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