Obstructive Site Localization in Patients With Obstructive Sleep Apnea Syndrome: A Comparison Between Otolaryngologic Data and Cephalometric Values

Abstract

SUMMARYPurpose. Obstructive Sleep Apnea Syndrome (OSAS) is a respiratory disorder characterized by repeated obstructive episodes affecting upper airways. This study aims at examining the anatomical craniofacial and pharyngeal characteristics of the patient as to identify the obstructive site which triggers the pathologic process. Correlations between otolaryngologic data observed in the patient and the cephalometric ones for the identification of the obstructive site were also highlighted. Materials and methods. We worked on a sample of 16 patients, 12 males and 4 females, attended to at the Otolaryngology Operative Unit of Bari University Hospital. The patients underwent an otolaryngologic (ORL) diagnostic procedure which provided for ApneaGraph (AG) recording, and a dental diagnostic procedure with cephalometric assessment. Results.The statistical analysis highlighted a strict correlation between the otolaryngologic value of AHI and the cephalometric values of the ANB angle, with the distance between the hyoid bone and the mandibular plane and with the distance between the hyoid bone and the plane passing between C3 and Me. Conclusions. We observed a concurrence between the ORL diagnosis of the obstruction level assessed with AG and the cephalometric values regarding respiratory tracts (IPAS and SAS). More precisely, we observed the correlation between the otolaryngologic value of AHI with cephalometric values of the ANB angle, with the distance between hyoid bone and mandibular plan, and with the distance between the hyoid bone and the plane passing between C3 and Me. Furthermore, the identification of the caudal position of the hyoid bone can be considered an alarm bell in the diagnosis of severe OSAS.

Gingival Crevicular Blood as a Potential Screening Tool: A Cross Sectional Comparative Study

“…Our data extend previous findings using the same study design that have documented successful blood glucose evaluation in undiagnosed diabetic patients and diabetic population. Interest in the detection of diabetes using GCB has been heightened by the results of several trials for the treatment of periodontal patients [ 7 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 ]. Of course, the optimal condition for GCB measurement occurs when the bleeding is abundant.…”

Impact of Periodontal Inflammation on Nutrition and Inflammation Markers in Hemodialysis Patients

“…However, the statistical analysis does not highlight interindividual differences that emerged in terms of modest improvements in creatinine values following non-surgical periodontal treatment [34,35]. These results are in contrast with previous studies conducted by Chen et al [36]. The authors performed a trial that included two-hundred and fifty-three HD patients, and they aimed to investigate the potential negative impact of periodontal infection on hemodialysis status.…”

Does Diabetes Induce the Vascular Endothelial Growth Factor (VEGF) Expression in Periodontal Tissues? A Systematic Review

“…Vascular endothelial growth factor (VEGF), a highly conserved heparin-binding homodimeric [12,13], disulfide-bound glycoprotein of 45kDa, is a key mediator of angiogenesis, a complex process which leads to the new growth of blood vessels from preexisting differentiated endothelial cells in the vascular network [14]. VEGF is a multifunctional growth factor implicated in embryonic development, and it is a powerful angiogenic agent in physiological and pathological neovascularization [13][14][15][16]. The vascular endothelial growth factor (VEGF) belongs to the endothelial growth factor family (VEGFs), currently consisting of seven known members with a regulatory role in different vascular systems: VEGF-A, VEGF-B, VEGF-C, VEGF-D, VEGF-E, VEGF-F, and PIGF [17].…”

“…The vascular endothelial growth factor (VEGF) belongs to the endothelial growth factor family (VEGFs), currently consisting of seven known members with a regulatory role in different vascular systems: VEGF-A, VEGF-B, VEGF-C, VEGF-D, VEGF-E, VEGF-F, and PIGF [17]. VEGF exerts its biological effects through interaction with specific (VEGF-R) receptors, which belong to the receptor tyrosine kinase (RTK) subfamily [3,5]; the fms-like tyrosine kinase Flt-1 (VEGFR-1/Flt-1), the fetal liver kinase (VEGFR-2/KDR/Flk-1), and Flk-4 (VEGFR-3), causing proliferation of blood vessels (VEGF-A, VEGF-B, VEGF-C and VEGF-E) and lymphangiogenesis (VEGF-C and VEGF-D) [14][15][16]. The vascular endothelial growth factor receptors are one of the most important signaling pathways that regulate angiogenesis [17][18][19][20].…”

“…Specifically, it has been demonstrated that diabetes causes defective VEGF signaling leading to impairment of tyrosine kinase receptors Flk-1 activation, the receptor implicated in different angiogenesis processes and in transmitting VEGF signaling [35]. This reduced activity results in increased serum VEGF levels, causing pathologic angiogenesis [15]. Sasso et al [50] have shown that the reduction of Flt-1 and Flk-1 receptors influenced the VEGF expression in the myocardium of diabetic patients, leading to a greater expression when compared to healthy subjects.…”