A Craniofacial morphology study of patients with obstructive sleep apnea

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Date
2005
Authors
Bahaa Mohammed, Osama (dr.)
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Abstract
Obstructive sleep apnea (OSA) is defined as a repetitive cessations of breathing (apneas) lasting for at least 10 seconds or more for each event during sleep. The respiratory muscles attempt to inspire, but blockages in the upper airway prevent air from reaching the lungs. This will cause partial (hypopnea) or complete (apnea) closure of the upper airways with consequent adverse effects on sleep quality and gas exchange. The condition affects approximately 4% of men and 2% of women in their middle-ages. OSA is a potentially lifethreatening condition in which a patient suffers periodic cessations of breathing during sleep. The aim of this study is to develop a data base on the craniofacial morphology of the upper airway morphology and skeletal patterns in patients with OSA and compare the findings with those of nonnal subjects in the control group. Twenty-five subjects as OSA patients and twenty-five as the control group were selected from the Sleep Laboratory by using Polysomnography. All the subjects of this study were adults age ranging 18-65 years. Methodologies include the measurements of the body mass index (BMI), neck circumference, lateral cephalometric X-ray, posterior-anterior X-ray, and upper and lower dental study models were taken. For severe OSA cases, the diameter of the pharynx was estimated by measuring the length and width of the pharynx at the level of nasopharynx, oropharynx, and hypopharynx, and compared with normal subjects by using CT scan. The results showed that there was a significant difference in BMI between OSA patients and control group (P value=.OOl ), the BMI significantly increased in OSA patients, the neck circumference was also increased in OSA patients. The length of soft palate, width of soft palate, width of :~}ngue, upper posterior airway space, middle posterior ainvay space, lower posterior airway space, distance from hyoid bone to mandibular plane, distance from hyoid bone to posterior nasal spine, maxillary width, and cranial base flexure angle were statically significantly different in OSA patients compared to the control group. There were no significant differences between the two study groups in the inter-canine, inter-first and second premolar, inter-molar distances of upper and lower arches, maxillary protrusion, mandibular prognathism, lower face height, total face height, posterior facial height, facial width, mandibular width, anterior cranial base, and posterior cranial base. The CT scan shown that severe OSA patients have narrowing of pharynx at the level of nasopharynx, oropharynx, and hypopharynx. In conclusion, craniofacial morphological differences have been found in patients suffering from OSA as compared to control, and that a number of investigations and measurements are required to detect underlying deformities, to decide for the most suitable management methods.
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Keywords
Obstructive , Morphology
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