Elsevier

Respiratory Medicine

Volume 98, Issue 4, April 2004, Pages 301-307
Respiratory Medicine

Computed tomographic evaluation of the role of craniofacial and upper airway morphology in obstructive sleep apnea in Chinese

https://doi.org/10.1016/j.rmed.2003.10.009Get rights and content
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Abstract

Objectives: To evaluate the relationship between cephalometric parameters, upper airway morphological factors and obstructive sleep apnea (OSA) in Chinese subjects.

Design: Polysomnogram (PSG) were performed and scored using standard criteria. Supine lateral cephalometric parameters and pharyngeal cross-sectional areas at the level of velopharynx (VA) and hypopharynx (HA) were measured from computed tomographic scans. The roles of these parameters and other anthropometric/demographic characteristics in OSA (apnea hypopnea index, AHI⩾5) and their relationship with severity of OSA were explored by multiple logistic and multi-nominal regression analysis.

Results: Ninety-two subjects, ranging from normal (n=36), mild/moderate OSA (n=34) to severe OSA (n=22), were evaluated. Compared with normal subjects, OSA subjects were heavier (body mass index 27 vs. 24 kg/m2) and older (47 vs. 42 years of age); had smaller VA size and VA to HA ratio, lower positioned hyoid bone, longer and thicker soft palate, and more retropositioned mandible relative to maxilla. After controlling for body mass index and age, subjects with severe OSA (AHI>30) had more retropositioned mandible relative to maxilla (odds ratio, OR 1.31, P=0.044) and longer soft palate (OR 1.16, P=0.01), while those with mild/moderate OSA had larger VA to HA ratio (OR 0.17, P=0.018).

Conclusions: Craniofacial factors and upper airway morphology contributed to severity of OSA in Chinese subjects. Having controlled for obesity, more retropositioned mandible was associated with more severe OSA.

Keywords

Computed tomography
Cephalometry
Upper airway
Obstructive sleep apnea

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This study was partially supported by the Competitive Earmarked Research Grant HKU457/96M from the Hong Kong Research Grants Council, Hong Kong.