Alsaeed Suliman, Huynh Nelly, Wensley David, Lee Kevin, Hamoda Mona M, Ayers Evan, Sutherland Kate, Almeida Fernanda R
Preventive Dental Sciences Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh 14611, Saudi Arabia.
King Abdullah International Medical Research Center, Riyadh 11481, Saudi Arabia.
Diagnostics (Basel). 2023 Jun 29;13(13):2213. doi: 10.3390/diagnostics13132213.
Obstructive sleep apnea (OSA) is a disorder in which ventilation becomes disrupted due to a complete or partial upper airway obstruction Altered craniofacial morphology is one of the most important anatomical factors associated with obstructive sleep apnea (OSA). Studies have assessed craniofacial features in the non-syndromic pediatric population. The aim of this study was to analyze the orthodontic and facial characteristic of craniofacial syndromic children referred for polysomnography (PSG) and to assess the correlation with the apnea-hypopnea index (AHI). In the current cross-sectional study, consecutive syndromic patients referred for PSG were invited to participate. A systematic clinical examination including extra- and intra-oral orthodontic examination was performed by calibrated orthodontists. Standardized frontal and profile photographs with reference points were taken and analyzed using ImageJ software to study the craniofacial morphology. PSG data were analyzed for correlation with craniofacial features. STROBE guidelines were strictly adopted during the research presentation. The sample included 52 syndromic patients (50% females, mean age 9.38 ± 3.36 years) diagnosed with 17 different syndromes, of which 24 patients had craniofacial photography analysis carried out. Most of the sample (40%) had severe OSA, while only 5.8% had no OSA. Down's syndrome (DS) was the most common syndrome (40%) followed by Goldenhar syndrome (5%), Pierre Robin Sequence (5%), and other syndromes. The severity of AHI was significantly correlated with decreased midfacial height. increased thyromental angle and cervicomental angle, decreased mandibular angle, and decreased upper facial height. All patients with DS were diagnosed with OSA (57% severe OSA), and their ODI was significantly correlated with increased intercanthal distance. Obesity was not correlated to the severity of AHI for syndromic patients. Decreased midfacial height and obtuse thyromental angle were correlated with increased AHI for syndromic patients. Increased intercanthal distance of DS patients could be a major predictor of OSA severity. Obesity does not seem to play a major role in the severity of OSA for syndromic patients. Further studies with larger samples are necessary to confirm these findings.
阻塞性睡眠呼吸暂停（OSA）是一种由于上呼吸道完全或部分阻塞导致通气中断的疾病。颅面形态改变是与阻塞性睡眠呼吸暂停（OSA）相关的最重要解剖因素之一。已有研究评估了非综合征性儿童人群的颅面特征。本研究的目的是分析因多导睡眠图（PSG）检查而转诊的颅面综合征儿童的正畸和面部特征，并评估其与呼吸暂停低通气指数（AHI）的相关性。在当前的横断面研究中，邀请了因PSG检查而转诊的连续综合征患者参与。由经过校准的正畸医生进行包括口腔外和口腔内正畸检查在内的系统临床检查。拍摄带有参考点的标准化正面和侧面照片，并使用ImageJ软件进行分析，以研究颅面形态。分析PSG数据与颅面特征的相关性。在研究报告过程中严格遵循STROBE指南。该样本包括52名被诊断患有17种不同综合征的综合征患者（50%为女性，平均年龄9.38±3.36岁），其中24名患者进行了颅面摄影分析。大多数样本（40%）患有重度OSA，而只有5.8%没有OSA。唐氏综合征（DS）是最常见的综合征（40%），其次是Goldenhar综合征（5%）、皮埃尔·罗宾序列征（5%）和其他综合征。AHI的严重程度与面中部高度降低、甲状软骨-颏下角度和颈颏角度增加、下颌角减小以及上面部高度降低显著相关。所有DS患者均被诊断为OSA（57%为重度OSA），其氧减指数与内眦间距增加显著相关。肥胖与综合征患者AHI的严重程度无关。面中部高度降低和甲状软骨-颏下角度钝与综合征患者AHI增加相关。DS患者内眦间距增加可能是OSA严重程度的主要预测指标。肥胖似乎在综合征患者OSA的严重程度中不起主要作用。需要进一步进行更大样本量的研究来证实这些发现。
