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Habumugisha J, Nakamura M, Kono K, Uchida K, Konko M, Izawa T, Kamioka H. Novel prediction models for pharyngeal-airway volume based on the cranial-base and midsagittal cross-sectional area of the airway in the pharyngeal region: A cephalometric and magnetic resonance imaging study. Orthod Craniofac Res 2024; 27:394-402. [PMID: 38059557 DOI: 10.1111/ocr.12735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/10/2023] [Indexed: 12/08/2023]
Abstract
OBJECTIVE The objective of the study was to elucidate the association between cranial base (Bjork-Jarabak analysis), midsagittal cross-sectional area of the airway in the pharyngeal region (MCSA-PR) data and pharyngeal-airway volume (PAV) and develop a model that could help clinicians predict PAV using two-dimensional (2D) data (Bjork polygon and MCSA-PR). MATERIALS AND METHODS Pre-treatment lateral cephalometric radiographs and magnetic resonance imaging (MRI) scans of 82 women were categorized into three anteroposterior skeletal groups based on ANB angle: Class I (n = 29), 1.5° ≤ ANB≤5.1°; Class II (n = 26), ANB >5.1°; Class III (n = 27), ANB <1.5°. The Bjork polygon, MCSA-PR data from cephalograms and PAV data from MRI scans were examined. Intergroup comparisons were performed using the Kruskal-Wallis test and one-way analysis of variance (ANOVA), with pairwise comparisons conducted using the Bonferroni-corrected Mann-Whitney U-test for the Kruskal-Wallis test and Bonferroni-corrected multiple comparison test for one-way ANOVA. Forward multiple linear regression was used to create model equations for predicting PAV. RESULTS MCSA-PR and anterior (N-S) and posterior (S-Ar) cranial-base lengths were positively correlated with the PAV. We developed four models; three operated at the group level, and one encompassed the entire sample. Notably, all models could effectively explain the variance in the PAV data. The model for the Class I group was the strongest (adjusted R2 = 0.77). CONCLUSION Our findings indicate the remarkable potential of the MCSA-PR, N-S and Bjork sum angles (BSA) as predictors of the PAV and the relevance of 2D cephalometric and cranial-base parameters in predicting the three-dimensional (3D) pharyngeal-airway size.
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Affiliation(s)
- Janvier Habumugisha
- Department of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Masahiro Nakamura
- Department of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Kana Kono
- Department of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Kenta Uchida
- Department of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Megumi Konko
- Department of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Takashi Izawa
- Department of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Hiroshi Kamioka
- Department of Orthodontics, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
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de Oliveira I, Costa S, Pinheiro R, Freitas B, Reher P, Rodrigues V. Oropharyngeal complex differences related to sex and occlusal factors in adolescents aged 12-17 years. Cranio 2023; 41:542-549. [PMID: 34132628 DOI: 10.1080/08869634.2021.1940439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To investigate oropharyngeal complex differences related to sex and occlusal factors in adolescents. METHODS A cross-sectional study was conducted with 108 patients aged 12-17 years. The oropharyngeal complex was evaluated by imaging exams. Occlusal variables included molar relationship, facial growth pattern, maxilla shape, tooth loss, anterior crossbite, and anterior open bite. Statistical analysis included independent t-test, Mann-Whitney, ANOVA, and Kruskal-Wallis tests. The significance level was 5%. RESULTS There were increases of the tongue measurement (p = 0.026) and the hyoid approach at the base of the mandible among boys (p = 0.016) and the distance from the hyoid at the base of the mandible among girls (p = 0.039). There was shortening of the soft palate measurements (p = 0.003 and p = 0.007) and tongue (p = 0.018) among adolescents with an anterior crossbite. CONCLUSION Findings suggest sex, age, and anterior crossbite can be related to oropharyngeal morphology.
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Affiliation(s)
- Izabel de Oliveira
- Dentistry Graduate Program, Federal University of Maranhão, São Luís, Brazil
| | - Silas Costa
- School of Dentistry, Federal University of Maranhão, São Luís, Brazil
- School of Dentistry, São Paulo State University, Araraquara, Brazil
| | - Raysa Pinheiro
- School of Dentistry, Federal University of Maranhão, São Luís, Brazil
| | - Benedito Freitas
- School of Dentistry, Federal University of Maranhão, São Luís, Brazil
| | - Peter Reher
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
| | - Vandilson Rodrigues
- Dentistry Graduate Program, Federal University of Maranhão, São Luís, Brazil
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Chen H, Emami E, Kauffmann C, Rompré P, Almeida F, Schmittbuhl M, van der Stelt P, Ge S, Lavigne G, Huynh N. Airway Phenotypes and Nocturnal Wearing of Dentures in Elders with Sleep Apnea. J Dent Res 2023; 102:263-269. [PMID: 36333889 DOI: 10.1177/00220345221133278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
The objective of this study was to examine to what extent the anatomic characteristics of the upper airway can influence the effect of nocturnal wearing of dentures on the sleep of edentulous elders with untreated sleep apnea. This study used the data from a randomized crossover clinical trial and an exploratory approach to address its objectives. Cone beam computed tomography scans of 65 edentulous individuals (female, n = 37; male, n = 28; mean ± SD age, 74.54 ± 6.42 y) with untreated obstructive sleep apnea (OSA) were used to identify anatomic variables. Polysomnography data were collected by means of one portable overnight recording. The respiratory variable values, including apnea-hypopnea index (AHI), with and without denture worn during sleep were used to calculate the change. Statistical analyses included multiple linear regressions, cluster analysis, and binary logistic regressions. A receiver operator characteristic curve was used to illustrate the accuracy of the statistical model. The regression model explained 15.8% (R2) of AHI change. An increase in the lateral dimension of the minimum cross-sectional area was associated with a decrease in AHI, oxygen desaturation index, and respiratory arousal index changes (P ≤ 0.041). Furthermore, an increase in the length of the hypopharynx was associated with an increase in AHI and oxygen desaturation index changes (P ≤ 0.027). An increase in the lateral dimension of the minimum cross-sectional area of the upper airway was associated with a decreased likelihood of being in the group having a worsened AHI (odds ratio = 0.85; 95% CI, 0.76 to 0.95; P = 0.006). An increase in the length of the oropharynx was associated with an increased likelihood of having increased AHI (odds ratio = 1.10; 95% CI, 1.01 to 1.20; P = 0.026). The nocturnal aggravation of respiratory variables in edentulous individuals with OSA who wear dentures at night can be linked to certain anatomic characteristics of the upper airway. Replication of these findings may open novel avenues for personalized advice regarding nocturnal wearing of dentures in edentulous individuals with OSA (ClinicalTrials.gov: NCT01868295).
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Affiliation(s)
- H Chen
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China.,Faculty of Dental Medicine, Université de Montréal, Montreal, Canada
| | - E Emami
- Faculty of Dental Medicine and Oral Health Sciences, McGill University, Montreal, Canada
| | - C Kauffmann
- Centre hospitalier de l'Université de Montréal, Montreal, Canada
| | - P Rompré
- Faculty of Dental Medicine, Université de Montréal, Montreal, Canada
| | - F Almeida
- Faculty of Dentistry, University of British Columbia, Vancouver, Canada
| | - M Schmittbuhl
- Faculty of Dental Medicine, Université de Montréal, Montreal, Canada.,Centre hospitalier de l'Université de Montréal, Montreal, Canada
| | - P van der Stelt
- Academic Centre for Dentistry Amsterdam, Amsterdam, the Netherlands
| | - S Ge
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - G Lavigne
- Faculty of Dental Medicine, Université de Montréal, Montreal, Canada.,Centre hospitalier de l'Université de Montréal, Montreal, Canada
| | - N Huynh
- Faculty of Dental Medicine, Université de Montréal, Montreal, Canada.,Centre hospitalier de l'Université de Montréal, Montreal, Canada
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Kang JH, Kim HJ, Song SI. Obstructive sleep apnea and anatomical structures of the nasomaxillary complex in adolescents. PLoS One 2022; 17:e0272262. [PMID: 35925992 PMCID: PMC9352039 DOI: 10.1371/journal.pone.0272262] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 07/14/2022] [Indexed: 11/19/2022] Open
Abstract
The aim of the present study was to reveal the associations between skeletal and soft tissue features of the nasomaxillary complex and development and severity of obstructive sleep apnea (OSA) in adolescents. A total of 100 adolescents (mean age, 14.9 ± 1.4 years; age range, 13–17 years) were enrolled. All participants underwent full-night polysomnography and had an assessment of size and position of the tongue, tonsillar size, body mass index (BMI), and circumference of the waist, neck, and hip. The skeletal features of the nasomaxillary complex, including the zygomatic arch width, nasal cavity width, nasal base width, intercanine width, intermolar width, maxillary dental arch length, palatal vault angle, palatal depth, and SNA were measured on the three-dimensional images constructed with computed tomography data. Participants with an apnea and hypopnea index (AHI) of lower than 5 (AHI ≤ 5) were classified as control and participants while those with an AHI of greater than 5 were classified as OSA group. Each variable with a significant outcome in the independent T-test and age and sex factors were integrated into the multivariate linear regression and the dependent variable was AHI. There were significant differences in the BMI and hip circumference between two groups. The width of nasal base, palatal vault angle and SNA also showed significant differences between groups. The results from multivariate linear regression demonstrated that the BMI, width of the nasal base, and SNA showed significant contributions to the severity of OSA in adolescents. The features of the nasomaxillary complex seemed to have significant influences on development and severity of OSA.
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Affiliation(s)
- Jeong-Hyun Kang
- Clinic of Oral Medicine and Orofacial Pain, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Gyeonggi-do, Korea (ROK)
| | - Hyun Jun Kim
- Department of Otolaryngology, School of Medicine, Ajou University, Suwon, Gyeonggi-do, Korea (ROK)
| | - Seung Il Song
- Department of Oral and Maxillofacial Surgery, Institute of Oral Health Science, Ajou University School of Medicine, Suwon, Gyeonggi-do, Korea (ROK)
- * E-mail:
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The Heritability of Upper Airway Dimensions Using MRI Scans in Twins. APPLIED SCIENCES-BASEL 2022. [DOI: 10.3390/app12157646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
Introduction: Obstructive sleep apnea (OSA) is a common disorder characterized by the repetitive collapse of the upper airways during sleep, most likely in the oropharyngeal region. Anatomical factors significantly contribute to the disease development; however, the heritability of the upper airway dimensions, which lead to the collapsibility of the upper airways, is less known. In the current study, we aimed to quantify the impact of heritable and environmental factors on the upper airway dimensions in twins using magnetic resonance imaging (MRI). Methods: We completed head and neck MRI imaging on 110 (66 monozygotic and 44 dizygotic, age median and Q1–Q3: 53 (44–63.75) years) adult twins from the Hungarian Twin Registry. We completed cephalometric, soft tissue and fatty tissue space measurements on T1- and T2-weighted images in sagittal, coronal and axial planes. For the analysis of the genetic and environmental, the determination of the measured parameters was performed with an ACE twin statistical model. Results: We found a strong genetic determination in the anteroposterior diameter of the tongue and the thickness of the submental fatty tissue of the neck. Other parameters of the tongue, soft palate and uvula have shown moderate heritability, while we found strong environmental determination in the thickness of the parapharyngeal fatty tissue, the thickness of the pharyngeal wall, and the smallest diameter of the posterior upper airways. Conclusion: Our twin study can help better understand the genetic and environmental background of anatomical structures involved in the development of sleep apnea.
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Orhan K, Shamshiev M, Ezhov M, Plaksin A, Kurbanova A, Ünsal G, Gusarev M, Golitsyna M, Aksoy S, Mısırlı M, Rasmussen F, Shumilov E, Sanders A. AI-based automatic segmentation of craniomaxillofacial anatomy from CBCT scans for automatic detection of pharyngeal airway evaluations in OSA patients. Sci Rep 2022; 12:11863. [PMID: 35831451 PMCID: PMC9279304 DOI: 10.1038/s41598-022-15920-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Accepted: 07/01/2022] [Indexed: 11/21/2022] Open
Abstract
This study aims to generate and also validate an automatic detection algorithm for pharyngeal airway on CBCT data using an AI software (Diagnocat) which will procure a measurement method. The second aim is to validate the newly developed artificial intelligence system in comparison to commercially available software for 3D CBCT evaluation. A Convolutional Neural Network-based machine learning algorithm was used for the segmentation of the pharyngeal airways in OSA and non-OSA patients. Radiologists used semi-automatic software to manually determine the airway and their measurements were compared with the AI. OSA patients were classified as minimal, mild, moderate, and severe groups, and the mean airway volumes of the groups were compared. The narrowest points of the airway (mm), the field of the airway (mm2), and volume of the airway (cc) of both OSA and non-OSA patients were also compared. There was no statistically significant difference between the manual technique and Diagnocat measurements in all groups (p > 0.05). Inter-class correlation coefficients were 0.954 for manual and automatic segmentation, 0.956 for Diagnocat and automatic segmentation, 0.972 for Diagnocat and manual segmentation. Although there was no statistically significant difference in total airway volume measurements between the manual measurements, automatic measurements, and DC measurements in non-OSA and OSA patients, we evaluated the output images to understand why the mean value for the total airway was higher in DC measurement. It was seen that the DC algorithm also measures the epiglottis volume and the posterior nasal aperture volume due to the low soft-tissue contrast in CBCT images and that leads to higher values in airway volume measurement.
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Affiliation(s)
- Kaan Orhan
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Ankara University, Ankara, Turkey. .,Medical Design Application, and Research Center (MEDITAM), Ankara University, Ankara, Turkey. .,Department of Dental and Maxillofacial Radiodiagnostics, Medical University of Lublin, Lublin, Poland.
| | | | | | | | - Aida Kurbanova
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Near East University, Nicosia, Cyprus
| | - Gürkan Ünsal
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Near East University, Nicosia, Cyprus.,Research Center of Experimental Health Science (DESAM), Near East University, Nicosia, Cyprus
| | | | | | - Seçil Aksoy
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Near East University, Nicosia, Cyprus
| | - Melis Mısırlı
- Department of Dentomaxillofacial Radiology, Faculty of Dentistry, Near East University, Nicosia, Cyprus
| | - Finn Rasmussen
- Internal Medicine Department Lunge Section, SVS Esbjerg, Esbjerg, Denmark.,Life Lung Health Center, Nicosia, Cyprus
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de Oliveira I, Pinheiro R, Freitas B, Reher P, Rodrigues V. Relationship between craniofacial and dental arch morphology with pharyngeal airway space in adolescents. J Orofac Orthop 2022; 84:93-103. [PMID: 35608631 DOI: 10.1007/s00056-022-00403-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 02/25/2022] [Indexed: 11/30/2022]
Abstract
PURPOSE The aim of the study was to investigate a possible relationship between pharyngeal airway space, craniofacial variables, and dental arch form in adolescents grouped by sex. METHODS This cross-sectional study included 108 adolescents aged between 12 and 17 years. Lateral cephalometric radiographs were used to analyze sagittal craniofacial variables and the pharyngeal airway space. For evaluation of the dental arch form, we used plaster models. Statistical analysis included Student's t‑test and Pearson's correlation coefficient (r). RESULTS Maxillary length was directly proportional to upper nasopharyngeal airway dimensions in males (r = 0.312, p = 0.021) and females (r = 0.310, p = 0.022). In the female group, upper oropharyngeal measurements showed an inverse correlation with a labial inclination of the upper incisors (r = -0.415, p = 0.001), protrusion of the upper incisors (r = -0.364, p = 0.006), and soft palate thickness (r = -0.27, p = 0.043). In the male group, upper nasopharynx measurements showed an inverse correlation with soft palate thickness (r = -0.277, p = 0.042). The upper arch form appeared to be related to oropharyngeal measurements in females, while the lower arch form was related to oropharyngeal dimensions in males. CONCLUSION The findings suggest that there are sex-dependent correlations of the nasopharyngeal and oropharyngeal airway space with the sagittal craniofacial morphology and the transversal dental arch form.
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Affiliation(s)
| | - Raysa Pinheiro
- School of Dentistry, Federal University of Maranhão, São Luís, Brazil
| | - Benedito Freitas
- School of Dentistry, Federal University of Maranhão, São Luís, Brazil
| | - Peter Reher
- School of Dentistry and Oral Health, Griffith University, Gold Coast, Australia
| | - Vandilson Rodrigues
- School of Dentistry, Federal University of Maranhão, São Luís, Brazil. .,Department of Morphology, Federal University of Maranhão, São Luís, Brazil.
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Zhang C, Chen M, Shen Y, Gong Y, Ma J, Wang G. Impact of Upper Airway Characteristics on Disease Severity and CPAP Therapy in Chinese Patients With OSA: An Observational Retrospective Study. Front Neurol 2022; 13:767336. [PMID: 35309580 PMCID: PMC8930821 DOI: 10.3389/fneur.2022.767336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 01/27/2022] [Indexed: 11/13/2022] Open
Abstract
Objective The characteristics of the upper airway (UA) are important for the evaluation and treatment of obstructive sleep apnea (OSA). This study aimed to investigate the association of UA characteristics with OSA severity, titration pressure, and initiation of and 3-month compliance with continuous positive airway pressure (CPAP). Methods This retrospective study included consecutive patients examined using a semi-quantitative UA evaluation system (combination with physical examination and awake endoscopy) during 2008–2018 at the Department of Respiratory and Critical Care Medicine, Peking University First Hospital. First, the differences in UA characteristics were compared between patients with simple snorers and mild OSA and those with moderate-to-severe OSA. Then, the effect of UA characteristics on the initiation to CPAP therapy and 3-month adherence to CPAP was conducted. Results Overall, 1,002 patients were included, including 276 simple snorers and patients in the mild OSA group [apnea-hypopnea index (AHI) <15] and 726 patients in the moderate-to-severe OSA group (AHI ≥15). Tongue base hypertrophy, tonsillar hypertrophy, mandibular recession, neck circumstance, and body mass index (BMI) were independent risk factors for moderate-to-severe OSA. Among those patients, 119 patients underwent CPAP titration in the sleep lab. The CPAP pressures in patients with thick and long uvulas, tonsillar hypertrophy, lateral pharyngeal wall stenosis, and tongue hypertrophy were higher than those of the control group (P < 0.05, respectively). The logistic regression analysis showed that nasal turbinate hypertrophy, mandibular retrusion, and positive Müller maneuver in the retropalate and retroglottal regions were independent predictors for the initiation of home CPAP treatment. Conclusion Multisite narrowing and function collapse of the UA are important factors affecting OSA severity, CPAP titration pressure, and the initiation of home CPAP therapy. Clinical evaluation with awake endoscopy is a safe and effective way for the assessment of patients with OSA in internal medicine.
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Affiliation(s)
- Cheng Zhang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Mingxin Chen
- Department of Respiratory and Critical Care Medicine, The First Affiliated Hospital of Harbin Medical University, Harbin, China
| | - Yane Shen
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Yuhong Gong
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
| | - Jing Ma
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
- *Correspondence: Jing Ma
| | - Guangfa Wang
- Department of Respiratory and Critical Care Medicine, Peking University First Hospital, Beijing, China
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Abdelwahab M, Poomkonsarn S, Ren X, Awad M, Capasso R, Riley R, Most S, Liu SYC. A Comprehensive Strategy for Improving Nasal Outcomes After Large Maxillomandibular Advancement for Obstructive Sleep Apnea. Facial Plast Surg Aesthet Med 2021; 23:437-442. [PMID: 34287054 DOI: 10.1089/fpsam.2020.0569] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
Background: Rate of corrective nasal surgery after maxillomandibular advancement (MMA) for obstructive sleep apnea (OSA) has been reported to be 18.7% for functional and aesthetic indications. Objective: Describe a comprehensive strategy to optimize nasal outcomes with MMA for OSA. Methods: A retrospective review of patients undergoing MMA for OSA in a tertiary referral center was performed, with a comprehensive perioperative intervention to optimize nasal outcomes from January 2014 to February 2018. Outcomes included the Apnea-Hypopnea Index (AHI), oxygen saturation (SpO2) nadir, corrective nasal surgery needed after MMA, and Nasal Obstruction Symptom Evaluation (NOSE) scores. Results: AHI after MMA showed significant reduction (-34.65, p < 0.001), SpO2 nadir increased (+6.08, p < 0.001), and NOSE scores decreased (-5.96, p < 0.001). Corrective nasal surgery needed after MMA was reported in 6.5% (8 of 122) subjects at a mean of 8.5 months, ranging from 1 to 24.7 months. Six subjects underwent either septoplasty and/or valve stenosis repair, and two subjects underwent functional and aesthetic rhinoplasty. Conclusion: A perioperative strategy was applied since 2014 that showed effectiveness in reducing post-MMA corrective nasal surgery to 6.5%.
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Affiliation(s)
- Mohamed Abdelwahab
- Division of Sleep Surgery, Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
- Department of Otolaryngology-Head & Neck Surgery, Mansoura University Faculty of Medicine, Mansoura, Egypt
| | - Sasikarn Poomkonsarn
- Division of Sleep Surgery, Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
- Center of Excellence in Otolaryngology Head and Neck Surgery, Rajavithi Hospital, College of Medicine, Rangsit University, Bangkok, Thailand
| | - Xiatong Ren
- Division of Sleep Surgery, Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
- Department of Otolaryngology, Longgang District Central Hospital of Shenzhen, Shantou University Medical College, Shenzhen, China
| | - Michael Awad
- Division of Sleep Surgery, Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
- Division of Sleep Surgery, Department of Otolaryngology-Head and Neck Surgery, Northwestern University, Chicago, Illinois, USA
| | - Robson Capasso
- Division of Sleep Surgery, Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Robert Riley
- Division of Sleep Surgery, Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Sam Most
- Division of Facial Plastic and Reconstructive Surgery, Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - Stanley Yung-Chuan Liu
- Division of Sleep Surgery, Department of Otolaryngology-Head & Neck Surgery, Stanford University School of Medicine, Stanford, CA, USA
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Tan SN, Yang HC, Lim SC. Anatomy and Pathophysiology of Upper Airway Obstructive Sleep Apnoea: Review of the Current Literature. SLEEP MEDICINE RESEARCH 2021. [DOI: 10.17241/smr.2020.00829] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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11
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De Meyer MMD, Vanderveken OM, De Weerdt S, Marks LAM, Cárcamo BA, Chavez AM, Matamoros FA, Jacquet W. Use of mandibular advancement devices for the treatment of primary snoring with or without obstructive sleep apnea (OSA): A systematic review. Sleep Med Rev 2020; 56:101407. [PMID: 33326914 DOI: 10.1016/j.smrv.2020.101407] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 07/17/2020] [Accepted: 07/30/2020] [Indexed: 02/07/2023]
Abstract
The aim of this review was to systematically evaluate the available scientific evidence on the benefit of mandibular advancement devices (MADs) in the treatment of primary snoring (PS). From 905 initially identified articles, 18 were selected. Papers that provided indirect information regarding obstructive sleep apnea syndrome (OSAS) and/or sleep breathing disorders (SBD) were included. Information was obtained on monoblock and duoblock appliances from the selected studies. The devices were most commonly able to achieve 50%-70% of the maximum mandibular protrusion. The frequently used outcome measurements were the apnea-hypopnea index, Epworth sleepiness scale, and oxygen desaturation index, which all yielded positive post-treatment results. The most common side effects were temporomandibular joint pain and excessive salivation, which improved with time. Our findings indicated that the use of MADs, even with varying designs, improved outcomes in all the reported patient populations (PS, OSAS, and SBD). Despite the lack of studies on PS, the available evidence supports the use of MADs for treatment of PS. Snoring should be treated from a preventive and psychosocial perspective to avoid progression to more severe diseases that could have a significant medical and economic impact.
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Affiliation(s)
- Micheline M D De Meyer
- Oral Health in Special Needs, Sleep Breathing Disorders, Oral Health Sciences, Ghent University Hospital, Gent, Belgium; Department of Dentistry, Radboud University Medical Center and Radboud Institute for Health Sciences, Nijmegen, the Netherlands; Department of Pneumology, UZ Brussels, Brussels, Belgium; Faculty of Dentistry, University of Concepción, Concepción, Chile; Department of Educational Sciences EDWE-LOCI, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium; Department of Materials, Textiles and Chemical Engineering, Faculty of Engineering and Architecture, Ghent University, Belgium.
| | - Olivier M Vanderveken
- Department of Ear, Nose, and Throat, Head and Neck Surgery, Antwerp University Hospital, Edegem, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium
| | | | - Luc A M Marks
- Special Care in Dentistry, Oral Health Sciences, Ghent University Hospital, Gent, Belgium
| | | | - Andrés M Chavez
- Faculty of Dentistry, University of Concepción, Concepción, Chile
| | | | - Wolfgang Jacquet
- Special Care in Dentistry, Oral Health Sciences, Ghent University Hospital, Gent, Belgium; Department of Oral Health Sciences ORHE, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Educational Sciences EDWE-LOCI, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium; Department of Materials, Textiles and Chemical Engineering, Faculty of Engineering and Architecture, Ghent University, Belgium
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Obstructive sleep apnea, depression and cognitive impairment. Sleep Med 2020; 72:50-58. [DOI: 10.1016/j.sleep.2020.03.017] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 03/10/2020] [Accepted: 03/12/2020] [Indexed: 12/22/2022]
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Hsu WY, Chiu NY, Chang CC, Chang TG, Lane HY. The association between cigarette smoking and obstructive sleep apnea. Tob Induc Dis 2019; 17:27. [PMID: 31582938 PMCID: PMC6751985 DOI: 10.18332/tid/105893] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 03/21/2019] [Accepted: 03/22/2019] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Obstructive sleep apnea (OSA) is a serious sleep disorder characterized by repetitive episodes of paused or shallow breathing during sleep. Patients with OSA often have excessive daytime sleepiness. The role of cigarette smoking in OSA remains controversial. The aim of this study was to examine the relationship between cigarette smoking and OSA. METHODS In this retrospective chart review, we reviewed 18-month sleep laboratory charts in central Taiwan. We collected data regarding sleep, current cigarette smoking status, sex, age, body mass index (BMI), neck circumference, Epworth Sleepiness Scale score, and polysomnographic sleep parameters. In total, 733 subjects were recruited; among these, 151 were smokers and 582 were non-smokers. RESULTS Smokers had significantly higher apnea–hypopnea index (p<0.001) for non-rapid eye movement sleep stage, higher apnea–hypopnea index (p<0.001) for total sleep time, and higher snore frequency (p<0.001) in t-test analysis. They also demonstrated higher Epworth Sleepiness Scale scores, shorter sleep times, lower percentage of slow-wave (deep) sleep, and longer snore times. However, no significant association was found between cigarette smoking and OSA after adjusting for sex, age, and BMI (OR=1.02, 95% CI: 0.66–1.57). CONCLUSIONS We did not find any significant association between cigarette smoking and OSA after adjusting for age, sex, and BMI. Further well-designed prospective controlled cohort studies might clarify the relationship between cigarette smoking and OSA.
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Affiliation(s)
- Wen-Yu Hsu
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.,Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Nan-Ying Chiu
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Cheng-Chen Chang
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Ting-Gang Chang
- Department of Psychiatry, Changhua Christian Hospital, Changhua, Taiwan
| | - Hsien-Yuan Lane
- Graduate Institute of Clinical Medical Science, China Medical University, Taichung, Taiwan.,Department of Psychiatry & Brain Disease Research Center, China Medical University Hospital, Taichung, Taiwan.,Department of Psychology, College of Medical and Health Science, Asia University, Taichung, Taiwan
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