Cephalometric analysis with magnetic resonance imaging in patients with obstructive sleep apnea syndrome

kbb uygulamaları, vol.12, no.2, pp.62-69, 2024 (Peer-Reviewed Journal)

ABSTRACT

Objectives: The study aimed to assess soft tissues and bony structures in

patients with snoring and obstructive sleep apnea syndrome (OSAS) by

magnetic resonance imaging (MRI) cephalometry and to investigate the

correlation between the degree of OSAS with cephalometric measures.

Patients and Methods: The prospective study included 137 adult

patients (86 males, 51 females; mean age: 44.2±11.8; range 21 to

70 years) admitted with complaints of snoring or witnessed apnea

between December 2020 and June 2023. Polysomnography and MRI

cephalometry were performed for each patient. According to the

polysomnography results, patients were assigned to one of the following

groups: simple snorers [apnea-hypopnea index (AHI) <5; n=25], mild

OSAS (AHI between 5 and 15; n=37), moderate OSAS (AHI between

15 and 30; n=36), and severe OSAS (AHI >30; n=39). The SNA (sella,

nasion-point A), SNB (sella, nasion-point B), submental fat thickness,

retropalatal and retro glossal distance, tongue, uvula, basion, and

hyoid-related cephalometric measurements were evaluated with MRI

cephalometry.

Results: The H-A (hyoid-point A) values were found to be higher in the

severe OSAS patients than in other groups (p<0.001, p<0.001 and p<0.05,

respectively). The PNS-UT (posterior nasal spine-uvula tip) values of the

patients in the severe OSAS group were found to be higher than patients in

both the snoring and moderate OSAS groups (p<0.001). The SNB values

of the patients in the mild OSAS group were found to be higher than the

patients in the snoring group (p<0.05). In the parameters of UW (uvula

thickness), PAS-RG (posterior airway space-retroglossal distance), and

H-B (hyoid-point B), statistically meaningful differences were found only

between the simple snorers group and the group with severe OSAS.

Conclusion: In OSAS patients, some important distances, angles,

and lengths can be evaluated by avoiding ionizing radiation with MRI

cephalometry.

Keywords: Cephalometry, magnetic resonance imaging, obstructive sleep apnea

syndrome, polysomnography, sleep.