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Lateral cephalometric analysis and the risks of moderate to severe obstructive sleep-disordered breathing in Thai patients

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Abstract

Purposes

This cross-sectional study was aimed to compare lateral cephalometric parameters among patients with different severities of obstructive sleep-disordered breathing and to determine if there are radiographic variables that increase risk of moderate to severe obstructive sleep apnea (OSA).

Methods

Ten linear and 5 angular parameters of lateral cephalometry in 188 adult subjects which included 47 controls and 141 patients with OSA classified by apnea–hypopnea index (AHI) from level-I polysomnography, were analyzed. All radiographs were done under standardized processes and measured twice on separate occasions.

Results

There were statistically significant differences between controls and patients with AHI ≥ 15 in parameters such as a distance from mandibular plane to hyoid (MP-H), posterior airway space (PAS), skull base angle (NSBA), a distance from posterior nasal spine to posterior pharyngeal wall (PNS-PP), and soft palate length (PNS-P), (p < 0.01). However, no significant difference was found between controls and mild OSA. Logistic regression analysis showed that only MP-H with cutoff point of ≥ 18 millimeters, NSBA ≤ 130°, and PAS ≤ 10 millimeters were independent cephalometric variables that increased risk of having AHI ≥ 15 compared to controls with adjusted odds ratio of 17.1, 8.3 and 4.2, respectively. Gender did not significantly associate with OSA severity in this analysis.

Conclusions

Patients who had longer MP-H, narrower PAS and narrower NSBA than specific cutoff points significantly increased risks of moderate to severe OSA. Treatments that effectively improve these parameters, particularly at tongue base level (MP-H and PAS), may decrease the severity of disease.

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Acknowledgments

This study was funded by the Faculty of Medicine Siriraj Hospital, Mahidol University. Our grateful appreciation is expressed to associate Professor Cheerasook Chongkolwatana, chairperson of the Department of Otorhinolaryngology; Mr.Suthipol Udompunturak, our consulting statistician; and Ms.Jeerapa Kerdnoppakhun, our research assistant, for their kind contributions. We also would like to thank all staffs of the Diagnostic Radiology Division and Dentistry Department of Siriraj hospital as well as the patients who involved in this project.

Conflict of interest

All of the authors declared that they have no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, 10700, Thailand

    Wish Banhiran, Pisit Wanichakorntrakul & Choakchai Metheetrairut

  2. Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

    Pipat Chiewvit

  3. The Dental Division, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand

    Wandee Planuphap

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  1. Wish Banhiran
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  2. Pisit Wanichakorntrakul
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  3. Choakchai Metheetrairut
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Correspondence to Wish Banhiran.

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Banhiran, W., Wanichakorntrakul, P., Metheetrairut, C. et al. Lateral cephalometric analysis and the risks of moderate to severe obstructive sleep-disordered breathing in Thai patients. Sleep Breath 17, 1249–1255 (2013). https://doi.org/10.1007/s11325-013-0830-7

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  • DOI: https://doi.org/10.1007/s11325-013-0830-7

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