• Title/Summary/Keyword: Upper airway width

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Cone-beam CT analysis of patients with obstructive sleep apnea compared to normal controls

  • Buchanan, Allison;Cohen, Ruben;Looney, Stephen;Kalathingal, Sajitha;De Rossi, Scott
    • Imaging Science in Dentistry
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    • v.46 no.1
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    • pp.9-16
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    • 2016
  • Purpose: To evaluate the upper airway dimensions of obstructive sleep apnea (OSA) and control subjects using a cone-beam computed tomography (CBCT) unit commonly applied in clinical practice in order to assess airway dimensions in the same fashion as that routinely employed in a clinical setting. Materials and Methods: This was a retrospective analysis utilizing existing CBCT scans to evaluate the dimensions of the upper airway in OSA and control subjects. The CBCT data of sixteen OSA and sixteen control subjects were compared. The average area, average volume, total volume, and total length of the upper airway were computed. Width and anterior-posterior (AP) measurements were obtained on the smallest axial slice. Results: OSA subjects had a significantly smaller average airway area, average airway volume, total airway volume, and mean airway width. OSA subjects had a significantly larger airway length measurement. The mean A-P distance was not significantly different between groups. Conclusion: OSA subjects have a smaller upper airway compared to controls with the exception of airway length. The lack of a significant difference in the mean A-P distance may indicate that patient position during imaging (upright vs. supine) can affect this measurement. Comparison of this study with a future prospective study design will allow for validation of these results.

Cone-beam computed tomography assessment of upper airway dimensions in patients at risk of obstructive sleep apnea identified using STOP-Bang scores

  • Eow, Pei Ying;Lin, Kar Yi;Kohli, Shivani;Math, Swarna Yerebairapura
    • Imaging Science in Dentistry
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    • v.51 no.4
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    • pp.439-446
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    • 2021
  • Purpose: The aim of this study was to identify correlations between the STOP-Bang score and upper airway dimensions using cone-beam computed tomography (CBCT) scans. Materials and Methods: This study included 101 subjects (46 men, 55 women) from dental patients who received CBCT scans from 2014 to 2020. The patients were divided into those with a low obstructive sleep apnoea (OSA) risk (STOP-Bang score<3) and those with an intermediate to high OSA risk (STOP-Bang score≥3), and their upper airway dimensions were then analysed on CBCT scans. Comparisons between the low-risk and intermediate/high-risk groups were conducted using the t-test and the Mann-Whitney test. Correlations between the total STOP-Bang score and upper airway dimension parameters were established using Spearman correlation coefficients. P values≤0.05 were considered to indicate statistical significance. Results: Intermediate/high-risk subjects were predominantly male and over 50 years of age, with a higher body mass index. They had significantly longer upper airways, smaller average airway volumes, and smaller widths and antero-posterior dimensions of the narrowest upper airway segment. The total upper airway length was positively correlated with the STOP-Bang score (rs=0.278). The average volume (rs= -0.203) and width of the narrowest upper airway segment(rs= -0.305) were both negatively correlated with STOP-Bang scores. Conclusion: Subjects with higher STOP-Bang scores had upper airways that were longer, narrower, and smaller in terms of average volume. CBCT scans taken for dental patients as part of investigative procedures could be correlated with STOP-Bang scores to screen for patients at risk of OSA.

Relationship between Upper Airway and Sleep-Disordered Breathing in Children with Mouth Breathing (구호흡 어린이에서 수면호흡장애와 상기도와의 관계)

  • Kim, Doyoung;Lee, Daewoo;Kim, Jaegon;Yang, Yeonmi
    • Journal of the korean academy of Pediatric Dentistry
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    • v.46 no.1
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    • pp.38-47
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    • 2019
  • The most common cause of mouth breathing is obstacles caused by mechanical factors in upper airway. Mouth breathing could be consequently pathological cause of sleep-disordered breathing. Sleep-disordered breathing in children can cause growth disorders and behavioral disorders. The purpose of this study was to investigate relationship between upper airway and sleep-disordered breathing in children with mouth breathing. Twenty boys between 7 - 9 years old who reported to have mouth breathing in questionnaire were evaluated with clinical examination, questionnaires, lateral cephalometric radiographs, and portable sleep testing. This study assessed apnea-hypopnea index (AHI) and oxygen desaturation index (ODI) for the evaluation of sleep-disordered breathing and was done to investigate the correlation between these values and the upper airway width measured by lateral cephalometric radiographs. There was no significant correlation with the size of the tonsils (p = 0.921), but the adenoid hypertrophy was higher in the abnormal group than in the normal group (p = 0.008). In the classification according to AHI and ODI, retropalatal and retroglossal distance showed a statistically significant decrease in the abnormal group compared to the normal group (p = 0.002, p = 0.001). As AHI and ODI increased, upper airway width tended to be narrower. This indicates that mouth breathing could affect the upper airway, which is related to sleep quality.

Factors Influencing Upper Airway Dimensions in Skeletal Class II Children and Adolescents: A CBCT Study (골격성 II급 소아·청소년의 상기도 공간에 영향을 미치는 요인 : CBCT 연구)

  • Kim, Byounghwa;Lee, Jewoo;Ra, Jiyoung
    • Journal of the korean academy of Pediatric Dentistry
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    • v.48 no.1
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    • pp.1-11
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    • 2021
  • The purpose of this study is to investigate factors influencing the upper airway dimensions in skeletal Class II children and adolescents. In total, 67 patients were selected. Airway volume and minimal cross-sectional area were three-dimensionally assessed. Craniofacial morphology and skeletal maturity were assessed on generated two-dimensional cephalograms. The measurements were analyzed using Mann-Whitney test, one-way ANOVA, Pearson's correlation, and multiple regression analysis. Upper airway dimensions were significantly smaller in pre-peak stage group, and positively associated with age. Anterior facial height and age were the most relevant factors for airway volume. Mandibular width and age were the most relevant factors for minimal cross-sectional area. Upper airway dimensions were significantly associated with age, skeletal maturity and craniofacial morphology in all three planes.

Study of Cephalometry and Polysomnogrphy in Habitual Snorers (습관성 코골이 환자의 측방두부규격방사선사진과 수면다원검사 연구)

  • 정성창
    • Journal of Oral Medicine and Pain
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    • v.23 no.1
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    • pp.75-84
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    • 1998
  • The Purpose of this Study was to examine the anatomic differences in the upper airway according to severity of respiratory disturbance index of habitual snorers. Forty-three male habitual snorers, aged 28-68, were examined by polysomnography and divided into 4 groups according to severity determined by polysomnography. Anatomic differences in the upper airway were assessed by lateral cephalograms in upright position, and epidemiological surveys were done by using questionnaires. The obtained results were as follows : 1. All subjects were habitual snorers and 35 patients (81.4%) complained the loudness of snoring as severe as be heard outside of the room. 2. According to the results of polysomnography, the number of the primary snoring patients was 7(16.3%), mild obtrusive sleep apnea 7(16.3%), moderate 7(16.3%), and severe 22(51.2%). 3. The respiratory disturbance index (RDI) of subjects was 39.5$\pm$24.4 and the body mass index(BMI) was 26.2$\pm$2. 4. More inferiorly positioned hyoid bone according to the degree of respiratory disturbace index (RDI) was observed. (p<0.001) 5. The width of superior oropharyngeal airway space was according to the degree of RDI. (p<0.001)

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Three-dimensional analysis of changes in airway space after bimaxillary orthognathic surgery with maxillomandibular setback and their association with obstructive sleep apnea

  • Jang, Seung-Il;Ahn, Jaemyung;Paeng, Jun Young;Hong, Jongrak
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.40
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    • pp.33.1-33.11
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    • 2018
  • Background: Bimaxillary orthognathic surgery with maxillomandibular setback is often accompanied by changes in airway space. We analyzed the changes in airway space before and after surgery and assessed their association with obstructive sleep apnea. Methods: This study is based on the cohort of 13 adult patients (9 males, 4 females, average age 23.85 years) who underwent bimaxillary orthognathic surgery with maxillomandibular setback. We performed computed tomography and portable polysomnography before and after the surgery to assess changes in airway space and Apnea-Hypopnea Index (AHI) values (total, supine, non-supine). Results: The oropharyngeal airway volume decreased by 29% after the surgery, which was statistically significant (p < .05). The upper airway volume and hypopharyngeal airway volume were decreased, but not significantly (4 and 19%, respectively). The changes in airway surface area were statistically significant at all levels examined (p < .05). Changes in the maximum anteroposterior width of the airway were also significant at all levels (p < .05). However, the changes in maximum lateral width were only statistically significant at C2 level (p < .05). AHI values were increased after the surgery but not significantly at any position. Conclusions: Although bimaxillary surgery with maxillomandibular setback significantly reduces the airway space, it does not affect AHI values or induce obstructive sleep apnea.

CHANGES IN TONGUE POSITION, AIRWAY WIDTH, GONIAL ANGLE, LOWER FACIAL HEIGHT AFTER BILATERAL SAGITTAL SPLIT RAMUS OSTEOTOMY IN MANDIBULAR PROGNATHIC PATIENTS (하악전돌증 환자의 하악지분할시상골절단술 후 혀의 위치, 기도의 폭경, 하악각 및 구강용적의 변화)

  • Lee, Kyu-Hong;Hwang, Yong-In;Kim, Yoon-Ji;Cheon, Se-Hwan;Kim, Hyung-Wook;Park, Jun-Woo;Rhee, Gun-Joo;Park, Yang-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.33 no.2
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    • pp.109-113
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    • 2007
  • Introduction. In patients with mandibular prognathism, Bilateral Sagittal Split Ramus Osteotomy(BSSRO) combined with orthodontic treatment reduces oral volume and influences tongue and other surrounding tissues. Purpose of this study was to analyze post-operative tongue position and airway dimension, as well as mandibular changes in vertical, horizontal, and angular dimensions. Materials and methods. Height of dorsum of tongue, width of airway, gonial angle and lower facial height of mandibular prognathic patients who visited Kangdong Sacred Heart Hospital from Jan. 2001 to Dec. 2006 were anaylzed via pre-operative and post-operative cephalograms. T-test was used to compare pre-operative and post-operative measurements. Also, correlations among pre-operative measurements of the patients were analyzed. Results and conclusion. A significant correlation was shown between ANS-Xi-PM area and location of dorsum of tongue in pre-operative patients. A significant superior movement of tongue and decrease of airway width was observed in post-operative patients. Also the upper gonial angle decreased significantly.

CEPHALOMETRIC PREDICTORS OF OBSTRUCTIVE SLEEP APNEA (폐쇄성 수면 무호흡증에 있어 두부 규격 방사선 계측학적 기여 인자)

  • Kwon, Tae-Geon;Cho, Yong-Won;Ahn, Byung-Hoon;Suh, Young-Sung
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.29 no.5
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    • pp.338-345
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    • 2003
  • Purpose : This study was intended to perform cephalometric comparison between the patients with and without obstructive sleep apnea (OSA). The factors influencing the OSA in the lateral cephalogram was also investigated. Patient and Method : Twenty four patients who visited Sleep Disorder Clinic in Dongsan Medical Center, Keimyung University and evaluated with polysomnograph(PSG) and cephalogram were included in the study. The patients had apnea-hypopnea episode(AHI) over 10 times per hour was diagnosed as OSA after overnight PSG. To evaluate hard and soft tissue profile, cephalometric radiogram were taken at maximal intercuspation(P1) and mandibular protruding position(P2). The diffefence between the OSA and normal group were evaluated statistically and the stepwise regression analysis was applied to analyse the cephalometric influencing factors to OSA. Result : The OSA Group(n=14) had significantly higher Body Mass Index(BMI) than control group(n=10). Lower facial height(ANSGn) was longer in OSA group. However statistically significant difference was not detected in other anteroposterior craniofacial measurements. The soft palate lenth (PNS-P), hyoid position (MP-Hyoid) had positive correlation between AHI (r=0.496, r=0.413, respectively, p<0.05). However, the measurements of oropharyngeal airway was not different between the two groups. The hypothesis, the antero-posteriorly narrow oropharyngeal airway might aggravate the airway resistance and can give rise to higher AHI, was not accepted in the study. This can be attributed by inclusion of the patients performed uvulopalatopharyngoplasty because of the tonsilar or soft palate hypertrophy in the present study. The results of regression analysis revealed that PNS-P, upper airway width(Nph1), upper facial heght(N-ANS), and lower facial height(ANS-Gn) could influence the degree of AHI (F value < 0.0001, $R^2$ = 0.829). Conclusion : We suggest lateral cephalogram may utilized as a useful method to evaluate OSA. The patient with long soft palate, narrow upper airway width, long upper & lower facial height can be expected to have high risk of OSA. However, it should be emphasized the comphrehensive intraoral inspection including soft palate and tonsilar hypertrophy because lateral cepahlogram cannot visualize oropharyngeal status completely.

Upper airway dimensions and craniofacial morphology: A correlation study using cone beam computed tomography

  • Ana Rita da Rocha Martins de Carvalho;Maria Cristina Figueiredo Pollmann;Eugenio Joaquim Pereira Martins
    • The korean journal of orthodontics
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    • v.54 no.5
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    • pp.274-283
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    • 2024
  • Objective: To determine the correlation between dentoskeletal parameters related to craniofacial morphology and the upper airway (UA) volume. Methods: Cone-beam computed tomography images of 106 randomly selected orthodontic patients were analyzed using NemoFab Ortho software. The dentoskeletal variables assessed were anterior facial height (AFH), posterior facial height (PFH), PFH/AFH ratio, hyoid position, maxillary width (MW), and palatal depth. The UA volume (evaluation in anatomical regions and as a whole) was also assessed using the same software. We also evaluated potential differences in UA variables between age and sex groups. The correlation between the dentoskeletal parameters and UA volume was calculated using the Pearson correlation coefficient (R). Analysis of variance and Student's t test were performed to assess differences between age and sex for UA variables. Statistical analyses were performed using SPSS software (version 26 for Windows). Results: This study found that PFH, AFH, and MW were the dentoskeletal parameters most strongly correlated with UA volume. However, the ANB angle did not show any significant correlation with UA volume. Additionally, differences in UA volumes were observed between age groups. Sex differences were found in both the "8-12" and "≥ 16" age groups for oropharyngeal and pharyngeal volumes. Conclusions: In conclusion, our findings indicate a significant correlation between UA volume and dentoskeletal parameters, particularly those related to facial height and MW.

A cephalometric and dental cast study of obstructive sleep apnea patients (폐쇄성 수면 무호흡 환자의 측모 두부방사선계측사진 및 치아모형 연구)

  • Jung, Mi-Ra;Nam, Ki-Young;Kim, Jong-Bae;Kwon, Oh-Won;Hwang, Sang-Hee
    • The korean journal of orthodontics
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    • v.36 no.3 s.116
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    • pp.228-236
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    • 2006
  • 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.