Orthodontics, Division of Paediatric Dentistry and Orthodontics, Faculty of Dentistry, the University of Hong Kong, Hong Kong, Hong Kong SAR, PRC.
Department of Radiology, Hong Kong Children's Hospital, Hong Kong, Hong Kong SAR, PRC.
Dentomaxillofac Radiol. 2023 Jul;52(5):20220422. doi: 10.1259/dmfr.20220422. Epub 2023 May 16.
The proportionality between anatomical characteristics and disease severity in children and adolescents with obstructive sleep apnea (OSA) has not been well characterized. The present study investigated the relationship between the dentoskeletal and oropharyngeal features of young patients with OSA and either the apnea-hypopnea index (AHI) or the amount of upper airway obstruction.
MRI of 25 patients (8- to 18-year-old) with OSA (mean AHI = 4.3 events/h) was retrospectively analyzed. Sleep kinetic MRI (kMRI) was used to assess airway obstruction, and static MRI (sMRI) was used to assess dentoskeletal, soft tissue, and airway parameters. Factors related to AHI and obstruction severity were identified with multiple linear regression (significance level = 0.05).
As evidenced by kMRI, circumferential obstruction was present in 44% of patients, while laterolateral and anteroposterior was present in 28%; as evidenced by kMRI, obstructions were retropalatal in 64% of cases and retroglossal in 36% (no nasopharyngeal obstructions); kMRI showed a higher prevalence of retroglossal obstructions compared to sMRI( = 0.037); the main obstruction airway area was not related to AHI; the maxillary skeletal width was related to AHI ( = -0.512, = 0.007) and obstruction severity ( = 0.625, = 0.002); and the retropalatal width was related to AHI ( = -0.384, = 0.024) and obstruction severity ( = 0.519, = 0.006).
In children and adolescents, the severity of OSA and obstruction were inversely proportional to the maxillary basal width and retropalatal airway width. Further studies are needed to assess the benefits of targeted clinical treatments widening the transverse dimension of these structures.
阻塞性睡眠呼吸暂停（OSA）患儿和青少年的解剖学特征与疾病严重程度之间的比例关系尚未得到很好的描述。本研究调查了年轻 OSA 患者的牙颌面和口咽特征与呼吸暂停低通气指数（AHI）或上气道阻塞程度之间的关系。
回顾性分析 25 例 OSA 患者（8-18 岁，平均 AHI=4.3 次/小时）的 MRI 资料。睡眠动力学 MRI（kMRI）用于评估气道阻塞，静态 MRI（sMRI）用于评估牙颌面、软组织和气道参数。采用多元线性回归识别与 AHI 和阻塞严重程度相关的因素（显著性水平为 0.05）。
kMRI 显示，44%的患者存在周向阻塞，28%的患者存在侧-侧和前-后向阻塞；64%的病例存在舌根后阻塞，36%的病例存在舌根后阻塞（无鼻咽阻塞）；kMRI 显示舌根后阻塞的发生率高于 sMRI（=0.037）；主要阻塞气道面积与 AHI 无关；上颌骨宽度与 AHI（=−0.512，=0.007）和阻塞严重程度（=0.625，=0.002）相关；舌根后宽度与 AHI（=−0.384，=0.024）和阻塞严重程度（=0.519，=0.006）相关。
在儿童和青少年中，OSA 和阻塞的严重程度与上颌基宽和舌根后气道宽度呈反比。需要进一步研究评估针对这些结构的横向扩展的靶向临床治疗的益处。
