者（68例患者）。对所有患者进行侧位头影测量。使用32个参数进行组间比较（2/4、1/2、3/4），以研究骨骼结构大小、它们之间的关系以及上气道大小的影响。
四组在年龄方面具有可比性。与第1组（正常体重打鼾者）相比，第4组（肥胖呼吸暂停者）的AHI更高。与第3组（肥胖打鼾者）相比，第1组（正常体重打鼾者）下颌后缩（SNB和ANB角较小）、面部发散更明显且舌骨水平的咽腔更窄。与第1组（正常体重打鼾者）相比，第2组（正常体重呼吸暂停者）在不同水平的咽腔更窄。与第3组（肥胖打鼾者）相比，用不同的头影测量变量评估时，第4组（肥胖呼吸暂停者）的舌骨位置更低。
本研究主要表明，呼吸暂停患者根据体重指数分为两组时表现出颅面差异。我们的研究结果与先前的报告一致，并可能提示OSAS的双重病因。
