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Cephalometric analysis in patients with obstructive sleep apnoea syndrome.

I. Skeletal Morphology

Published online by Cambridge University Press:  29 June 2007

T. Lyberg*
Affiliation:
Department of Maxillofacial Surgery, Ullevål University Hospital
O. Krogstad
Affiliation:
Department of Orthodonties, University of Oslo, Oslo, Norway
G. Djupesland
Affiliation:
Department of Otorhinolaryngology, Ullevål University Hospital
*
Dr Torstein Lyberg, Department of Maxillofacial Surgery, Ullevål University Hospital, 0407 Oslo 4, Norway.

Abstract

Facial skeletal morphology was studied by cephalometric analysis in 25 patients with obstructive sleep apnoea syndrome (OSAS) and ten controls. The hyoid bone was more inferiorly positioned in patients (at the level of cervical vertebrae C4-C6) than in controls (C3-C4 level). The height and length of the nasal cavity was normal, while the length of the bony nasopharynx was moderately reduced. The mandibular plane inclination was slightly larger in patients as was the anterior face height. Mandibular retrognathia was demonstrated in six patients (24 per cent), but the angles of maxillary and mandibular prognathism was within normal limits when the group was considered as a unity. Cephalometric analysis is highly recommended as a diagnostic aid in OSAS patients, especially when surgical intervention is considered.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1989

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References

Bear, S. E. and Priest, J. H. (1980) Sleep apnea syndrome: correction with surgical advancement of the mandible. Journal of Oral Surgery, 38: 543549.Google ScholarPubMed
Bench, R. (1963) Growth of the cervical vertebrae as related to tongue, face and denture behaviour. American Journal of Orthodontics, 49: 183214.CrossRefGoogle Scholar
deBerry-Borowiecki, B., Pollak, C. P., Weitzman, E. D., Rakoff, S. and Imperato, J. (1978) Fibro-optic study of pharyngeal airway during sleep in patients with hypersomnia obstructive sleepapnea syndrome. Laryngoscope, 88: 13101313.CrossRefGoogle Scholar
deBerry-Borowiecki, B. and Sassin, J. F. (1983) Surgical treatment of sleep apnea. Archives of Otolaryngology, 109: 508512.CrossRefGoogle Scholar
deBerry-Borowiecki, B., Kukwa, A. A. and Blanks, R. H. I. (1985) Indications for palatopharyngoplasty. Archives of Otolaryngology, 111: 659663.CrossRefGoogle ScholarPubMed
Coccagna, G., Cirignotta, F. and Lugaresi, E. (1978) The birdlike face syndrome (Acquired micrognathia, hypersomnia, and sleep apnea). In sleep apnea syndromes, ed. Guilleminault, C. & Dement, W. C., Alan R. Liss, Inc., New York, pp. 259271.Google Scholar
Djupesland, G., Godtliebsen, O. B., Lindemann, R. and Langslet, A. (1984) Large tonsils and adenoids as a cause of sleep induced apnoea and hypopnea in children. Acta OtoLaryngologica Suppl. 412: 3032.Google Scholar
Durzo, C. and Brodie, A. (1962) Growth behaviour of the hyoid. Angle Orthodontist, 32: 193204.Google Scholar
Grant, L. (1959) A radiographic study of the hyoid bone position in Angle's class I, II and III malocclusions, unpublished masters thesis, University of Kansas City.Google Scholar
Guilleminault, C., Riley, R. and Powell, N. (1984) Obstructive sleep apnoea and abnormal cephalometric measurements. Chest, 86: 793794.CrossRefGoogle ScholarPubMed
Guilleminault, C., Riley, R. and Powell, N. (1985) Sleep apnoea in normal subjects following mandibular osteotomy with retrusion. Chest, 88: 776778.CrossRefGoogle ScholarPubMed
Halperin, E., Lavie, P., Alroy, G., Eliashar, I. and Gordon, C. (1979) The hypersomnia—sleep-apnoea-syndrome (HSAS): ENT findings. Sleep Research, 8: 188.Google Scholar
Harper, R. M. and Sauerland, E. K. (1978) The role of the tongue in sleep apnea. In Sleep apnea syndromes, ed. Guilleminault, C. & Dement, W. C., Alan, R. Liss, Inc., New York, pp. 219234.Google Scholar
Johnston, C., Taussig, L. M., Koopmann, C., Smith, P. and Bjelland, J. (1981) Obstructive sleep apnea in Treacher-Collins syndrome. Cleft Palate Journal, 18: 3944.Google ScholarPubMed
Kuo, P. C., West, R. A., Bloomquist, D. S. and MacNeil, R. W. (1979) The effect of mandibular osteotomy in three patients with hypersomnia sleep apnoea. Journal of Oral Surgery, 48: 385392.CrossRefGoogle Scholar
LaBanc, J. P. and Epker, B. N. (1984) Changes on the hyoid bone and tongue following advancement of the mandible. Journal of Oral Surgery, 57: 351356.CrossRefGoogle ScholarPubMed
Lapidot, A. and Ben-Hur, N. (1975) Fastening the base of the tongue forward to the hyoid for relief of respiratory distress in the Pierre Robin syndrome. Plastic and Reconstructive Surgery, 56: 8991.CrossRefGoogle Scholar
Lauritzen, C., Lilja, J. and Jarlstedt, J. (1986) Airway obstruction and sleep apnea in children with craniofacial anomalies. Plastic and Reconstructive Surgery, 77: 15.CrossRefGoogle ScholarPubMed
Mezon, B. J., West, P., Maclean, J. P. and Kryger, M. H. (1980) Sleep apnea in acromegaly. American Journal of Medicine, 69: 615618.CrossRefGoogle ScholarPubMed
Moldofsky, H., Kiraly, L., Lue, F., Phillipson, E. and Munro, I. R. (1979) Two cases of successful treatment of obstructive sleep apnoea syndrome by correction of oropharyngeal pathology. Sleep Research, 8: 202.Google Scholar
Orr, W. C. and Martin, R. J. (1981) Obstructive sleep apnea associated with tonsillar hypertrophy in adults. Archives of Internal Medicine, 141: 990992.CrossRefGoogle ScholarPubMed
Panje, W. R. and Holmes, D. K. (1984) Mandibulectomy without reconstruction can cause sleep apnea. Laryngoscope, 94: 15911594.CrossRefGoogle ScholarPubMed
Riley, R., Guilleminault, C., Herran, J. and Powell, N. (1983) Cephalometric analysis and flow-volume loops in obstructive sleep apnoea patients. Sleep, 6: 303311.CrossRefGoogle Scholar
Riley, R., Guilleminault, C., Powell, N. and Derman, S. (1984) Mandibular osteotomy and hyoid bone advancement for obstructive sleep apnoea: A case report. Sleep, 7: 7982.CrossRefGoogle ScholarPubMed
Rivlin, J., Hoffstein, V., Kalbfleisch, J., McNicholas, W., Zamel, N. and Charles Bryan, A. (1984) Upper airway morphology in patients with idiopathic obstructive sleep apnea. American Review of Respiratory Disease, 129: 355360.Google ScholarPubMed
Rojewski, T. E., Schuller, D. E. and Clark, R. W. (1984) Videoendoscopic determination of the mechanism of obstruction in sleep apnea syndrome. Otolaryngology—Head and Neck Surgery, 92: 127131.CrossRefGoogle Scholar
Sarnäs, K. V. and Solow, B. (1980) Early adult changes in the skeletal and soft-tissue profile. European Journal of Orthodontics, 2: 112.CrossRefGoogle ScholarPubMed
Schafer, M. E. (1982) Upper airway obstruction and sleep disorders in children with craniofacial anomalies. Clinics in Plastic Surgery, 9: 555567.CrossRefGoogle ScholarPubMed
Simmons, F. B. and Hill, M. W. (1974) Hypersomnia caused by upper airway obstruction. Annals of Otology, Rhinology and Laryngology, 83: 670673.CrossRefGoogle Scholar
Simmons, F. B., Guilleminault, C. and Dement, W. C. (1977) Surgical management of airway obstruction during sleep. Laryngoscope, 87: 326338.CrossRefGoogle ScholarPubMed
Slagsvold, O. (1969) Variasjoner i kraniets breddedimensjoner. Thesis, University of Oslo, 226 pp.Google Scholar
Solow, B. (1966) The pattern of craniofacial associations. Acta Odontologica Scandinavica, 24: suppl. 46.Google Scholar
Tagaki, Y., Gamble, J. W., Proffit, W. R. and Christiansen, R. L. (1967) Postural change of the hyoid bone following osteotomy of the mandible. Journal of Oral Surgery, 23: 688695.CrossRefGoogle Scholar
Tammeling, G. J., Blokzijl, E. J., Boonstra, S. and Sluiter, H. J. (1972) Micrognathia, hypersomnia and periodic breathing. Bulletin de Physiopathologie respiratoire, 8: 12291238.Google ScholarPubMed
Valero, A. and Alroy, G. (1965) Hypoventilation in acquired micrognathia. Archives of Internal Medicine, 115: 307310.CrossRefGoogle ScholarPubMed
Wickwire, N. A., White, R. P. and Proffit, W. R. (1972) The effect of mandibular osteotomy on tongue position. Journal of Oral Surgery, 30: 184190.Google ScholarPubMed