Craniofacial obesity in patients with obstructive sleep apnea.

INTRODUCTION

Obstructive sleep apnea (OSA) and obesity are serious, widespread public health issues.

OBJECTIVE

To localize and quantify geometric morphometric differences in facial soft tissue morphology in adults with and without OSA.

MATERIALS AND METHODS

Eighty adult Malays, consisting of 40 patients with OSA and 40 non-OSA controls, were studied. Both groups were evaluated by the attending physician and through ambulatory sleep studies. 3-D stereophotogrammetry was used to capture facial soft tissues of both groups. The 3-D mean OSA and control facial configurations were computed and subjected to principal components analysis (PCA) and finite-element morphometry (FEM).

RESULTS

The body mass index was significantly greater for the OSA group (32.3 kg/m(2) compared to 24.8 kg/m(2), p < 0.001). The neck circumference was greater for the OSA group (42.7 cm compared to 37.1 cm, p < 0.001). Using PCA, significant differences were found in facial shape between the two groups using the first two principal components, which accounted for 50% of the total shape change (p < 0.05). Using FEM, these differences were localized in the bucco-submandibular regions of the face predominantly, indicating an increase in volume of 7-22% (p < 0.05) for the OSA group.

CONCLUSION

Craniofacial obesity in the bucco-submandibular regions is associated with OSA and may provide valuable screening information for the identification of patients with undiagnosed OSA.