Evaluation of cephalometric indices in patients with obstructive sleep apnea in comparison with healthy individuals

Ahmadi, Kiyan; Amali, Amin; Saedi, Babak; Dasdar, Shayan; Rashedi, Sina; Kianfar, Nika; Fakhar, Hoorieh Bashizadeh; Amirifard, Hamed; Erfanian, Reza; Heidari, Reihaneh

doi:10.1016/j.adoms.2021.100250

Cited by 2 publications

(2 citation statements)

References 22 publications

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“…The proposed cut-off values are <10-11 mm for IPAS, <77 • for SNB, and >67 • for NSGn [26][27][28][29]. However, these definitions remain indistinctive because of their markedly overlapping value range between the affected and non-affected groups and, thus, the insufficient diagnostic selectivity [30]. Most published values were obtained with patients sitting or standing in an upright position, distinguishing the three-dimensional complexity of the anatomical conditions from the two-dimensional measurements on a single spatial plane.…”

Section: Discussionmentioning

confidence: 99%

“…The two-dimensional cephalometric factors associated with SASN, RSAV, and OSAS are discussed in a highly controversial manner [26][27][28][29][30]. Moreover, there is little information available with regard to additional three-dimensional parameters or the correlation of two-dimensional parameters with three-dimensional airway morphology [31][32][33][34].…”

Section: Introductionmentioning

confidence: 99%

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Cephalometric Screening Assessment for Superior Airway Space Narrowing—Added Value of Three-Dimensional Imaging

Meisgeier,

Dürrschnabel,

Pienkohs

et al. 2024

JCM

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Assessing the morphology of the superior airway space is a crucial diagnostic step in the treatment planning of patients with obstructive sleep apnea syndrome (OSAS) or prior to orthognathic surgery. The aim of this study is to evaluate the necessary scope of a two-dimensional cephalometric assessment and the necessity of three-dimensional imaging in the identification of superior airway space narrowing (SASN). Methods: The computed tomography studies of 100 non-obese, non-OSAS patients were evaluated and analyzed retrospectively. Multiplanar reconstructions were created and underwent cephalometric evaluation. The three-dimensional superior airway morphology was segmented and measured for the minimal cross-sectional area (Amin) and volume (V0). Patients were grouped according to Amin < 80 mm2 and V0 < 12 cm3. Cephalometric parameters (CPs) were analyzed according to Amin and V0 with an unpaired t-test, Pearson correlation, and ROC-curve analysis. Results: The CPs regarding sagittal airway space dimensions (IPAS, MPAS, SPAS) and mandibular body length (GoGn) show the strongest correlation to the three-dimensional minimal cross-sectional area (Amin). The ROC-curve analysis classifying for SASN led to an AUC of 0.86 for IPAS, 0.87 for MPAS, 0.88 for SPAS, and 0.63 for GoGn. Three-dimensional imaging may further improve the diagnostic accuracy in the identification of SASN for IPAS below 13.5 mm, MPAS below 10.2 mm, SPAS below 12.5 mm, and GoGn below 90.2 mm. Conclusions: Two-dimensional cephalometric sagittal airway space diameters and mandibular body length are useful initial screening parameters in the identification of superior airway space narrowing. Nevertheless, as the correlation of two-dimensional cephalometric parameters with three-dimensional upper airway space narrowing is varying and highly dependent on acquisition circumstances, indications for three-dimensional imaging, if possible, in the supine position to evaluate upper airway space morphology should be provided generously, especially in patients with low but normal airway space parameters in two-dimensional cephalometry.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Cephalometric Screening Assessment for Superior Airway Space Narrowing—Added Value of Three-Dimensional Imaging

Meisgeier,

Dürrschnabel,

Pienkohs

et al. 2024

JCM

View full text Add to dashboard Cite

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Surgical hyoid bone repositioning effects on mandibular advancement and upper airway collapsibility

Tannous,

Samaha,

Chami

et al. 2024

Preprint

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Mandibular advancement serves as a treatment option for obstructive sleep apnea (OSA), but its effectiveness differs among patients. The position of the hyoid bone is crucial for maintaining upper airway patency and may influence mandibular advancement outcomes. This study aimed to assess the impact of surgical hyoid re-positioning on mandibular advancement-induced changes in upper airway collapsibility in an animal model.MethodsTwelve anesthetized male New Zealand White rabbits underwent mandibular advancement (0-4mm), combined with hyoid repositioning in various directions (anterior, cranial, caudal, anterior-cranial, anterior-caudal) and increments (0- 4mm). Upper airway collapsibility was quantified as the negative pressure required to close the airway (Pclose) at various mandibular and hyoid positions.ResultsIncreasing mandibular advancement alone led to a progressive reduction in Pclose, indicating a decrease in upper airway collapsibility. Similarly, anterior hyoid repositioning alone resulted in incremental reductions in Pclose, with similar outcomes observed for anterior-cranial and anterior-caudal directions. When mandibular advancement was combined with anterior-based hyoid repositioning directions, a further decrease in Pclose was observed compared to when either intervention was applied alone. Cranial and caudal hyoid repositioning had no direct effect on Pclose or on mandibular advancement outcomes.ConclusionsIn summary, decreases in upper airway collapsibility induced by mandibular advancement are dependent on both hyoid repositioning direction and increment. The findings suggest that combining mandibular advancement with anterior-based hyoid repositioning may enhance the effectiveness of mandibular advancement in treating OSA.

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Evaluation of cephalometric indices in patients with obstructive sleep apnea in comparison with healthy individuals

Cited by 2 publications

References 22 publications

Cephalometric Screening Assessment for Superior Airway Space Narrowing—Added Value of Three-Dimensional Imaging

Cephalometric Screening Assessment for Superior Airway Space Narrowing—Added Value of Three-Dimensional Imaging

Surgical hyoid bone repositioning effects on mandibular advancement and upper airway collapsibility

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