Comparison of cone-beam CT parameters and sleep questionnaires in sleep apnea patients and control subjects

Abstract

Objective-To compare the Cone-Beam Computerized Tomography (CBCT) scan measurements between patients with Obstructive Sleep Apnea (OSA) and snorers to develop a prediction model for OSA based on CBCT imaging and the Berlin Questionnaire.Materials and methods-80 subjects (46 OSA patients with Apnea-Hypoapnea Index [AHI]≥ 10 and 34 snorers AHI<10 based on ambulatory somnographic assessment) were recruited through flyers and mail at USC School of Dentistry and at a private practice. Each patient answered the Berlin Questionnaire, and was imaged with CBCT in supine position. Linear and volumetric measurements of the upper airway were performed by one blinded operator and multivariate logistic regression analysis was used to identify risk factors for OSA.Results-OSA patients were predominantly male, older, had a larger neck size and larger Body Mass index than the snorers. The minimum cross-sectional area of the upper airway and its lateral dimension were significantly smaller in the cases. Airway uniformity defined as the minimum crosssectional area divided by the average area was significantly smaller in the OSA patients.Conclusions-Age>57 years, male gender, a "high risk" Berlin Questionnaire and narrow upper airway lateral dimension (<17mm) were identified as significant risk factors for OSA. The results of this study indicate that 3-dimensional CBCT airway analysis could be used as a tool to assess the presence and severity of OSA. The presence and severity (as measured by the RDI) of OSA is

Cone beam computed tomography and obstructive sleep apnoea

“…20 Enciso et al conducted their study using the Newtom CBCT (Imageworks, New York, USA), which is the only commercially available CBCT that images the patient in supine position. 41 They were able to show that the OSA cases had a slightly more spherical airway shape than snorers that was consistent with Mayer et al's study, 26 a narrower LAT dimension of the airway compared with snorers that is consistent with Hora et al's study using MRI in awake patients. 42 A study by Pevernagie et al showed the effects of changes in body position on upper airway size and shape using 'fast' CT scan.…”

Cone-beam computerized tomography imaging and analysis of the upper airway: a systematic review of the literature

“…Of all the studied parameters, only the ratio 'airway cross-section area/square area' showed statistically significant differences between both groups. Other studies compared the cross-sectional configuration of the oropharynx in OSA and non-OSA patients 53 and developed a prediction model for OSA based on CBCT features and sleep questionnaires 31 . Both studies 31,53 found a statistically significant smaller minimum cross-sectional area in OSA patients.…”

“…In occlusion 47,67 In maximum intercuspation 45,72,76 No 2 Not specified 3,24,29,31,37,44,[52][53][54]70 Not relevant 11,12,15,17,18,21,35,39,40,43,59,61,62,64,73,75 Tongue position control…”

What can anthropometric measurements tell us about obstructive sleep apnoea?

“…In the aetiology of OSA, some of the most important parameters are the airway volume, airway length and various anthropometric measurements [1,9,10,21,36]. According to the CT study performed by Enciso et al [10], men older than 57 years and individuals having narrow upper airway measurement have been identified as a high risk group for OSA.…”