Department of Otorhinolaryngology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
PLoS One. 2013 Dec 2;8(12):e81590. doi: 10.1371/journal.pone.0081590. eCollection 2013.
We hypothesized that the size of the hyoid bone itself may affect the severity of sleep apnea. The aim of this study was to identify the relationship between hyoid bone dimensions and the severity of sleep apnea using computerized tomography (CT) axial images.
We retrospectively measured the hyoid bone in axial images of neck CTs and correlated these measurements with results of polysomnography in a total of 106 male patients. The new hyoid bone parameters studied in this study were as follows: distance between bilateral lesser horns (LH-d), distance between bilateral greater horns (GH-d), distance from the most anterior end of the hyoid arch to GH-d (AP), distance from the greater to the lesser horn on right and left sides (GH-LH), and the anterior angle between bilateral extensive lines from the greater to the lesser horn (H-angle). Data was analyzed using univariate and multivariate logistic regression, and Pearson correlation tests.
We found a significant inverse correlation between the apnea-hypopnea index (AHI) and GH-d or AP. Neither the LH-d, GH-LH, nor H-angle were associated with the AHI. The patient group that met the criteria of both GH-d<45.4 and AP<33.4 demonstrated the most severe AHI.
The lateral width or antero-posterior length of hyoid bone was associated with AHI and predicted the severity of sleep apnea in male patients. This finding supports the role of expansion hyoidplasty for treatment of sleep apnea. Pre-operative consideration of these parameters may improve surgical outcomes in male patients with sleep apnea.
我们假设舌骨本身的大小可能会影响睡眠呼吸暂停的严重程度。本研究旨在使用计算机断层扫描（CT）轴位图像来确定舌骨尺寸与睡眠呼吸暂停严重程度之间的关系。
我们回顾性地测量了颈部 CT 轴位图像中的舌骨，并将这些测量结果与 106 例男性患者的多导睡眠图结果进行了相关性分析。本研究中研究的新舌骨参数如下：双侧小角（LH-d）之间的距离、双侧大角（GH-d）之间的距离、舌骨弓最前端到 GH-d 的距离（AP）、右侧和左侧大角到小角的距离（GH-LH），以及双侧从大角到小角的广泛线之间的前角（H 角）。使用单变量和多变量逻辑回归以及 Pearson 相关检验对数据进行了分析。
我们发现呼吸暂停低通气指数（AHI）与 GH-d 或 AP 呈显著负相关。LH-d、GH-LH 或 H 角均与 AHI 无关。符合 GH-d<45.4 和 AP<33.4 标准的患者组表现出最严重的 AHI。
舌骨的侧向宽度或前后长度与 AHI 相关，并可预测男性患者睡眠呼吸暂停的严重程度。这一发现支持了扩张舌骨成形术治疗睡眠呼吸暂停的作用。术前考虑这些参数可能会改善男性睡眠呼吸暂停患者的手术效果。
