Ryu Hyun-Ho, Kim Chul-Hoon, Cheon Sang-Myung, Bae Woo-Yong, Kim Sang-Ho, Koo Soo-Kweon, Kim Myoung-Soo, Kim Bok-Joo
Postgraduate, Department of Oral and Maxillofacial Surgery, Dong-a University Medical Center, Busan, Korea.
Professor, Department of Oral and Maxillofacial Surgery, Dong-a University Medical Center, Busan, Korea.
Oral Surg Oral Med Oral Pathol Oral Radiol. 2015 Jan;119(1):20-31. doi: 10.1016/j.oooo.2014.07.537. Epub 2014 Sep 30.
Obstructive sleep apnea syndrome (OSAS) is a disorder characterized by apnea and hypopnea maintained for over 10 seconds and occurring at least 5 times per hour, with at least 30 episodes during 7 hours of nocturnal sleep. The most important pathophysiology in OSAS is the obstruction of the upper airway during sleep. The aim of this study was to identify the correlations between lateral cephalometric parameters, which seemed to be related to OSAS severities, and polysomnography (PSG) indices and to thus determine the cephalometric parameters reflecting OSAS severity.
A total of 140 participants (122 males, 18 females) were evaluated by lateral cephalography and PSG. A total of 29 measurements (24 distances and 5 angles) were made on lateral cephalography. Cephalometric and PSG parameters were evaluated statistically to select and validate the cephalometric parameters reflecting OSAS severity.
OSAS has a significant relationship with the anatomic deformities of craniofacial and soft tissues. Lateral cephalometry revealed that patients with OSAS have a significant vertical airway length, a regrognathic mandible, a thick uvula, a large tongue, and a long mid-face length. The position of the hyoid bone had a tendency to displace inferiorly and/or posteriorly. Using the discriminant variable combination, including tongue base-posterior nasal spine (T1-PNS), sella-nasion-B point angle (SNB), maximum uvula thickness (Max U), tongue base-tongue tip (T1-TT), and nasion-anterior nasal spine (N-ANS), 102 of 140 (72.9%) patients were correctly assigned to the normal-to-mild and moderate-to-severe apnea-hypopnea index (AHI) groups.
Lateral cephalometric radiography may be an accessible and suitable tool for evaluation of craniofacial and soft tissue deformities in their correlations with OSAS severity. Further research on the cephalometric parameters reflecting OSAS severity is needed.
阻塞性睡眠呼吸暂停综合征（OSAS）是一种以呼吸暂停和低通气持续超过10秒且每小时至少发生5次为特征的疾病，夜间睡眠7小时内至少有30次发作。OSAS最重要的病理生理学特征是睡眠期间上气道阻塞。本研究的目的是确定似乎与OSAS严重程度相关的头颅侧位测量参数与多导睡眠图（PSG）指标之间的相关性，从而确定反映OSAS严重程度的头颅测量参数。
对140名参与者（122名男性，18名女性）进行头颅侧位摄影和PSG评估。在头颅侧位摄影上共进行了29项测量（24个距离和5个角度）。对头颅测量和PSG参数进行统计学评估，以选择和验证反映OSAS严重程度的头颅测量参数。
OSAS与颅面及软组织的解剖畸形有显著关系。头颅侧位测量显示，OSAS患者有显著的垂直气道长度、下颌后缩、悬雍垂增厚、舌体增大和中面部长度增加。舌骨位置有向下和/或向后移位的趋势。使用包括舌根-后鼻棘（T1-PNS）、蝶鞍-鼻根点-B点角（SNB）、最大悬雍垂厚度（Max U）、舌根-舌尖（T1-TT）和鼻根点-前鼻棘（N-ANS）在内的判别变量组合，140名患者中有102名（72.9%）被正确分为正常至轻度和中度至重度呼吸暂停低通气指数（AHI）组。
头颅侧位X线摄影可能是评估颅面及软组织畸形与OSAS严重程度相关性的一种可行且合适的工具。需要对反映OSAS严重程度的头颅测量参数进行进一步研究。
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