Lateral cephalometric analysis and the risks of moderate to severe obstructive sleep-disordered breathing in Thai patients

• Published in: Sleep & breathing Vol. 17; no. 4; pp. 1249 - 1255
• Main Authors: Banhiran, Wish, Wanichakorntrakul, Pisit, Metheetrairut, Choakchai, Chiewvit, Pipat, Planuphap, Wandee
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.12.2013; Springer; Springer Nature B.V
• Subjects: Adolescent; Adult; Aged; Biological and medical sciences; Cephalometry - methods; Dentistry; Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes; Female; Fundamental and applied biological sciences. Psychology; Humans; Internal Medicine; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Multiple sclerosis and variants. Guillain barré syndrome and other inflammatory polyneuropathies. Leukoencephalitis; Nervous system (semeiology, syndromes); Neurology; Original Article; Otorhinolaryngology; Pediatrics; Pneumology; Pneumology/Respiratory System; Polysomnography; Predictive Value of Tests; Reference Values; Respiration; Respiratory system : syndromes and miscellaneous diseases; Risk Factors; Sleep apnea; Sleep Apnea, Obstructive - diagnosis; Sleep Apnea, Obstructive - epidemiology; Sleep Apnea, Obstructive - etiology; Sleep. Vigilance; Thailand; Vertebrates: nervous system and sense organs; Young Adult; Thailand; Thai; Obstructive sleep apnea; Lateral cephalometry; Sleep-disordered breathing; Snoring; Human; Nervous system diseases; Sleep apnea syndrome; Respiratory disease; Sleep disorder; Risk analysis; Sleep; Sleep wake cycle; Neurological disorder
• DOI: 10.1007/s11325-013-0830-7
• ISSN: 1520-9512

Purposes This cross-sectional study was aimed to compare lateral cephalometric parameters among patients with different severities of obstructive sleep-disordered breathing and to determine if there are radiographic variables that increase risk of moderate to severe obstructive sleep apnea (OSA). Methods Ten linear and 5 angular parameters of lateral cephalometry in 188 adult subjects which included 47 controls and 141 patients with OSA classified by apnea–hypopnea index (AHI) from level-I polysomnography, were analyzed. All radiographs were done under standardized processes and measured twice on separate occasions. Results There were statistically significant differences between controls and patients with AHI ≥ 15 in parameters such as a distance from mandibular plane to hyoid (MP-H), posterior airway space (PAS), skull base angle (NSBA), a distance from posterior nasal spine to posterior pharyngeal wall (PNS-PP), and soft palate length (PNS-P), ( p  < 0.01). However, no significant difference was found between controls and mild OSA. Logistic regression analysis showed that only MP-H with cutoff point of ≥ 18 millimeters, NSBA ≤ 130°, and PAS ≤ 10 millimeters were independent cephalometric variables that increased risk of having AHI ≥ 15 compared to controls with adjusted odds ratio of 17.1, 8.3 and 4.2, respectively. Gender did not significantly associate with OSA severity in this analysis. Conclusions Patients who had longer MP-H, narrower PAS and narrower NSBA than specific cutoff points significantly increased risks of moderate to severe OSA. Treatments that effectively improve these parameters, particularly at tongue base level (MP-H and PAS), may decrease the severity of disease.