Three dimensional computed tomographic evaluation of upper airway, mandible and surrounding tissues in obstructive sleep apnea adults
Creators: name: Mouhanna-Fattal, Carole
Publisher: name: Aristotle University of Thessaloniki
Year: 2014
Subjects: Αποφρακτική άπνοια κατά τον ύπνο
Αξονική τομογραφία
Τρισδιάστατη
Άνω αεραγωγός
Obstructive sleep apnea
Computer tomography
Three dimensions
Upper airway

description: Three dimensional computed tomographic evaluation of upper airway, mandible and surrounding tissues in obstructive sleep apnea adults. The aim of the present investigation was to assess, with a descriptive 3D study, the characteristics of upper airway volume, craniofacial volumetric structures, maxilla, mandible and hyoid bone spatial positions to cranium in adult patients suffering from obstructive sleep apnea (OSA) and compare them with the corresponding findings of adult subjects with no sleep disorders. A sample of 27 male subjects suffering from OSA diagnosed by means of the Apnea Hypopnea Index (AHI), after nocturnal polysomnography, was compared to a group of 27 male adult subjects with no history of sleep disorder, matching the subjects in the OSA group according to their age and Body Mass Index. All subjects had a cone beam computerized tomography (CBCT) scan performed with a Kodak Cone Beam 3D System, in the natural head position and the occlusion in maximal intercuspal position. The upper airway volume (UAWV) was assessed with the Amira® software, and a data-processing program, developed for the study, allowed the construction of tetrahedrons, using anatomical landmarks relevant to the craniofacial structures, for calculating in cm3 the studied volumes: naso-maxillary volume, cranium upper anterior volume, oral cavity volume, post-oral cavity volume, hyoid to mandible volume, and post-hyoid volume. Calculations were also made by grouping anterior and posterior volumes, to evaluate ratios over the total volume. Linear and angular measurements for the craniofacial structures were calculated using the Amira® measuring tool. The statistical analysis included the Shapiro-Wilk test, the Levene's test for Equality of Variances, the t-test for Equality, the Mann-Whitney test, the Pearson correlation coefficient and Spearman rank correlation coefficient, using the SPSS 19.0 for Windows. The level of significance for all tests was set at p≤0.05. The intra-examiner reliability was assessed by using the Intra-Class Correlation Coefficient. The results showed a mean value of UAWV significantly smaller in the OSA group than in the control group. No correlations were found between UAWV and the craniofacial volumes used in this study, for the OSA group. The post-hyoid volume, the posterior volume, and the ratio of posterior volume over total volume showed significant differences between the two groups, suggesting a role of soft tissue in obstructing the upper airway. The linear and angular findings indicated that OSA subjects had a more anteriorly positioned maxilla, a shorter mandible corpus, and a more vertical hyoid bone position influencing the upper airway.
description: Τρισδιάστατη αξιολόγηση με αξονική τομογραφία του άνω αεραγωγού της κάτω γνάθου και των περιβαλλόντων ιστών σε ενήλικες ασθενείς με αποφρακτική άπνοια κατά τον ύπνο