Department of Otolaryngology, Head and Neck Surgery Istanbul Surgery Hospital, Adnan Saygun Cad Gözde Sok Engin B Apt Da:13 2.Ulus Beşiktaş, Istanbul, Turkey.
Eur Arch Otorhinolaryngol. 2011 Jul;268(7):1053-9. doi: 10.1007/s00405-010-1448-z. Epub 2010 Dec 4.
The objective of the study is to evaluate the cephalometric characteristics and investigate the measurement differences between habitual snorers and subjects with obstructive sleep apnea (OSA) in nonobese Turkish male population. The study design is prospective and nonrandomized. The setting is sleep-snoring center of referral hospital. Total of 60 male subjects constituted OSA (n = 20), habitual snorer (n = 20) and control group (n = 20). Clinical evaluation, Epworth sleepiness scale scoring, flexible nasopharyngoscopy, polysomnography, Tweed and Delaire analysis on cephalometric images were performed. The main outcome measures include cranial base maxillary angle (SNA), cranial base mandibular angle (SNB), posterior airway space (PAS), mandibular plane and hyoid distance (MPH), soft palate length, soft palate thickness, cranial height ratio (C2/C1), cranial base angle (C1⊥C3), and craniofacial angle (C3⊥F1) parameters were compared. In comparison of OSA and habitual snorers, PAS at palatal and tongue base level (p = 0.037, p = 0.001), MPH (p = 0.07), C3⊥F1 (p = 0.001) were found statistically different. In comparison of controls with OSA and habitual snorers PAS at palatal level (p < 0.001, p = 0.01), MPH (p < 0.001, p = 0.015), soft plate length (p < 0.001, p < 0.001) and thickness (p < 0.001, p = 0.056) were found statistically different. The soft palate length, PAS, C3⊥F1 and MPH were detected as the most effective four parameters in discriminating three groups. In conclusion, this study increased MPH, soft palate length and decreased PAS were identified as the determinant characteristics in OSA and habitual snoring group. PAS and MPH values reported were higher in OSA as compared to habitual snorers. The selected cephalometric data may be used as a complementary to endoscopic examination, sleep tests and imaging techniques to determine anatomic site, management plan and follow-up of outcome in habitual snorers and OSA subjects.
这项研究的目的是评估非肥胖土耳其男性人群中习惯性打鼾者和阻塞性睡眠呼吸暂停（OSA）患者的头影测量特征，并研究两者之间的测量差异。研究设计为前瞻性、非随机。该研究在一家转诊医院的睡眠打鼾中心进行。共有 60 名男性受试者组成 OSA 组（n=20）、习惯性打鼾组（n=20）和对照组（n=20）。进行临床评估、Epworth 嗜睡量表评分、软腭悬雍垂镜检查、多导睡眠图检查、Tweed 和 Delaire 头影测量分析。主要观察指标包括颅底上颌角（SNA）、颅底下颌角（SNB）、后气道空间（PAS）、下颌平面与舌骨距离（MPH）、软腭长度、软腭厚度、颅高比（C2/C1）、颅底角（C1⊥C3）和颅面角（C3⊥F1）等参数。与 OSA 和习惯性打鼾者相比，腭部和舌根部的 PAS（p=0.037，p=0.001）、MPH（p=0.07）、C3⊥F1（p=0.001）存在统计学差异。与对照组相比，OSA 和习惯性打鼾者的腭部 PAS（p＜0.001，p=0.01）、MPH（p＜0.001，p=0.015）、软腭长度（p＜0.001，p＜0.001）和厚度（p＜0.001，p=0.056）存在统计学差异。软腭长度、PAS、C3⊥F1 和 MPH 被确定为区分三组的最有效四个参数。结论：本研究中发现，OSA 和习惯性打鼾组中，MPH 增加、软腭长度增加和 PAS 降低是决定特征。与习惯性打鼾者相比，OSA 的 PAS 和 MPH 值更高。选择的头影测量数据可作为内镜检查、睡眠测试和影像学技术的补充，以确定习惯性打鼾者和 OSA 患者的解剖部位、治疗计划和随访结果。
