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
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<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>
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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>
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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>
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<p>In a pilot study, 12 consecutive subjects (3 women, body mass index: 22.4 Kg/m<sup>2</sup>
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<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>
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<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>
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<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>
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<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). The authors have no other funding, financial relationships, or conflicts of interest to disclose.</note>
<subject lang="en"><genre>keywords</genre>
<topic>Three‐dimensional computed tomography</topic>
<topic>obstructive sleep apnea</topic>
<topic>maxillomandibular advancement</topic>
<topic>upper airway size</topic>
<topic>Level of Evidence: 2c.</topic>
</subject>
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<topic>Sleep Medicine</topic>
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<identifier type="ISSN">0023-852X</identifier>
<identifier type="eISSN">1531-4995</identifier>
<identifier type="DOI">10.1002/(ISSN)1531-4995</identifier>
<identifier type="PublisherID">LARY</identifier>
<part><date>2011</date>
<detail type="volume"><caption>vol.</caption>
<number>121</number>
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<detail type="issue"><caption>no.</caption>
<number>6</number>
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<extent unit="pages"><start>1336</start>
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<identifier type="DOI">10.1002/lary.21813</identifier>
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<accessCondition type="use and reproduction" contentType="copyright">Copyright © 2011 The American Laryngological, Rhinological, and Otological Society, Inc.</accessCondition>
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