Shigeta Yuko, Ogawa Takumi, Ando Eriko, Clark Glenn T, Enciso Reyes
Department of Fixed Prosthodontics, School of Dental Medicine, Tsurumi University, Yokohama, Japan.
Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2011 Feb;111(2):239-43. doi: 10.1016/j.tripleo.2010.10.013.
The objective of this study was to investigate the influence on the upper airway of the size ratio of tongue and mandible (T/M ratio) with 3D reconstructed models from computed tomography (CT) data.
The subjects were 40 OSA male patients. The age of the patients ranged from 25 to 77 years, with an average age of 52.6 ± 12.5 years. The body mass index (BMI) of the patients ranged from 20.1 to 35.8 kg/m(2), with an average BMI of 25.4 ± 3.4 kg/m(2). All patients underwent a full-night polysomnography. The mean AHI for our subjects was 23.6 ± 18.3 events per hour. CT imaging examinations were carried out in each patient. The mandible and airway volume (between posterior nasal spine [PNS] and the tip of the epiglottis) were segmented based on Hounsfield units, automatically or semi-automatically, and their volume was calculated from the number of voxels. The tongue was carefully outlined, and the inside of the tongue was smeared on each of the axial, frontal, and sagittal planes with a semi-automatic segmentation tool. The tongue/mandible (T/M) ratio was calculated from the volume of the mandible and the tongue. In addition, we investigated simple correlations between our anatomical variables and BMI, age, and AHI.
In this study, the mean tongue and mandible volume were 79.00 ± 1.06 cm(3) and 87.80 ± 1.21 cm(3), respectively. As BMI increases, tongue volume increases (P = .004) and airway volume decreases (P = .021). However, no significant correlation was found between severity of OSA (AHI) and other variables. On the other hand, there was a negative correlation between airway volume and T/M ratio (P = .046).
As tongue volume increases with BMI, the posterior airway is affected, and thus is likely to be involved in the development of OSA; however, in this study there was no correlation between the severity of sleep apnea (AHI) and other variables in the study.
本研究的目的是利用计算机断层扫描（CT）数据构建的三维重建模型，研究舌与下颌骨尺寸比（T/M比）对上气道的影响。
研究对象为40例男性阻塞性睡眠呼吸暂停（OSA）患者。患者年龄在25至77岁之间，平均年龄为52.6±12.5岁。患者的体重指数（BMI）在20.1至35.8kg/m²之间，平均BMI为25.4±3.4kg/m²。所有患者均接受了整夜多导睡眠图检查。我们研究对象的平均呼吸暂停低通气指数（AHI）为每小时23.6±18.3次事件。对每位患者进行了CT成像检查。根据亨氏单位，自动或半自动分割下颌骨和气道容积（后鼻棘[PNS]与会厌尖端之间），并根据体素数量计算其容积。仔细勾勒出舌头轮廓，并使用半自动分割工具在每个轴向、额面和矢状面上涂抹舌头内部。根据下颌骨和舌头的容积计算舌/下颌骨（T/M）比。此外，我们研究了解剖学变量与BMI、年龄和AHI之间的简单相关性。
在本研究中，平均舌容积和下颌骨容积分别为79.00±1.06cm³和87.80±1.21cm³。随着BMI增加，舌容积增加（P = 0.004），气道容积减小（P = 0.021）。然而，未发现OSA严重程度（AHI）与其他变量之间存在显著相关性。另一方面，气道容积与T/M比之间存在负相关（P = 0.046）。
随着舌容积随BMI增加，后气道受到影响，因此可能参与OSA的发生发展；然而，在本研究中，睡眠呼吸暂停严重程度（AHI）与研究中的其他变量之间没有相关性。
