대한치과교정학회지 (The korean journal of orthodontics)

  • 제36권3호
  • /
  • Pages.228-236
  • /
  • 2006
  • /
  • 2234-7518(pISSN)
  • /
  • 2005-372X(eISSN)
대한치과교정학회 (The Korean Association Of Orthodontists)
권호 표지

폐쇄성 수면 무호흡 환자의 측모 두부방사선계측사진 및 치아모형 연구

A cephalometric and dental cast study of obstructive sleep apnea patients

  • 정미라 (계명대학교 의과대학 동산의료원 치과) ;
  • 남기영 (계명대학교 의과대학 동산의료원 치과) ;
  • 김종배 (계명대학교 의과대학 동산의료원 치과) ;
  • 권오원 (경북대학교 치과대학 교정학 교실) ;
  • 황상희 (계명대학교 의과대학 동산의료원 치과)
  • Jung, Mi-Ra (Department of Orthodontics, Dong-San Medical Center, College of Medicine, Keimyung University) ;
  • Nam, Ki-Young (Department of Oral & Maxillofacial Surgery, Dong-San Medical Center, College of Medicine, Keimyung University) ;
  • Kim, Jong-Bae (Department of Oral & Maxillofacial Surgery, Dong-San Medical Center, College of Medicine, Keimyung University) ;
  • Kwon, Oh-Won (Department of Orthodontics, College of Dentistry, Kyungpook National University) ;
  • Hwang, Sang-Hee (Department of Orthodontics, Dong-San Medical Center, College of Medicine, Keimyung University)
  • 발행 : 2006.06.30
PDF 다운로드
⟨ 이전 논문 다음 논문 ⟩

초록

폐쇄성 수면 무호흡증이란 수면도중 주기적으로 호흡이 멈추는 증상을 말한다. 상악과 하악이 후퇴되어 있거나 하악이 작으며 수평적으로 기도 폭경이 좁고 혀가 후방에 위치하는 등 폐쇄성 수면 무호흡 환자의 전후방적인 악골 및 연조직 특성에 대한 평가는 많았으나 치열 및 악궁에 대한 평가가 부족하여 폐쇄성 수면 무호흡증 환자의 골격적 특징과 악궁의 폭경과 구개깊이와 수면무호흡지수와의 상관관계를 알아보고자 하였다. 계명대학교 의과대학 동산의료원 수면클리닉에 수면장애를 주소로 내원한 환자 중 수면다원검사와 측모 두부방사선계측사진과 치아모형이 갖추어진 38명의 남자를 대상으로 하여 치아모형과 측모 두부방사선계측사진, 수면무호흡지수와 체질량지수를 비교하였다. 수면무호흡지수와 악궁의 횡폭경, 구개깊이, 수직피개량 및 수평피개량과는 상관관계가 없었으며 수면무호흡군에서 상기도 폭경은 좁고, 하기도 폭경은 넓은 경향이 있었다. 수면무호흡지수와 상기도 폭경은 미약한 음의 상관관계를 가졌으나 하기도 폭경은 미약한 양의 상관관계를 가졌고, 수면무호흡지수가 클수록 하악 하연으로터 설골까지의 거리도 멀었다.

To evaluate the cephalometric and dental characteristics of obstructive sleep apnea (OSA) patients, 23 OSA patients and 15 control, non-OSA, patients who visited the Sleep Disorder Clinic Center, Keimyung University were investigated. Patients who suffered from apnea-hypopnea episodes over 10times per hour were diagnosed as having OSA after polysomnograph testing, Impressions were taken with alginate. Cephalometric radiographs were taken at maximum intercuspation. The dental cast measurements, including transpalatal width, intercanine width, intermolar width and palatal depth did not differ between the control and OAS groups and did not have a positive correlation with the apnea-hypopnea index (AHI). Upper airway width was statistically narrower than the control group. Upper airway width had a low negative correlation with AHI, but, lower airway width had a low positive correlation, and, the higher the AHI score, the longer the mandibular border to hyoid distance.

키워드

참고문헌

  1. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993;328:1230-5 https://doi.org/10.1056/NEJM199304293281704
  2. Kripke DF, Ancoli-Israel S, Klauber MR, Wingard DL, Mason WJ, Mullaney DJ. Prevalence of sleep-disordered breathing in ages 40-64 years: a population-based survey. Sleep 1997;20:65-76 https://doi.org/10.1093/sleep/20.1.65
  3. Sleep-related breathing disorders in adults: recommendation for syndrome definition and measurement techniques in clinical research. The report of an American Academy of Sleep Medicine Task Force. Sleep 1999;22:667-89 https://doi.org/10.1093/sleep/22.5.667
  4. He J, Kryger MH, Zorik FJ, Conway W, Roth T. Mortality and apnea index in obstructive sleep apnea. Experience in 385 male patients. Chest 1988;94:9-14 https://doi.org/10.1378/chest.94.1.9
  5. Shepard JW Jr, Gefter WB, Guilleminault C, Hoffman EA, Hoffstein V, Hudgel DW, Suratt PM, White DP. Evaluation of the upper airway in patients with obstructive sleep apnea. Sleep 1991;14:361-71 https://doi.org/10.1093/sleep/14.4.361
  6. Goldberg AN, Schwab RJ. Identifying the patient with sleep apnea: upper airway assessment and physical examination. Otolaryngol Clin North Am 1998;31:919-30 https://doi.org/10.1016/S0030-6665(05)70099-2
  7. Zorick F, Roth T, Kramer M, Flessa H. Exacerbation of upper airway sleep apnea by lymphocytic lymphoma. Chest 1980;77:689-90 https://doi.org/10.1378/chest.77.5.689
  8. Orr WC, Martin RJ. Obstructive sleep apnea associated with tonsillar hypertrophy in adults. Arch Intern Med 1981;141:990-2 https://doi.org/10.1001/archinte.141.8.990
  9. Perks WH, Horrocks PM, Cooper RA, Bradbury S, Allen A, Baldock N, Prowse K, van't Hoff W. Sleep apnoea in acromegaly. Br Med J 1980;280:894-7 https://doi.org/10.1136/bmj.280.6218.894
  10. Mezon BJ, West P, MaClean JP, KRyger MH. Sleep apnea in acromegaly. Am J Med 1980;69:615-8 https://doi.org/10.1016/0002-9343(80)90477-5
  11. 배응권, Lowe AA, 박영철. 폐쇄성 수면 무호흡환자의 안면 및 혀의 크기에 대한 연구. 대치교정지 1997;27:865-70
  12. Conway WA, Bower GC, Barnes ME. Hypersomnolence and intermittent upper airway obstruction. Occurrence caused by micrognathia. JAMA 1977;237:2740-2 https://doi.org/10.1001/jama.237.25.2740
  13. Riley R, Guilleminault C, Herran J, Powell N. Cephalometric analyses and flow-volume loops in obstructive sleep apnea patients. Sleep 1983;6:303-11 https://doi.org/10.1093/sleep/6.4.303
  14. Rivlin J, Hoffstein V, Kalbfleisch J, McNicholas W, Zamel N, Bryan AC. Upper airway morphology in patients with idiopathic obstructive sleep apnea. Am Rev Respir Dis 1984;129:355-60
  15. Lowe AA, Takada K, Yamagata Y, Sakada M. Dentoskeletal and tongue soft tissue correlates: a cephalometric analysis of rest position. Am J Orthod 1985;88:333-41 https://doi.org/10.1016/0002-9416(85)90133-2
  16. Lowe AA, Santamaria JD, Fleetham JA, Price C. Facial morphology and obstructive sleep apnea. Am J Orthod Dentofacial Orthop 1986;90:484-91 https://doi.org/10.1016/0889-5406(86)90108-3
  17. Finkelstein Y, Wexler D, Horowitz E, Berger G, Nachmani A, Shapiro-Feinberg M, Ophir D. Frontal and lateral cephalometry in patients with sleep-disordered breathing. Laryngoscope 2001;111:634-41 https://doi.org/10.1097/00005537-200104000-00014
  18. Wittels EH, Thompson S. Obstructive sleep apnea and obesity. Otolaryngol Clin North Am 1990;23:751-60
  19. Ong KC, Clerk AA. Comparison of the severity of sleep-disordered breathing in Asian and Caucasian patients seen at a sleep disorders center. Respir Med 1998;92:843-8 https://doi.org/10.1016/S0954-6111(98)90386-9
  20. Li KK Powell NB, Kushida C, Riley RW, Adornato B, Guilleminault C. A comparison of Asian and white patients with obstructive sleep apnea syndrome. Laryngoscope 1999:109:1937-40 https://doi.org/10.1097/00005537-199912000-00007
  21. Liu Y, Lowe AA, Zeng X, Fu M, Fleetham JA. Cephalometric comparisons between Chinenese and Caucasian patients with obstructive sleep apnea. Am J Orthd Dentofacial Orthop 2000;117:479-85 https://doi.org/10.1016/S0889-5406(00)70169-7
  22. Kwon TG, Cho YW, Ahn BH, Sub YS. Cephalometric predictors of obstructive sleep apnea. J Kor Oral Maxillofac Surg 2000;29:338-45
  23. Jamieson A, Guilleminault C, Partinen M, Quera-Salva MA. Obstructive sleep apneic patients have craniomandibular abnormalities. Sleep 1986;9:469-77 https://doi.org/10.1093/sleep/9.4.469
  24. Sher AE, Schechtman KB, Piccirillo JF. The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome. Sleep 1996:19:156-77 https://doi.org/10.1093/sleep/19.2.156
  25. Fujita S, Conway W, Zorick F, Roth T. Surgical correction of anatomic abnormalities in obstructive sleep apnea syndrome: uvulopalatopharyngoplasty, Otolaryngol Head Neck Surg 1981:89:923-34 https://doi.org/10.1177/019459988108900609