Lowe A A, Ono T, Ferguson K A, Pae E K, Ryan C F, Fleetham J A
Department of Clinical Dental Sciences, The University of British Columbia, Vancouver, Canada.
Am J Orthod Dentofacial Orthop. 1996 Dec;110(6):653-64. doi: 10.1016/s0889-5406(96)80043-6.
To investigate whether patients with obstructive sleep apnea (OSA) have abnormalities in their craniofacial and upper airway (UA) structures compared with normal subjects, cephalometric comparisons were systematically performed in both the upright and the supine positions in subjects with and without OSA, who were then grouped according to their craniofacial skeletal type and gender. A total of 347 patients with OSA and 101 control subjects were divided into male and female groups and then classified into Class I (CI), Class II, Division 1 (CII/1), Class II, Division 2 (CII/2), and Class III (CIII) skeletal subtypes. In the upright position, the most atypical craniofacial and UA structure was shown in male patients with CI OSA. In patients with OSA, the degree of UA abnormalities was less in the supine position regardless of skeletal subtype. In the supine position, the most atypical craniofacial and UA structure was also shown in male patients with CI OSA; there were no significant differences between male patients with CII/2 OSA and control subjects or between female patients with CI OSA and control subjects. With a change in body position from upright to supine, distinctive changes in the UA structure in both patients with OSA and control subjects occurred, according to skeletal subtype and gender. We conclude that there are a series of characteristics of craniofacial and UA structure that differ between patients with OSA and control subjects matched for skeletal subtype and gender. These differences may predispose to UA obstruction during sleep in patients with OSA.
为了研究阻塞性睡眠呼吸暂停（OSA）患者与正常受试者相比，其颅面和上气道（UA）结构是否存在异常，我们对有或无OSA的受试者在直立位和仰卧位进行了系统的头影测量比较，并根据他们的颅面骨骼类型和性别进行分组。共有347例OSA患者和101例对照受试者被分为男性和女性组，然后分为I类（CI）、II类1分类（CII/1）、II类2分类（CII/2）和III类（CIII）骨骼亚型。在直立位时，CI型OSA男性患者的颅面和UA结构表现出最不典型。在OSA患者中，无论骨骼亚型如何，仰卧位时UA异常程度较轻。在仰卧位时，CI型OSA男性患者的颅面和UA结构也表现出最不典型；CII/2型OSA男性患者与对照受试者之间或CI型OSA女性患者与对照受试者之间无显著差异。随着体位从直立位变为仰卧位，OSA患者和对照受试者的UA结构均根据骨骼亚型和性别发生了明显变化。我们得出结论，OSA患者与匹配骨骼亚型和性别的对照受试者之间，颅面和UA结构存在一系列特征差异。这些差异可能使OSA患者在睡眠期间易发生UA阻塞。
