Association between the intensity of obstructive sleep apnea and skeletal alterations in the face and hyoid bone

Soares, Manoela M.; Romano, Fabio L.; Dias, Franciele Voltarelli da Silva; Souza, Jaqueline Freitas de; Almeida, Lucas Ferreira de; Miura, Carolina Sponchiado; Itikawa, Carla E.; Matsumoto, Mírian Aiko Nakane; Anselmo‐Lima, Wilma Terezinha; Valera, Fabiana Cardoso Pereira

doi:10.1016/j.bjorl.2020.06.008

Cited by 8 publications

(4 citation statements)

References 17 publications

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“…Kurbanova et al 33 (2021) correlated cephalometric facial pattern measurements with the position of the hyoid bone using computed tomography (CT) in adults diagnosed with OSA, and they suggested that the hyoid bone could be a potential biological marker for OSA. In line with the present study, Ryu et al 26 (2015) and Soares et al 32 (2020) found a direct correlation between inferiorization of the hyoid bone and the AHI, using the HMP. Silva et al 34 (2014) reported that this was the only variable correlated with OSA severity.…”

Section: Table 3 Results For the Correlation Analysis Between Polysom...supporting

confidence: 92%

“…Many studies 23,27,31,32 suggest that the position of the hyoid bone plays an important role in the diagnosis and severity of OSA. This is especially due to the increase in the length of the pharynx and, consequently, its collapsible area and greater susceptibility to upper airway collapses during sleep.…”

Section: Table 3 Results For the Correlation Analysis Between Polysom...mentioning

confidence: 99%

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Cephalometric Evaluation in Patients with Obstructive Sleep Apnea undergoing Lateral Pharyngoplasty

Zanco,

Duarte,

Almeida

et al. 2024

Int Arch Otorhinolaryngol

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Introduction Lateral pharyngoplasty (LP) has shown promising results. Craniofacial deformity reduces the pharyngeal space, contributing to the etiopathogenesis. The analysis of craniofacial features can be performed using cephalometry. Objective To verify if craniofacial deformity is associated with worse polysomnographic data in patients with obstructive sleep apnea (OSA), and to verify if the preoperative cephalometric parameters can interfere with the surgical success of the LP. Methods The study included 21 patients with OSA aged between 18 and 65 years who underwent LP in a university hospital from 2015 to 2019. Polysomnography was performed postoperatively, after a minimum period of 6 months from the surgical procedure. In addition, a cephalometric evaluation was performed to assess craniofacial deformity, and to correlate it with the polysomnographic results. Results The mean and median of all polysomnographic respiratory parameters improved postoperatively, especially the apnea-hypopnea index (AHI), which went from 40.15 to 16.60 events per hour (p = 0.001). Of the 21 patients, 15 showed improvements in the AHI postoperatively. As for the cephalometric evaluations, we found that the longer the distance between the hyoid bone and the mandibular plane, the greater the patient's preoperative AHI (p = 0.011). When assessing whether cephalometric changes related to craniofacial deformities influence the surgical outcome of LP, no correlation was found for any cephalometric measurement. Conclusion The longer the distance between the hyoid bone and the mandibular plane, the greater the preoperative AHI, and LP was an effective OSA treatment. Cephalometric variables are not able to modify or determine the success of LP in apneic patients in the population assessed.

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Section: Table 3 Results For the Correlation Analysis Between Polysom...supporting

confidence: 92%

Section: Table 3 Results For the Correlation Analysis Between Polysom...mentioning

confidence: 99%

Cephalometric Evaluation in Patients with Obstructive Sleep Apnea undergoing Lateral Pharyngoplasty

Zanco,

Duarte,

Almeida

et al. 2024

Int Arch Otorhinolaryngol

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“…Previous studies investigating the hyoid related cephalometric variables in OSA patients are often limited to analyzing their relationship with respiratory disturbance values such as AHI [ 33 , 35 ]. In our study the investigation was expanded to include a wider range of variables related to oxygen saturation and sleep architecture to provide a more comprehensive view of the differences in sleep according to hyoid bone position.…”

Section: Discussionmentioning

confidence: 99%

Hyoid bone position as an indicator of severe obstructive sleep apnea

Park

Jang

et al. 2022

BMC Pulm Med

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Background The objective of this study was to evaluate the relationship between hyoid bone position and severity of obstructive sleep apnea (OSA), and to investigate its value as a complementary diagnostic method. Methods A total of 133 patients who were diagnosed as OSA with an apnea-hypopnea index ≥ 5 were included. Clinical examination, level I polysomnography (PSG) and lateral cephalographic analysis were done. Comprehensive PSG characteristics were compared according to hyoid bone position and the predictive power of the distance between the mandible and hyoid was assessed. Results The distance between the hyoid bone and mandibular plane was significantly longer in the severe OSA group (p = 0.013). The distance from hyoid bone to third vertebrae (C3) and hyoid bone to mentum were also longer in the severe OSA group but the difference did not reach statistical significance. The distance between hyoid bone and mandibular plane was effective in predicting severe OSA, with a cut-off value of 19.45 mm (AUC = 0.623, p = 0.040). When grouped according to a distance cut-off value of 19.45 mm, those with a longer distance between the hyoid bone and mandibular plane showed more respiratory disturbance, lower oxygen saturation levels, less deep slow wave sleep, and more fragmented sleep with arousals. Conclusions The distance between the hyoid bone and mandibular plane derived from cephalometric analysis can be a valuable diagnostic parameter that can be easily applied in differentiating severe OSA patients.

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“…This intervention should resolve the airway obstruction due to the glossoptosis caused by mandible contraction and restore the overall airway patency to alleviate respiratory obstruction. Previous studies 6,7,8,9,10 have verified that the airway volume of children with sleep apnea syndrome is related to the anatomical position of hyoid bone, and its hyoid bone position is relatively lower than that of normal children. The above research is mainly from two-dimensional linear measurement.…”

Section: Introductionmentioning

confidence: 93%

Changes in Hyoid Bone Position Before and After Distraction Osteogenesis in Infants With Robin Sequence

Hao

et al. 2021

Journal of Craniofacial Surgery

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Purpose: To study the changes of hyoid position in infants with Robin sequence before and after mandibular distraction osteogenesis, and to explore the related factors. Material and Methods: Twenty-six infants with Robin sequence underwent bilateral mandibular distraction osteogenesis from May 2016 to April 2020. Three-dimensional computed tomography data of patients before and after surgery were analyzed with Materialise Mimics 17.0. Changes in the three-dimensional position of the hyoid bone were studied. Results: The angle between the long axis of the tongue body and hard palate plane, and the angle between the long axis of the tongue body and mandibular plane were significantly decreased after surgery than before surgery. The hyoid bone-cranial base vertical distance, hyoid bone-mental point distance, and hyoid bone -epiglottis distance were significantly increased after surgery. The differences in the abovementioned data were statistically significant (P < 0.05). Changes in the angle between the long axis of the tongue body and the hyoid bonemental point line correlated with changes in the position of the hyoid bone relative to the cervical spine (P ¼ 0.006). Postoperatively, the hyoid bone moved forward and the increase in the hyoid bone -mental point osseous distance interval (41.28%) was significantly greater than the increase in the hyoid bone-epiglottis distance (18.73%). Differences in the total mandibular length and the hyoid bone -cranial base vertical distance are related to the age at the operation (P < 0.05). The younger the age at the time of surgical intervention, the greater the difference before and after surgery for the same follow-up interval. Conclusions: The three-dimensional direction of the hyoid bone changes after the distraction osteogenesis of the mandible, and the hyoid bone moves downward and forward. Because the mandibular length and airway changed, the relative positions of the long axis of the tongue body on the sagittal plane rotated clockwise.

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Association between the intensity of obstructive sleep apnea and skeletal alterations in the face and hyoid bone

Cited by 8 publications

References 17 publications

Cephalometric Evaluation in Patients with Obstructive Sleep Apnea undergoing Lateral Pharyngoplasty

Cephalometric Evaluation in Patients with Obstructive Sleep Apnea undergoing Lateral Pharyngoplasty

Hyoid bone position as an indicator of severe obstructive sleep apnea

Changes in Hyoid Bone Position Before and After Distraction Osteogenesis in Infants With Robin Sequence

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