Craniofacial structure in patients with obstructive sleep apnoea

• Autorzy: Dobrowolska-Zarzycka M. , Dunin-Wilczynska I. , Szymanska J.
• Języki publikacji: EN

Abstrakty

EN

Background: Obstructive sleep apnoea (OSA) is characterised by at least five 10-s episodes of apnoea or markedly shallow breathing per 1 h of sleep, which can lead to severe, sometimes life-threatening complications. It is essential to determine the specific features of the affected patients’ craniofacial structure, thus enabling their allocation to risk groups. The aim of the study was to assess the craniofacial structure in OSA patients, comparing the findings with Hasund’s and Segner’s cephalometric normal values. In addition, the sagittal dimensions of the upper airways, measured at two levels, were compared to McNamara’s normal values. Materials and methods: The study covered 41 patients diagnosed polysomnographically with OSA. Lateral cephalograms with cephalometric analysis and the measurements of the upper and lower sagittal dimensions of the upper airways were taken for each patient. Results: The only feature of the patents’ facial skeleton that significantly diverged from the normal range was the SNB angle (p = 0.004). Other angles, i.e. SNA, ANB, NL/NSL, NL/ML and NSL/ML, were not significantly different from normal. The average upper cross-sectional area of the upper airways was 10.4 mm; in 97.6% patients, this measurement was below McNamara’s normal values. In the majority of patients (75.6%), the average lower sagittal dimension of the upper airways (10.4 mm) was also below the normal. Conclusions: Mandibular retrognathia, manifested by the reduced SNB angle, and the narrowed upper and lower sagittal dimensions of the upper airways can be considered one of OSA prognostic factors. (Folia Morphol 2016; 75, 3: 311–315)

• Wydawca: -
• Czasopismo: Folia Morphologica
• Rocznik: 2016
• Tom: 75
• Numer: 3
• Opis fizyczny: p.311-315,fig.,ref.

Twórcy

autor

Dobrowolska-Zarzycka M.

• Chair and Department of Jaw Orthopaedics, Medical University of Lublin, Lublin, Poland

autor

Dunin-Wilczynska I.

• Chair and Department of Jaw Orthopaedics, Medical University of Lublin, Lublin, Poland

autor

Szymanska J.

• Chair and Department of Paedodontics, Medical University of Lublin, Karmelicka 7, 20–018 Lublin, Poland

Bibliografia

• 1. Abu Allhaija ES, Al-Khateeb NS (2005) Uvulo-glosso-pharyngeal dimensions in different anteroposterior skeletal patterns. Angle Orthod, 75: 1012–1018.
• 2. American Academy of Sleep Medicine Task Force (1999) Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. Sleep, 22: 667–689.
• 3. Bacon W., Turlot JC, Krieger J, Stierle JL (1990) Cephalometric evaluation of pharyngeal obstructive factors in patients with sleep apnea syndrome. Angle Orthod, 60: 115–121.
• 4. Barreiro B, Garcia L, Lozano L, Almagro P, Quintana S, Alsina M, Heredia JL (2013) Obstructive sleep apnea and metabolic syndrome in Spanish population. Open Respir Med J, 18: 71–76. doi: 10.2174/1874306401307010071.
• 5. Buda AJ, Schroeder JS, Guilleminault C (1989) Abnormalities of pulmonary artery wedge pressure in sleep-induced apnea. Int J Cardiol, 1: 67–74.
• 6. Catarino R, Spratley J, Catarino I, Lunet N, Pais-Clemente M (2014) Sleepiness and sleep-disordered breathing in truck drivers: risk analysis of road accidents. Sleep Breath, 18: 59–68. doi: 10.1007/s11325-013-0848-x.
• 7. Dumitrascu R, Tiede H, Eckermann J, Mayer K, Reichenberger F, Ghofrani HA, Seeger W, Heitmann I, Schulz R (2013) Sleep apnea in precapillary pulmonary hypertension. Sleep Med, 14: 247–251. doi: 10.1016/j.sleep.2012.11.013.
• 8. Friedel ME, Johnston DR, Singhal S, Al Khalili K, Farrel CJ, Evans JJ, Nyquist GG, Rosen MR (2013) Airway management and perioperative concerns in acromegaly patients undergoing endoscopic transsphenoidal surgery for pituitary tumors. Otolaryngol Head Neck Surg, 149: 840–844. doi: 10.1177/0194599813507236.
• 9. Guilleminault C, Quera-Salva M, Partinen M, Jamieson A (1988) Women and the obstructive sleep apnea syndrome. Chest, 93: 104–109.
• 10. Hoffstein V, Szalai JP (1993) Predictive value of clinical features in diagnosing obstructive sleep apnea. Sleep, 6: 118–122.
• 11. Jung HJ, Kim JW, Lee CH, Chung YJ, Mo J-H (2013) A thyroglossal duct cyst causing obstructive sleep apnea in adult. Clin Exp Otorhinolaryngol, 6: 187–190. doi: 10.3342/ceo.2013.6.3.187.
• 12. Krieger J (1998) Clinical presentations of sleep apnoea. Eur Respir Mon, 3: 75–105.
• 13. Levy P, Ryan S, Oldenburg O, Parati G (2013) Sleep apnoea and the heart. Eur Respir Rev, 22: 333–352.
• 14. Lowe AA, Santamaria JD, Fleetham JA, Price C (1986) Facial morphology and obstructive sleep apnea. Am J Orthod Dentofac Orthop, 90: 484–491.
• 15. Malthotra A, Huang Y, Fogel RB, Pillar G, Edwards JK, Kikinis R, Loring SH, White DP (2002) The male predisposition to pharyngeal collapse: importanceof airway length. Am J Resp Crit Care Med, 166: 1388–1395.
• 16. Mayer P, Pepin G, Bettega A, Veale D, Ferretti G, Deschaux C, Levy P (1996) Relationship between body mass index, age and upper airway measurements in snorers and sleep apnoea patients. Eur Respir J, 9: 1801–1809.
• 17. McNamara JA (1981) Influence of respiratory pattern on craniofacial growth. Angle Orthod, 51: 269–300.
• 18. McNamara J, Burdon W (1994) Orthodontic and orthopedic treatment in mixed dentition. Needham Press, Ann Arbor, MS.
• 19. McNicholas WT (2008) Diagnosis of obstructive sleep apnea in adults. Proc Am Thorac Soc, 5: 154–160.
• 20. Mete T, Yalcin Y, Berker D, Ciftici B, Guven Firat S, Popaloglu O, Cinar Yavus H, Guler S (2013) Relationship between obstructive sleep apnea syndrome and thyroid diseases. Endocrine, 44: 723–728. doi: 10.1007/s12020-013-9927-9.
• 21. Ojoo JC, Kastelik JA, Mori AH (2001) The respiratory system and the menopause. Menopause Int, 7: 168–173.
• 22. Ono T, Lowe AA, Ferguson KA, Fleetham JA (1996). Associations between upper airway structure, body position and obesity in skeletal Class I male patients with obstructive sleep apnea. Am J Orthod Dentofac Orthop, 109: 625–634.
• 23. Özbek MM, Keisuke M, Lowe AA, Fleetham JA (1998) Natural head posture, upper airway morphology and obstructive sleep apnoea severity in adults. Eur J Orthodontics, 20: 133–143.
• 24. Pae EK, Lowe AA, Fleetham JA (1997) A role of pharyngeal length in obstructive sleep apnea patients. Am J Orthod Dentofac Orthop, 111: 12–17.
• 25. Pracharktam N, Nelson S, Hans MG, Broadbent BH, Redline S, Rosenberg C, Strohl KP (1996) Cephalometric assessment in obstructive sleep apnea. Am J Orthod Dentofac Orthop, 109: 410–419.
• 26. Rivlin J, Hoffstein V, Kalbfleisch J, McNicholas W, Zamel N, Bryan AC (1984) Upper airway morphology in patients with idiopathic obstructive sleep apnea. Am Rev Respir Dis, 129: 355–360.
• 27. Sedaghat AR, Anderson IC, McGinley BM, Rossberg MI, Redett RJ, Ishman SL (2012) Characterization of obstructive sleep apnea before and after tongue-lip adhesion In children with micrognathia. Cleft Palate Craniofac J, 49: 21-26, doi: 10.1597/10-240.
• 28. Segner D, Hasund A (1996) Indywidualna kefalometria. Med Tour Press International, Wydawnictwo Medyczne, Warszawa.
• 29. Sung MW, Lee WH, Wee JH, Lee CH, Kim E, Kim JW (2013) Factors associated with hypertrophy of the lingual tonsils in adults in sleep-disordered breathing. JAMA Otolarymgol Head Neck Surg, 139: 598–603. doi: 10.1001/jamaoto.2013.3263.
• 30. Tangugsorn V, Skatvedt O, Krogstadt O, Lyberg T (1995) Obstructive sleep apnoea: a cephalometric study. Part I. Cervicocraniofacial skeletal morphology. Eur J Orthod, 17: 45–56.
• 31. Tasali E, Ip MSP (2008) Obstructive sleep apnea and metabolic syndrome: Alteration in glucose metabolism and inflammation. Proceedings ATS, 5: 207–217. doi: 10.1513/pats.200708-139MG.
• 32. Whittle AT, Marshall I, Mortimore IL, Wraith PK, Sellar RJ, Douglas NJ (1999) Neck soft tissue and fat distribution: comparison between normal men and women by magnetic resonance imaging. Thorax, 54: 323–328.
• 33. Whyte KF, Allen MB, Jeffrey AA, Gould GA, Douglas NJ (1989) Clinical feature of the sleep apnea/hypopnea syndrome. Q J Med, 72: 659–666.
• 34. Young T, Palta M, Dempsey J, Skatrud J, Weber S, Badr S (1993) The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med, 328: 1230–1235.

Identyfikatory

DOI

10.5603/FM.a2016.0003