Xia Liang, Jiang Wenxin, Yao Kan, Sun Hongxia, Lu Xiaofeng, Yu Wenwen
Department of Oral and Cranio-maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China; College of Stomatology, Shanghai Jiao Tong University, Shanghai, China; National Center for Stomatology, Shanghai, China; National Clinical Research Center for Oral Diseases, Shanghai, China; Shanghai Key Laboratory of Stomatology, Shanghai, China.
Department of Stomatology, Ren Ji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Int Dent J. 2025 Jun;75(3):1736-1744. doi: 10.1016/j.identj.2025.02.021. Epub 2025 Apr 5.
Craniofacial and upper airway development are closely associated with obstructive sleep apnea (OSA). This study aimed to analyse craniofacial and upper airway characteristics in adults with severe obesity and OSA to better understand the disease.
Ninety-four severely obese patients (BMI ≥ 35) underwent polysomnography (PSG) and lateral cephalograms to assess craniofacial and upper airway morphology. Cephalometric and airway measurements were analysed combined with PSG findings to evaluate craniofacial and airway features in severe OSA patients.
The study included 50 males and 44 females, with a mean age of 33.05 years and an average apnea-hypopnea index (AHI) of 52.22 events/h. Males had significantly higher AHI, neck circumference (NC), waist circumference, and arousal index, along with lower average and minimal oxygen saturation levels compared to females. Cephalometric analysis showed that males had greater mandibular ramus length and Sella-to-condyle vertical distance. Cross-correlation analysis indicated significant associations between AHI and both NC and the mandibular plane to Sella-Nasion line measurement. The Frankfurt horizontal plane to Nasion-Pogonion plane was correlated with BMI, NC, and waist circumference. Hyoid bone position was linked to tongue volume, Y-axis angle, pharyngeal airway space, facial height, and lip length. Tongue volume correlated with mandibular ramus length, upper anterior tooth angle, and upper lip length. Snoring index was associated with pharyngeal airway space and tongue height, while pharyngeal airway space width was related to oxygen saturation levels.
Severe obese individuals, particularly males, experience more severe OSA symptoms. A complex interplay exists between OSA, craniofacial morphology, and airway structure.
Craniofacial and dental features are consistent in severe obese OSA patients, suggesting that obesity-related fat accumulation has a greater impact on respiratory function than skeletal structure or dental alignment.
颅面与上气道发育与阻塞性睡眠呼吸暂停（OSA）密切相关。本研究旨在分析重度肥胖合并OSA的成年人的颅面与上气道特征，以更好地了解该疾病。
94例重度肥胖患者（体重指数≥35）接受了多导睡眠监测（PSG）和头颅侧位片检查，以评估颅面和上气道形态。结合PSG结果分析头影测量和气道测量数据，以评估重度OSA患者的颅面和气道特征。
该研究纳入50名男性和44名女性，平均年龄33.05岁，平均呼吸暂停低通气指数（AHI）为52.22次/小时。与女性相比，男性的AHI、颈围（NC）、腰围和觉醒指数显著更高，平均和最低血氧饱和度水平更低。头影测量分析显示，男性的下颌升支长度和蝶鞍至髁突垂直距离更大。交叉相关分析表明，AHI与NC以及下颌平面至蝶鞍-鼻根线测量值之间存在显著关联。法兰克福水平面至鼻根-颏前点平面与BMI、NC和腰围相关。舌骨位置与舌体积、Y轴角、咽气道间隙、面高和唇长有关。舌体积与下颌升支长度、上前牙角度和上唇长度相关。打鼾指数与咽气道间隙和舌高相关，而咽气道间隙宽度与血氧饱和度水平相关。
重度肥胖个体，尤其是男性，OSA症状更严重。OSA、颅面形态和气道结构之间存在复杂的相互作用。
重度肥胖OSA患者的颅面和牙齿特征一致，表明与肥胖相关的脂肪堆积对呼吸功能的影响大于骨骼结构或牙齿排列。
