Craniofacial and upper airway morphology in adult obstructive sleep apnea patients: A systematic review and meta-analysis of cephalometric studies

Neelapu, Bala Chakravarthy; Kharbanda, Om Prakash; Sardana, Harish Kumar; Balachandran, Rajiv; Sardana, Viren; Kapoor, Priyanka; Gupta, Abhishek; Vasamsetti, Srikanth

doi:10.1016/j.smrv.2016.01.007

Cited by 280 publications

(263 citation statements)

References 57 publications

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“…Over the last few decades, the majority of researchers have found several skeletal craniofacial differences between OSAHS and control subjects, using cephalometry: retruded mandible, maxillary deficiency and inferior displacement of the hyoid (Costa E Sousa and dos Santos Gil, 2013;Hoekema et al, 2003;Johal et al, 2007). However, a recent meta-analysis of cephalometric studies has found a strong correlation between limited parameters, facial height, pharyngeal airway area and hyoid position, and OSAHS (Neelapu et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

Facial phenotype in obstructive sleep apnea–hypopnea syndrome: a systematic review and meta‐analysis

Agha

Johal

2016

Journal of Sleep Research

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SUMMARYThis systematic review and meta-analysis explores the association between facial phenotype and obstructive sleep apnea-hypopnea syndrome in adults. A comprehensive electronic (Medline via Ovid, Scopus, and Embase) database and reference search were undertaken in relation to imaging modalities for surface craniofacial assessments in subjects with sleep apnea. The outcome measures were surface facial dimensions, morphology and profile. The quality of studies was assessed and a meta-analysis conducted. The studies were weighted using the inverse variance method, and the random effects model was used to analyse data. This systematic review identified eight case-control studies. In five studies (906 participants), adults with sleep apnea showed increased weighted mean differences in neck circumference by 1.26 mm (P = 0.0001) with extensive heterogeneity between studies (I² = 93%). Only two studies (467 participants) shared the following outcomes: mandible length, lower facial height, mandible width and anterior mandible height parameters. The pooled results demonstrated obstructive sleep apnea syndrome was associated with larger parameters than controls. In conclusion, the surface facial assessment was able to demonstrate some characteristic morphological features, facilitating a meta-analysis, in adults with obstructive sleep apnea-hypopnea syndrome. The strength of these findings, however, was limited by the heterogeneity of the studies precluding the identification of a clear phenotype.

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Section: Introductionmentioning

confidence: 99%

Facial phenotype in obstructive sleep apnea–hypopnea syndrome: a systematic review and meta‐analysis

Agha

Johal

2016

Journal of Sleep Research

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“…In relation to soft tissue structures, volumetric increases of the tongue, soft palate and neck are described, with consequent inferior position of the hyoid bone. The craniofacial and soft tissue characteristics should be analyzed, taking into account mainly the balance between them [21].…”

Section: Craniofacial Characteristics Of Osas Patientsmentioning

confidence: 99%

Mandibular Repositioning Appliance in the Treatment of Obstructive Sleep Apnea Syndrome-Mini Review

Cunha

Guimarães

Simamotto

et al. 2017

JDHODT

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“…Numerous studies using various imaging techniques have shown that patients with OSA have smaller airways than healthy controls. 5,6 It is therefore not unexpected that several studies have also reported smaller airway luminal area in severe as compared with mild-tomoderate OSA 7,8 or a relationship between OSA severity and airway cross-sectional area. [9][10][11] Perhaps more interestingly, the site of collapse has also been shown to change with the severity of OSA.…”

Section: Ua Anatomy/collapsibilitymentioning

confidence: 99%

Obstructive sleep apnoea pathogenesis from mild to severe: Is it all the same?

2016

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Obstructive sleep apnoea (OSA) is a common disorder caused by not only an impaired upper airway anatomy (i.e. anatomically narrow/collapsible airway), but also by several non-anatomical factors. In this review, we summarise what is known about how each of the pathological factors that cause OSA vary according to disease severity as measured by the apnoea-hypopnoea index. Our synthesis of the available literature indicates that most of the key factors that cause OSA vary with disease severity. However, there is substantial heterogeneity such that the relative contribution of each of these traits varies both between patients and within different severities of disease. These differences likely contribute to variable efficacy of many non-continuous positive airway pressure treatments and inconsistencies in responses with regard to different OSA severities at baseline.

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Craniofacial and upper airway morphology in adult obstructive sleep apnea patients: A systematic review and meta-analysis of cephalometric studies

Cited by 280 publications

References 57 publications

Facial phenotype in obstructive sleep apnea–hypopnea syndrome: a systematic review and meta‐analysis

Facial phenotype in obstructive sleep apnea–hypopnea syndrome: a systematic review and meta‐analysis

Mandibular Repositioning Appliance in the Treatment of Obstructive Sleep Apnea Syndrome-Mini Review

Obstructive sleep apnoea pathogenesis from mild to severe: Is it all the same?

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