Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
Department of Preventive Dentistry, Faculty of Dentistry, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
J World Fed Orthod. 2024 Aug;13(4):175-180. doi: 10.1016/j.ejwf.2024.03.003. Epub 2024 Apr 29.
Obstructive sleep apnea (OSA) is the most common sleep-related breathing disorder characterized by repetitive collapse of the upper airway during sleep. However, little evidence is available on the differences between the sub-regions of the upper airway morphology and OSA severity. Since orthodontists frequently perform cone beam computed tomography (CBCT) in the neck area, we aimed to investigate the relationship and the differences between upper airway morphology and OSA severity using CBCT.
The medical records, CBCT imaging of 21 OSA patients diagnosed by polysomnography, and the apnea-hypopnea index (AHI) results were included to classify OSA severity as mild, moderate, or severe. The minimum cross-sectional areas (MCA) and volumes of the upper pharyngeal airway boundaries in four sub-regions: nasopharynx, retropalatal, retroglossal, and hypopharynx were measured. Dolphin Imaging software was used for upper airway segmentation. The correlation coefficient (r), one-way ANOVA, and the least significant difference post hoc multiple comparison test were applied to fulfill the objectives.
A statistically significant relationship was found between the MCA of the nasopharynx and the AHI (r = -0.473, P < 0.05). Furthermore, a difference was found between mild and moderate and moderate and severe OSA severity in the MCA results of the retroglossal region (P < 0.05). However, no relationship was found between the upper airway volume and OSA severity.
MCA was moderately negatively correlated to AHI only in the nasopharynx subregion. Moderate OSA presented significantly less MCA than mild and severe OSA only in the oropharynx and retroglossal subregions.
阻塞性睡眠呼吸暂停（OSA）是最常见的睡眠相关呼吸障碍，其特征是睡眠期间上气道反复塌陷。然而，关于上气道形态与 OSA 严重程度之间的亚区差异的证据很少。由于正畸医生经常在颈部区域进行锥形束计算机断层扫描（CBCT），我们旨在使用 CBCT 研究上气道形态与 OSA 严重程度之间的关系和差异。
纳入了 21 例经多导睡眠图诊断为 OSA 的患者的病历、CBCT 成像和呼吸暂停低通气指数（AHI）结果，将 OSA 严重程度分为轻度、中度或重度。测量了上咽气道边界的四个亚区（鼻咽、腭后、会厌后和下咽）的最小横截面积（MCA）和体积。使用 Dolphin Imaging 软件对上气道进行分割。应用相关系数（r）、单因素方差分析和最小显著差异事后多重比较检验来实现研究目的。
发现鼻咽 MCA 与 AHI 之间存在统计学显著的相关性（r = -0.473，P < 0.05）。此外，在轻度和中度以及中度和重度 OSA 严重程度之间，会厌后区 MCA 结果存在差异（P < 0.05）。然而，上气道体积与 OSA 严重程度之间没有关系。
MCA 仅与鼻咽亚区的 AHI 呈中度负相关。中重度 OSA 的 MCA 明显小于轻度和重度 OSA，仅在口咽和会厌后亚区。
