• Maxillofacial Plastic and Reconstructive Surgery
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• v.35 no.3
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• pp.161-166
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• 2013

Purpose: This study was intended to perform a cephalometric comparison between the patients with and without obstructive sleep apnea (OSA). The factors influencing the OSA in the lateral cephalogram were also investigated. Methods: Fifty patients who had visited the Sleep Disorder Clinic at the Ajou University Hospital and evaluated with the polysomnograph (PSG) and cephalogram, were included in the study. The patients had the apnea-hypopnea episode over 5 times per hour (apnea-hypopnea index $[AHI]{\geq}5$) were diagnosed as OSA after the overnight PSG. To evaluate the hard and soft tissue profiles, the cephalometric radiograms were taken at the maximal intercuspation. The correlation between the patient's age, height, weight, body mass index (BMI) and AHI was inspected in the OSA and control group. The difference between the OSA and control group was evaluated (Mann-Whitney U Test). The cephalometric influencing factors to OSA were analyzed (Pearson's correlation coefficient) statistically using SPSS statistics. Results: The OSA Group had a significantly higher BMI than the control group. The mean lower facial height (ANS-Me) was longer in the OSA group; however, statistically significant difference was not detected in the anteroposterior craniofacial measurements. The distance between mandibular plane and hyoid bone of the OSA group was significantly longer than that of the control group. The hyoid position (MP-Hyoid) had a positive correlation between AHI (P<0.001). However, the measurements of oropharyngeal airway were not different between the two groups. The hypothesis, that the antero-posteriorly narrow oropharyngeal airway may aggravate the airway resistance and give rise to a higher AHI, was rejected in the study. Conclusion: We suggest that the lateral cephalogram may be utilized as a useful method to evaluate OSA. The patients with a lower hyoid position can be expected to have higher risks of OSA. However, a comprehensive intraoral inspection, including the soft palate and tonsilar hypertrophy, is emphasized, as the lateral cepahlogram cannot visualize the oropharyngeal status completely.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.34 no.4
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• pp.435-444
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• 2008

Purpose: Clinical study to evaluate the efficacy and the safety of various surgical treatments in snoring and obstructive sleep apnea. Methods and materials: We performed surgical treatments such as radiofrequency ablation, uvulopalatopharyngoplasty(UPPP) with tonsillectomy, uvulopalatopharyngoplasty with advancement genioplasty, orthognathic surgery(maxillomandibluar advancement), distraction osteogenesis device insertion. Diagnosis was performed with clinical examination, polysomnography, lateral cephalometric and computed tomography. 62(M : F = 45 : 17, mean age 41.5, mean follow-up 4 weeks) patients underwent radiofrequency ablation and 7 (M : F = 5 : 2, mean age 38.9, mean follow-up 19months)patients experienced uvulopalatopharyngoplasty with tonsillectomy. Uvulopalatophayngoplasty with advancement genioplasty was performed for 3 (M : F = 2: 1, mean age 30.2, mean follow-up 14 months)patients. The last 3(M : F = 2 : 1, mean age 21.5, mean follow-up 24 months)patients was treated with orthognathic surgery including distraction device insertion. The results was evaluated by questionnaires, polysomnography, investigation of complications. Results: Of the patients treated with radiofrequency ablation, 95% reported improvement of their symptom. 100% improvement was reported in patients treated with UPPP with tonsillectomy and UPPP with advancement genioplasty. The two of three patients who underwent orthognathic surgery showed the satisfactory of treatments. Dryness of mouth was the most common complication during short period in radiofrequency ablation and UPPP with tonsillectomy. Relapse complication was not found in any surgical treatments. Conclusion: Treatment for snoring and OSA is determined by severity degree of the physiologic derangements, predominant type of apnea and obstructive site. Accuracy diagnosis should be performed prior to treatment for satisfactory treatment result. This study demonstrates feasibility, safety and efficacy of surgical treatments in snoring and OSA.