Upper Airway Morphology and Head Posture in Healthy Men and Women

10.1152/japplphysiol.00461.2001.—Obstructive sleep apnea (OSA) is more common in men than in women for reasons that are not clearly understood. An underlying difference between men and women in the respiratory-related neural control of upper airway dilator muscles has been suggested as a possible reason for the gender difference. We have compared three aspects of upper airway dilator muscle function in healthy men and women: 1) resting inspiratory genioglossus electromyogram (EMGgg) activity, 2) the respiratory EMGgg “afterdischarge” after a brief hypoxic stimulus, and 3) the relationship between the EMGgg and pharyngeal airway pressure. Inspired minute ventilation (V˙i), epiglottic pressure (Pepi), and EMGgg and diaphragm EMG (EMGdi) activity were measured in 24 subjects (12 men, 12 women in the luteal menstrual phase) and were compared between genders while lying supine awake. Every 7–8 min over 2 h, subjects were exposed to 45-s periods of isocapnic hypoxia (9% O2 in N2) that were abruptly terminated with one breath of 100% O2. The relationship between Pepi and EMGgg activity was also compared between genders. The results of 117 trials with satisfactory end-tidal Pco 2 control and no sighs or swallows are reported. There was no gender difference in the resting level of peak inspiratory EMGgg [3.7 ± 0.8 (women) vs. 3.2 ± 0.6% maximal activity (men)]. Repeated-measures ANOVA showed no gender or gender-by-time interaction effect between men and women inV˙i or EMGgg or EMGdi activity during or after the hypoxic stimulus. The relationship between Pepi and EMGgg was not different between men (slope −0.63 ± 0.20) and women (slope −0.69 ± 0.33). These results do not support the hypothesis that the higher prevalence of OSA in men is related to an underlying gender difference in respiratory neural control of upper airway dilator muscles.

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Reliability of Lateral Cephalometric Radiographs in the Assessment of the Upper Airway in Children: A Retrospective study

The Angle Orthodontist ◽

10.2319/022119-131.1 ◽

2019 ◽

Vol 90 (1) ◽

pp. 47-55 ◽

Cited By ~ 3

Author(s):

Fabio Savoldi ◽

Gou Xinyue ◽

Colman P. McGrath ◽

Yanqi Yang ◽

Shiu Cheuk Chow ◽

...

Keyword(s):

Soft Palate ◽

Hyoid Bone ◽

Intraclass Correlation ◽

Upper Airway ◽

Critical Parameters ◽

Head Posture ◽

Bland Altman Method ◽

Excellent Method ◽

Test Errors ◽

Airway Morphology

ABSTRACT Objectives To test the reliability of Lateral cephalometric radiographs (LCRs) for use in the assessment of the upper airway, hyoid bone, soft palate, and tongue. Materials and Methods The records of 57 healthy Chinese children from a nonhospital population (mean age = 12.6 years, SD = 0.5, 28 males and 29 females) who received two consecutive LCRs in the natural head posture were retrospectively analyzed. Fifteen linear, angular, and area measurements were used to describe the airway, hyoid bone, soft palate, and tongue. The reliability between the two LCRs was assessed with the intraclass correlation coefficient (ICC) and F-test. Errors were estimated with the Dahlberg and Bland-Altman method, and intra- and inter-assessor agreements were determined. Results Measurements of upper airway and hyoid bone had excellent method reliability, intra-assessor reliability, and inter-assessor reliability (ICC > 0.8). However, the method reliability and the inter-assessor reliability for soft palate and tongue was less favorable (ICC from 0.60 to 0.96). Soft palate area and thickness were the most critical parameters. Intra-assessor reliability was greater than both method reliability and inter-assessor reliability (which were similar). Conclusions The measurement of upper airway morphology, defined as the intramural space, and of the hyoid bone position were highly reliable on LCRs of children. However, the limited reliability in the assessment of tongue and soft palate area may compromise the diagnostic application of LCRs to these structures.

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