Three‐dimensional computed tomography in obstructive sleep apneics treated by maxillomandibular advancement
Identifieur interne : 001B07 ( Istex/Corpus ); précédent : 001B06; suivant : 001B08Three‐dimensional computed tomography in obstructive sleep apneics treated by maxillomandibular advancement
Auteurs : Cheng-Hui Lin ; Yu-Fang Liao ; Ning-Hung Chen ; Lun-Jou Lo ; Yu-Ray ChenSource :
- The Laryngoscope [ 0023-852X ] ; 2011-06.
English descriptors
- KwdEn :
- Advancement, Airway, Airway dimension, Airway dimensions, Airway length, Angular measurements, Anterior, Apnea, Apnea syndrome, Body mass index, Cephalometric, Cervical spine, Chang gung university, Cornu, Corr, Correlated, Counterclockwise, Counterclockwise rotation, Craniofacial, Craniofacial skeleton, Dentoskeletal, Dentoskeletal malocclusion, Digastric muscles, Dimensional changes, Epiglottic, Epiglottis, Facial appearance, Guilleminault, High mandibular plane, Horizontal distance, Horizontal distances, Horizontal position, Hyoid, Hyoid bone, Inferior point, Interosseous distances, Jlch, June, Landmark, Laryngoscope, Lateral, Lateral airway dimensions, Lateral dimension, Lateral dimensions, Lesser cornu, Lower nasopharynx, Mandible, Mandibular, Mandibular advancement, Maxilla, Maxillary, Maxillomandibular, Maxillomandibular advancement, Middle pharyngeal constrictor, Midsagittal, Midsagittal point, Nadir oxygen saturation, Nasopharynx, Obstructive, Oral cavity, Oropharynx, Osteotomy, Pharyngeal, Pharyngeal airway, Pilot study, Posterior midsagittal line, Posterior pharyngeal wall, Riley, Segmental, Segmental maxillomandibular, Segmental osteotomy, Sella, Skeletal advancement, Skeletal landmarks, Skeletal movements, Smmra, Soft palate, Standard deviation, Superior point, Surg, Surgery, Surgical, Total length, Upper airway, Upper nasopharynx, Uvula, Vertical distance, Wilcoxon test.
- Teeft :
- Advancement, Airway, Airway dimension, Airway dimensions, Airway length, Angular measurements, Anterior, Apnea, Apnea syndrome, Body mass index, Cephalometric, Cervical spine, Chang gung university, Cornu, Corr, Correlated, Counterclockwise, Counterclockwise rotation, Craniofacial, Craniofacial skeleton, Dentoskeletal, Dentoskeletal malocclusion, Digastric muscles, Dimensional changes, Epiglottic, Epiglottis, Facial appearance, Guilleminault, High mandibular plane, Horizontal distance, Horizontal distances, Horizontal position, Hyoid, Hyoid bone, Inferior point, Interosseous distances, Jlch, June, Landmark, Laryngoscope, Lateral, Lateral airway dimensions, Lateral dimension, Lateral dimensions, Lesser cornu, Lower nasopharynx, Mandible, Mandibular, Mandibular advancement, Maxilla, Maxillary, Maxillomandibular, Maxillomandibular advancement, Middle pharyngeal constrictor, Midsagittal, Midsagittal point, Nadir oxygen saturation, Nasopharynx, Obstructive, Oral cavity, Oropharynx, Osteotomy, Pharyngeal, Pharyngeal airway, Pilot study, Posterior midsagittal line, Posterior pharyngeal wall, Riley, Segmental, Segmental maxillomandibular, Segmental osteotomy, Sella, Skeletal advancement, Skeletal landmarks, Skeletal movements, Smmra, Soft palate, Standard deviation, Superior point, Surg, Surgery, Surgical, Total length, Upper airway, Upper nasopharynx, Uvula, Vertical distance, Wilcoxon test.
Abstract
The goal of this study was to understand the changes to the head and neck musculoskeleton and the pharyngeal airway after surgery. We tested the correlation between the changes in the skeleton and pharyngeal airway and the apnea‐hypopnea index (AHI).
Url:
DOI: 10.1002/lary.21813
Links to Exploration step
ISTEX:376D6A7E89A3ED7C4AAA92535D6EE6E00716E450Le document en format XML
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Memorial Hospital and Chang Gung University, 5 Fushing Street, Gueishan, Taoyuan, Taiwan 333</mods:affiliation></affiliation></author><author><name sortKey="Liao, Yu Ang" sort="Liao, Yu Ang" uniqKey="Liao Y" first="Yu-Fang" last="Liao">Yu-Fang Liao</name><affiliation><mods:affiliation>Sleep Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan</mods:affiliation></affiliation><affiliation><mods:affiliation>Craniofacial Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan</mods:affiliation></affiliation></author><author><name sortKey="Chen, Ning Ung" sort="Chen, Ning Ung" uniqKey="Chen N" first="Ning-Hung" last="Chen">Ning-Hung Chen</name><affiliation><mods:affiliation>Sleep Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan</mods:affiliation></affiliation><affiliation><mods:affiliation>Department of Pulmonology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, 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unit="vol">121</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="1336">1336</biblScope><biblScope unit="page" to="1347">1347</biblScope><biblScope unit="page-count">12</biblScope><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2011-06">2011-06</date></imprint><idno type="ISSN">0023-852X</idno></series></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0023-852X</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Advancement</term><term>Airway</term><term>Airway dimension</term><term>Airway dimensions</term><term>Airway length</term><term>Angular measurements</term><term>Anterior</term><term>Apnea</term><term>Apnea syndrome</term><term>Body mass index</term><term>Cephalometric</term><term>Cervical spine</term><term>Chang gung university</term><term>Cornu</term><term>Corr</term><term>Correlated</term><term>Counterclockwise</term><term>Counterclockwise rotation</term><term>Craniofacial</term><term>Craniofacial skeleton</term><term>Dentoskeletal</term><term>Dentoskeletal malocclusion</term><term>Digastric muscles</term><term>Dimensional changes</term><term>Epiglottic</term><term>Epiglottis</term><term>Facial appearance</term><term>Guilleminault</term><term>High mandibular plane</term><term>Horizontal distance</term><term>Horizontal distances</term><term>Horizontal position</term><term>Hyoid</term><term>Hyoid bone</term><term>Inferior point</term><term>Interosseous distances</term><term>Jlch</term><term>June</term><term>Landmark</term><term>Laryngoscope</term><term>Lateral</term><term>Lateral airway dimensions</term><term>Lateral dimension</term><term>Lateral dimensions</term><term>Lesser cornu</term><term>Lower nasopharynx</term><term>Mandible</term><term>Mandibular</term><term>Mandibular advancement</term><term>Maxilla</term><term>Maxillary</term><term>Maxillomandibular</term><term>Maxillomandibular advancement</term><term>Middle pharyngeal constrictor</term><term>Midsagittal</term><term>Midsagittal point</term><term>Nadir oxygen saturation</term><term>Nasopharynx</term><term>Obstructive</term><term>Oral cavity</term><term>Oropharynx</term><term>Osteotomy</term><term>Pharyngeal</term><term>Pharyngeal airway</term><term>Pilot study</term><term>Posterior midsagittal line</term><term>Posterior pharyngeal wall</term><term>Riley</term><term>Segmental</term><term>Segmental maxillomandibular</term><term>Segmental osteotomy</term><term>Sella</term><term>Skeletal advancement</term><term>Skeletal landmarks</term><term>Skeletal movements</term><term>Smmra</term><term>Soft palate</term><term>Standard deviation</term><term>Superior point</term><term>Surg</term><term>Surgery</term><term>Surgical</term><term>Total length</term><term>Upper airway</term><term>Upper 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distances</term><term>Horizontal position</term><term>Hyoid</term><term>Hyoid bone</term><term>Inferior point</term><term>Interosseous distances</term><term>Jlch</term><term>June</term><term>Landmark</term><term>Laryngoscope</term><term>Lateral</term><term>Lateral airway dimensions</term><term>Lateral dimension</term><term>Lateral dimensions</term><term>Lesser cornu</term><term>Lower nasopharynx</term><term>Mandible</term><term>Mandibular</term><term>Mandibular advancement</term><term>Maxilla</term><term>Maxillary</term><term>Maxillomandibular</term><term>Maxillomandibular advancement</term><term>Middle pharyngeal constrictor</term><term>Midsagittal</term><term>Midsagittal point</term><term>Nadir oxygen saturation</term><term>Nasopharynx</term><term>Obstructive</term><term>Oral cavity</term><term>Oropharynx</term><term>Osteotomy</term><term>Pharyngeal</term><term>Pharyngeal airway</term><term>Pilot study</term><term>Posterior midsagittal line</term><term>Posterior pharyngeal wall</term><term>Riley</term><term>Segmental</term><term>Segmental maxillomandibular</term><term>Segmental osteotomy</term><term>Sella</term><term>Skeletal advancement</term><term>Skeletal landmarks</term><term>Skeletal movements</term><term>Smmra</term><term>Soft palate</term><term>Standard deviation</term><term>Superior point</term><term>Surg</term><term>Surgery</term><term>Surgical</term><term>Total length</term><term>Upper airway</term><term>Upper nasopharynx</term><term>Uvula</term><term>Vertical distance</term><term>Wilcoxon test</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract">The goal of this study was to understand the changes to the head and neck musculoskeleton and the pharyngeal airway after surgery. We tested the correlation between the changes in the skeleton and pharyngeal airway and the apnea‐hypopnea index (AHI).</div></front></TEI><istex><corpusName>wiley</corpusName><keywords><teeft><json:string>airway</json:string><json:string>pharyngeal</json:string><json:string>pharyngeal airway</json:string><json:string>hyoid</json:string><json:string>apnea</json:string><json:string>nasopharynx</json:string><json:string>mandibular</json:string><json:string>maxillomandibular</json:string><json:string>obstructive</json:string><json:string>uvula</json:string><json:string>laryngoscope</json:string><json:string>lateral</json:string><json:string>midsagittal</json:string><json:string>osteotomy</json:string><json:string>june</json:string><json:string>cornu</json:string><json:string>airway dimensions</json:string><json:string>hyoid bone</json:string><json:string>oropharynx</json:string><json:string>lateral dimension</json:string><json:string>upper 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distance</json:string><json:string>total length</json:string><json:string>airway length</json:string><json:string>posterior midsagittal line</json:string><json:string>horizontal distances</json:string><json:string>superior point</json:string><json:string>inferior point</json:string><json:string>skeletal landmarks</json:string><json:string>standard deviation</json:string><json:string>nadir oxygen saturation</json:string><json:string>middle pharyngeal constrictor</json:string><json:string>craniofacial skeleton</json:string><json:string>chang gung university</json:string><json:string>high mandibular plane</json:string><json:string>lateral airway dimensions</json:string><json:string>lower nasopharynx</json:string><json:string>dentoskeletal malocclusion</json:string><json:string>segmental</json:string><json:string>advancement</json:string><json:string>surgery</json:string><json:string>anterior</json:string></teeft></keywords><author><json:item><name>Cheng‐Hui Lin MD</name><affiliations><json:string>Sleep Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan</json:string><json:string>Craniofacial Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan</json:string><json:string>E-mail: clementlin0614@gmail.com</json:string><json:string>Correspondence address: Craniofacial Center, Chang Gung Memorial Hospital and Chang Gung University, 5 Fushing Street, Gueishan, Taoyuan, Taiwan 333</json:string></affiliations></json:item><json:item><name>Yu‐Fang Liao DDS, PhD</name><affiliations><json:string>Sleep Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan</json:string><json:string>Craniofacial Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan</json:string></affiliations></json:item><json:item><name>Ning‐Hung Chen MD</name><affiliations><json:string>Sleep Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan</json:string><json:string>Department of Pulmonology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan</json:string></affiliations></json:item><json:item><name>Lun‐Jou Lo MD</name><affiliations><json:string>Craniofacial Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan</json:string></affiliations></json:item><json:item><name>Yu‐Ray Chen MD</name><affiliations><json:string>Sleep Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan</json:string><json:string>Craniofacial Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Three‐dimensional computed tomography</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>obstructive sleep apnea</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>maxillomandibular advancement</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>upper airway size</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>Level of Evidence: 2c.</value></json:item></subject><articleId><json:string>LARY21813</json:string></articleId><arkIstex>ark:/67375/WNG-5P3TJMPG-W</arkIstex><language><json:string>eng</json:string></language><originalGenre><json:string>article</json:string></originalGenre><abstract>The goal of this study was to understand the changes to the head and neck musculoskeleton and the pharyngeal airway after surgery. We tested the correlation between the changes in the skeleton and pharyngeal airway and the apnea‐hypopnea index (AHI).</abstract><qualityIndicators><score>7.48</score><pdfWordCount>6615</pdfWordCount><pdfCharCount>45247</pdfCharCount><pdfVersion>1.3</pdfVersion><pdfPageCount>12</pdfPageCount><pdfPageSize>603 x 801 pts</pdfPageSize><refBibsNative>true</refBibsNative><abstractWordCount>40</abstractWordCount><abstractCharCount>250</abstractCharCount><keywordCount>5</keywordCount></qualityIndicators><title>Three‐dimensional computed tomography in obstructive sleep apneics treated by maxillomandibular advancement</title><pmid><json:string>21557248</json:string></pmid><genre><json:string>article</json:string></genre><host><title>The Laryngoscope</title><language><json:string>unknown</json:string></language><doi><json:string>10.1002/(ISSN)1531-4995</json:string></doi><issn><json:string>0023-852X</json:string></issn><eissn><json:string>1531-4995</json:string></eissn><publisherId><json:string>LARY</json:string></publisherId><volume>121</volume><issue>6</issue><pages><first>1336</first><last>1347</last><total>12</total></pages><genre><json:string>journal</json:string></genre><subject><json:item><value>Sleep Medicine</value></json:item></subject></host><namedEntities><unitex><date><json:string>2011</json:string><json:string>June 2011 1344</json:string><json:string>June 2011 1338</json:string><json:string>June 2011 1340</json:string><json:string>June 2011 1346</json:string><json:string>June 2011 1336</json:string></date><geogName></geogName><orgName><json:string>Sleep Center</json:string><json:string>Craniofacial Center</json:string><json:string>Chang Gung Memorial Hospital and Chang Gung University</json:string><json:string>Craniofacial Research Institute, Chang Gung University</json:string><json:string>and Department of Pulmonology</json:string><json:string>Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan</json:string></orgName><orgName_funder></orgName_funder><orgName_provider></orgName_provider><persName><json:string>Yu-Ray Chen</json:string><json:string>L. Comparison</json:string><json:string>T. Surgical</json:string><json:string>Professor Chien-Ming</json:string><json:string>Cheng-Hui Lin</json:string><json:string>I. Demographic</json:string><json:string>Lat Ar</json:string><json:string>U. Morphology</json:string><json:string>C. Patient</json:string><json:string>Polysomnographic</json:string><json:string>Lun-Jou Lo</json:string><json:string>Herbert J. Yue</json:string><json:string>Lev Mean</json:string><json:string>Paired Difference</json:string><json:string>Ning-Hung Chen</json:string></persName><placeName><json:string>Rochester</json:string><json:string>San Antonio</json:string><json:string>Frankfort</json:string><json:string>Krogstad</json:string><json:string>Taiwan</json:string><json:string>Murcia</json:string><json:string>MN</json:string></placeName><ref_url><json:string>http://thesis.lib.cgu.edu.tw/ cgi-bin/cdrfb</json:string></ref_url><ref_bibl><json:string>Fairburn et al.</json:string><json:string>Lin et al.</json:string><json:string>Mehra et al.</json:string></ref_bibl><bibl></bibl></unitex></namedEntities><ark><json:string>ark:/67375/WNG-5P3TJMPG-W</json:string></ark><categories><wos><json:string>1 - science</json:string><json:string>2 - otorhinolaryngology</json:string><json:string>2 - medicine, research & experimental</json:string></wos><scienceMetrix><json:string>1 - health sciences</json:string><json:string>2 - 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scheme="https://publication-type.data.istex.fr/ark:/67375/JMC-0GLKJH51-B">journal</note></notesStmt><sourceDesc><biblStruct type="article"><analytic><title level="a" type="main" xml:lang="en">Three‐dimensional computed tomography in obstructive sleep apneics treated by maxillomandibular advancement<ref type="note" target="#fn4"></ref><ref type="note" target="#fn5"></ref></title><title level="a" type="short" xml:lang="en">3D CT in OSA Treated by MMA</title><author xml:id="author-0000" role="corresp"><persName><forename type="first">Cheng‐Hui</forename><surname>Lin</surname><roleName type="degree">MD</roleName></persName><email>clementlin0614@gmail.com</email><affiliation>Sleep Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan<address><country key="TW"></country></address></affiliation><affiliation>Craniofacial Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan<address><country key="TW"></country></address></affiliation><affiliation>Craniofacial Center, Chang Gung Memorial Hospital and Chang Gung University, 5 Fushing Street, Gueishan, Taoyuan, Taiwan 333</affiliation></author><author xml:id="author-0001"><persName><forename type="first">Yu‐Fang</forename><surname>Liao</surname><roleName type="degree">DDS, PhD</roleName></persName><affiliation>Sleep Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan<address><country key="TW"></country></address></affiliation><affiliation>Craniofacial Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan<address><country key="TW"></country></address></affiliation></author><author xml:id="author-0002"><persName><forename type="first">Ning‐Hung</forename><surname>Chen</surname><roleName type="degree">MD</roleName></persName><affiliation>Sleep Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan<address><country key="TW"></country></address></affiliation><affiliation>Department of Pulmonology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan<address><country key="TW"></country></address></affiliation></author><author xml:id="author-0003"><persName><forename type="first">Lun‐Jou</forename><surname>Lo</surname><roleName type="degree">MD</roleName></persName><affiliation>Craniofacial Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan<address><country key="TW"></country></address></affiliation></author><author xml:id="author-0004"><persName><forename type="first">Yu‐Ray</forename><surname>Chen</surname><roleName type="degree">MD</roleName></persName><affiliation>Sleep Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan<address><country key="TW"></country></address></affiliation><affiliation>Craniofacial Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan<address><country key="TW"></country></address></affiliation></author><idno type="istex">376D6A7E89A3ED7C4AAA92535D6EE6E00716E450</idno><idno type="ark">ark:/67375/WNG-5P3TJMPG-W</idno><idno type="DOI">10.1002/lary.21813</idno><idno type="unit">LARY21813</idno><idno type="toTypesetVersion">file:LARY.LARY21813.pdf</idno></analytic><monogr><title level="j" type="main">The Laryngoscope</title><title level="j" type="alt">LARYNGOSCOPE</title><idno type="pISSN">0023-852X</idno><idno type="eISSN">1531-4995</idno><idno type="book-DOI">10.1002/(ISSN)1531-4995</idno><idno type="book-part-DOI">10.1002/lary.v121.6</idno><idno type="product">LARY</idno><imprint><biblScope unit="vol">121</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="1336">1336</biblScope><biblScope unit="page" to="1347">1347</biblScope><biblScope unit="page-count">12</biblScope><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>Hoboken</pubPlace><date type="published" when="2011-06"></date></imprint></monogr></biblStruct></sourceDesc></fileDesc><profileDesc><abstract xml:lang="en" style="main"><head>Abstract</head>
Objectives/Hypothesis:
<p>The goal of this study was to understand the changes to the head and neck musculoskeleton and the pharyngeal airway after surgery. We tested the correlation between the changes in the skeleton and pharyngeal airway and the apnea‐hypopnea index (AHI).</p>
Study Design:
<p>Prospective, noncontrolled study.</p>
Methods:
<p>In a pilot study, 12 consecutive subjects (3 women, body mass index: 22.4 Kg/m<hi rend="superscript">2</hi> ± 2.7, AHI: 35.9/sec ± 18.0) with Class II dentoskeletal malocclusion and high mandibular plane underwent segmental maxillomandibular rotational advancement (SMMRA). Subjects underwent overnight polysomnography and three‐dimensional computed tomography scanning of the head and neck before and 3 months after surgery. Linear, angular, and area measurements were obtained from skeletal images placed in the Frankfort horizontal position and from horizontal cross‐sectional tomograms derived from the upright pharyngeal airway. Skeletal movements, dimensional changes of the airway, and correlations between measurements and AHI were calculated. A linear regression model was generated using significant bivariate correlations.</p>
Results:
<p>The AHI was significantly reduced to 4.6/sec ± 4.1 with improvement in the nadir oxygen saturation from 83.0% ± 7.2 to 90.6% ± 3.6 after SMMRA. Following skeletal advancement, the hyoid bone was advanced and elevated by 7.5 mm ± 2.9 and 6.7 mm ± 5.5, respectively; the cervical spine was rotated forward by 4.6° ± 2.8; and the airway length was shortened by 6.8 mm ± 4.0 (all <hi rend="italic">P</hi> < .01). Variable improvement of airway dimensions was noted at each horizontal level. A quadratic regression model was derived using the measurements of the Sella‐Nasion‐B point angle and AHI (Rsq = 0.557, sig = 0.000).</p>
Conclusions:
<p>Dimensions of pharyngeal airway were correlated with dimensions of craniofacial skeleton. Sella‐Nasion‐B point angle could be used as a guidance in achieving normalized AHI after surgery.</p></abstract><textClass><keywords xml:lang="en"><term xml:id="kwd1">Three‐dimensional computed tomography</term><term xml:id="kwd2">obstructive sleep apnea</term><term xml:id="kwd3">maxillomandibular advancement</term><term xml:id="kwd4">upper airway size</term><term xml:id="kwd5">Level of Evidence: 2c.</term></keywords><keywords rend="articleCategory"><term>Sleep Medicine</term></keywords><keywords rend="tocHeading1"><term>Sleep Medicine</term></keywords><keywords rend="tocHeading2"><term>Original Reports</term></keywords></textClass><langUsage><language ident="en"></language></langUsage></profileDesc></teiHeader></istex:fulltextTEI><json:item><extension>txt</extension><original>false</original><mimetype>text/plain</mimetype><uri>https://api.istex.fr/document/376D6A7E89A3ED7C4AAA92535D6EE6E00716E450/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>Hoboken</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-4995</doi><issn type="print">0023-852X</issn><issn type="electronic">1531-4995</issn><idGroup><id type="product" value="LARY"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="LARYNGOSCOPE">The Laryngoscope</title><title type="short">The Laryngoscope</title></titleGroup></publicationMeta><publicationMeta level="part" position="60"><doi origin="wiley" registered="yes">10.1002/lary.v121.6</doi><numberingGroup><numbering type="journalVolume" number="121">121</numbering><numbering type="journalIssue">6</numbering></numberingGroup><coverDate startDate="2011-06">June 2011</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="350" status="forIssue"><doi origin="wiley" registered="yes">10.1002/lary.21813</doi><idGroup><id type="unit" value="LARY21813"></id></idGroup><countGroup><count type="pageTotal" number="12"></count></countGroup><titleGroup><title type="articleCategory">Sleep Medicine</title><title type="tocHeading1">Sleep Medicine</title><title type="tocHeading2">Original Reports</title></titleGroup><copyright ownership="publisher">Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.</copyright><eventGroup><event type="manuscriptReceived" date="2010-09-23"></event><event type="manuscriptRevised" date="2011-03-03"></event><event type="manuscriptAccepted" date="2011-03-09"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:2.4.9 mode:FullText" date="2011-05-24"></event><event type="publishedOnlineEarlyUnpaginated" date="2011-05-06"></event><event type="publishedOnlineFinalForm" date="2011-05-19"></event><event type="firstOnline" date="2011-05-06"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-01"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-11-04"></event></eventGroup><numberingGroup><numbering type="pageFirst">1336</numbering><numbering type="pageLast">1347</numbering></numberingGroup><correspondenceTo>Craniofacial Center, Chang Gung Memorial Hospital and Chang Gung University, 5 Fushing Street, Gueishan, Taoyuan, Taiwan 333</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:LARY.LARY21813.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="5"></count><count type="tableTotal" number="7"></count><count type="referenceTotal" number="29"></count><count type="wordTotal" number="13679"></count></countGroup><titleGroup><title type="main" xml:lang="en">Three‐dimensional computed tomography in obstructive sleep apneics treated by maxillomandibular advancement<link href="#fn4"></link><link href="#fn5"></link></title><title type="short" xml:lang="en">3D CT in OSA Treated by MMA</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1 #af2" corresponding="yes"><personName><givenNames>Cheng‐Hui</givenNames><familyName>Lin</familyName><degrees>MD</degrees></personName><contactDetails><email>clementlin0614@gmail.com</email></contactDetails></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Yu‐Fang</givenNames><familyName>Liao</familyName><degrees>DDS, PhD</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af1 #af3"><personName><givenNames>Ning‐Hung</givenNames><familyName>Chen</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af2"><personName><givenNames>Lun‐Jou</givenNames><familyName>Lo</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af1 #af2"><personName><givenNames>Yu‐Ray</givenNames><familyName>Chen</familyName><degrees>MD</degrees></personName></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="TW" type="organization"><unparsedAffiliation>Sleep Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="TW" type="organization"><unparsedAffiliation>Craniofacial Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="TW" type="organization"><unparsedAffiliation>Department of Pulmonology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en" type="author"><keyword xml:id="kwd1">Three‐dimensional computed tomography</keyword><keyword xml:id="kwd2">obstructive sleep apnea</keyword><keyword xml:id="kwd3">maxillomandibular advancement</keyword><keyword xml:id="kwd4">upper airway size</keyword><keyword xml:id="kwd5">Level of Evidence: 2c.</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><section xml:id="abs1-1"><title type="main">Objectives/Hypothesis:</title><p>The goal of this study was to understand the changes to the head and neck musculoskeleton and the pharyngeal airway after surgery. We tested the correlation between the changes in the skeleton and pharyngeal airway and the apnea‐hypopnea index (AHI).</p></section><section xml:id="abs1-2"><title type="main">Study Design:</title><p>Prospective, noncontrolled study.</p></section><section xml:id="abs1-3"><title type="main">Methods:</title><p>In a pilot study, 12 consecutive subjects (3 women, body mass index: 22.4 Kg/m<sup>2</sup> ± 2.7, AHI: 35.9/sec ± 18.0) with Class II dentoskeletal malocclusion and high mandibular plane underwent segmental maxillomandibular rotational advancement (SMMRA). Subjects underwent overnight polysomnography and three‐dimensional computed tomography scanning of the head and neck before and 3 months after surgery. Linear, angular, and area measurements were obtained from skeletal images placed in the Frankfort horizontal position and from horizontal cross‐sectional tomograms derived from the upright pharyngeal airway. Skeletal movements, dimensional changes of the airway, and correlations between measurements and AHI were calculated. A linear regression model was generated using significant bivariate correlations.</p></section><section xml:id="abs1-4"><title type="main">Results:</title><p>The AHI was significantly reduced to 4.6/sec ± 4.1 with improvement in the nadir oxygen saturation from 83.0% ± 7.2 to 90.6% ± 3.6 after SMMRA. Following skeletal advancement, the hyoid bone was advanced and elevated by 7.5 mm ± 2.9 and 6.7 mm ± 5.5, respectively; the cervical spine was rotated forward by 4.6° ± 2.8; and the airway length was shortened by 6.8 mm ± 4.0 (all <i>P</i> < .01). Variable improvement of airway dimensions was noted at each horizontal level. A quadratic regression model was derived using the measurements of the Sella‐Nasion‐B point angle and AHI (Rsq = 0.557, sig = 0.000).</p></section><section xml:id="abs1-5"><title type="main">Conclusions:</title><p>Dimensions of pharyngeal airway were correlated with dimensions of craniofacial skeleton. Sella‐Nasion‐B point angle could be used as a guidance in achieving normalized AHI after surgery.</p></section></abstract></abstractGroup></contentMeta><noteGroup><note xml:id="fn4"><p>Part of the paper was presented with the title “Three‐Dimensional Computed Tomographic Evaluation of Airway and Craniofacial Changes in Adult Patients With Obstructive Sleep Apnea Who Underwent Segmental Maxillo‐Mandibular Rotational Advancement” at the SLEEP 2010 24th Annual Meeting of the Associated Professional Sleep Societies, LLC (APSS), San Antonio, Texas, U.S.A., June 5–9, 2010.</p></note><note xml:id="fn5"><p>This study was supported by the National Science Council, Taiwan (NSC 95‐2314‐B‐182‐020‐Yu‐Ray Chen MD‐PI). The authors have no other funding, financial relationships, or conflicts of interest to disclose.</p></note></noteGroup></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Three‐dimensional computed tomography in obstructive sleep apneics treated by maxillomandibular advancement</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>3D CT in OSA Treated by MMA</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Three‐dimensional computed tomography in obstructive sleep apneics treated by maxillomandibular advancement</title></titleInfo><name type="personal"><namePart type="given">Cheng‐Hui</namePart><namePart type="family">Lin</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Sleep Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan</affiliation><affiliation>Craniofacial Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan</affiliation><affiliation>E-mail: clementlin0614@gmail.com</affiliation><affiliation>Correspondence address: Craniofacial Center, Chang Gung Memorial Hospital and Chang Gung University, 5 Fushing Street, Gueishan, Taoyuan, Taiwan 333</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Yu‐Fang</namePart><namePart type="family">Liao</namePart><namePart type="termsOfAddress">DDS, PhD</namePart><affiliation>Sleep Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan</affiliation><affiliation>Craniofacial Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ning‐Hung</namePart><namePart type="family">Chen</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Sleep Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan</affiliation><affiliation>Department of Pulmonology, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Lun‐Jou</namePart><namePart type="family">Lo</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Craniofacial Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Yu‐Ray</namePart><namePart type="family">Chen</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Sleep Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan</affiliation><affiliation>Craniofacial Center, Chang Gung Memorial Hospital and Chang Gung University, Taoyuan, Taiwan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article" authority="ISTEX" authorityURI="https://content-type.data.istex.fr" valueURI="https://content-type.data.istex.fr/ark:/67375/XTP-6N5SZHKN-D">article</genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">Hoboken</placeTerm></place><dateIssued encoding="w3cdtf">2011-06</dateIssued><dateCaptured encoding="w3cdtf">2010-09-23</dateCaptured><dateValid encoding="w3cdtf">2011-03-09</dateValid><copyrightDate encoding="w3cdtf">2011</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><extent unit="figures">5</extent><extent unit="tables">7</extent><extent unit="references">29</extent><extent unit="words">13679</extent></physicalDescription><abstract>The goal of this study was to understand the changes to the head and neck musculoskeleton and the pharyngeal airway after surgery. We tested the correlation between the changes in the skeleton and pharyngeal airway and the apnea‐hypopnea index (AHI).</abstract><abstract>Prospective, noncontrolled study.</abstract><abstract>In a pilot study, 12 consecutive subjects (3 women, body mass index: 22.4 Kg/m2 ± 2.7, AHI: 35.9/sec ± 18.0) with Class II dentoskeletal malocclusion and high mandibular plane underwent segmental maxillomandibular rotational advancement (SMMRA). Subjects underwent overnight polysomnography and three‐dimensional computed tomography scanning of the head and neck before and 3 months after surgery. Linear, angular, and area measurements were obtained from skeletal images placed in the Frankfort horizontal position and from horizontal cross‐sectional tomograms derived from the upright pharyngeal airway. Skeletal movements, dimensional changes of the airway, and correlations between measurements and AHI were calculated. A linear regression model was generated using significant bivariate correlations.</abstract><abstract>The AHI was significantly reduced to 4.6/sec ± 4.1 with improvement in the nadir oxygen saturation from 83.0% ± 7.2 to 90.6% ± 3.6 after SMMRA. Following skeletal advancement, the hyoid bone was advanced and elevated by 7.5 mm ± 2.9 and 6.7 mm ± 5.5, respectively; the cervical spine was rotated forward by 4.6° ± 2.8; and the airway length was shortened by 6.8 mm ± 4.0 (all P < .01). Variable improvement of airway dimensions was noted at each horizontal level. A quadratic regression model was derived using the measurements of the Sella‐Nasion‐B point angle and AHI (Rsq = 0.557, sig = 0.000).</abstract><abstract>Dimensions of pharyngeal airway were correlated with dimensions of craniofacial skeleton. Sella‐Nasion‐B point angle could be used as a guidance in achieving normalized AHI after surgery.</abstract><note type="content">*Part of the paper was presented with the title “Three‐Dimensional Computed Tomographic Evaluation of Airway and Craniofacial Changes in Adult Patients With Obstructive Sleep Apnea Who Underwent Segmental Maxillo‐Mandibular Rotational Advancement” at the SLEEP 2010 24th Annual Meeting of the Associated Professional Sleep Societies, LLC (APSS), San Antonio, Texas, U.S.A., June 5–9, 2010.</note><note type="content">*This study was supported by the National Science Council, Taiwan (NSC 95‐2314‐B‐182‐020‐Yu‐Ray Chen MD‐PI). 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