Korean J Orthod.  2008 Jun;38(3):202-213. 10.4041/kjod.2008.38.3.202.

Cephalometric differences in obstructive sleep apnea between obese and non-obese Korean male patients

• Hwang SH
• Park IS
• Nam KY
• Kim JB
• Cho YW
• Suh YS
• Ahn BH
• Park SG
• Park HS

• KMID: 1975908
• DOI: http://doi.org/10.4041/kjod.2008.38.3.202

Abstract

OBJECTIVE
The purpose of this study was to compare the cephalometric measurements of obese and non-obese Korean male patients with obstructive sleep apnea syndrome (OSA). METHODS: Eighty-seven adults who had visited the Sleep Disorder Clinic Center in Keimyung University, Daegu, Korea were examined and evaluated with polysomnography (PSG) and lateral cephalogram. They were divided into 4 groups (non-obese simple snorers, obese simple snorers, non-obese OSA patients, obese OSA patients) according to AHI (Apnea-Hypopnea Index) and BMI (Body Mass Index). RESULTS: The obese OSA group had the highest AHI among the 4 groups. The non-obese OSA group had a significantly steeper mandibular angle and shorter tongue length than the obese OSA group. The hyoid bone of the obese OSA group was positioned anterior and inferior as compared with the non-obese OSA group. Multiple regression analysis showed that tongue length in the obese OSA group and retroposition of hyoid bone in the non-obese OSA group were significant determinants for the severity of AHI. CONCLUSIONS: From a cephalometric point of view, the obese and non-obese pateints with OSA may be characterized by different pathogeneses. Therefore, they have to be managed by individualized treatment. For the obese OSA patients, weight control must be advised as a first choice and for the non-obese OSA patients, oral appliance, nasal CPAP, UPPP and others could be chosen according to the obstructive sites.

Keyword

BMI; OSA; Lateral cephalogram; Individualized treatment

MeSH Terms

Adult
Humans
Hyoid Bone
Korea
Male
Polysomnography
Sleep Apnea, Obstructive
Tongue

Figure

• 

  Fig. 1 Cephalometric landmarks. S (Sella), midpoint of the fossa hypophysealis; N (Nasion), anterior point at the frontonasal suture, Ba (Basion), most postero-inferior point on clivus; ANS (Anterior nasal spine), most anterior point of the nasal spine; PNS (Posterior nasal spine), most posterior point of the nasal spine; A, deepest anterior point in the concavity of the anterior maxilla; B, deepest anterior point in the concavity of the anterior mandible; Cd (Condylion), most postero-superior point of the condylar head; Gn (Gnathion), most antero-inferior point of the chin bone; Go (Gonion), a mid-point at the gonial angle located by bisecting the posterior and inferior borders of the mandible; Me (Menton), most inferior point of the chin bone; P, most inferior tip of soft palate; H, most antero-superior point of the hyoid bone; V, most antero-inferior point of the epiglottic fold; TT, most anterior point of the tip of the tongue; C3, most antero-inferior point of the third cervial vertebrae; MP (Mandibular plane), a tangent line constructed from Me to mandibular inferior border.

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