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

2019 ◽  
Vol 90 (1) ◽  
pp. 47-55 ◽  
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.

scholarly journals Gender-specific cephalometric features related to obesity in sleep apnea patients: trilogy of soft palate-mandible-hyoid bone

2019 ◽  
Vol 41 (1) ◽  
Author(s):  
Seok Hyun Cho ◽  
Jae-Yun Jeon ◽  
Kun-Soo Jang ◽  
Sang Yoon Kim ◽  
Kyung Rae Kim ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Soft Palate ◽  
Hyoid Bone ◽  
Upper Airway ◽  
Apnea Hypopnea Index ◽  
Receiver Operating Characteristic Curves ◽  
Mandibular Plane ◽  
Obstructive Sleep ◽  
Lateral Cephalometry ◽  
Gender Specific

Abstract Background The aim of this study is to investigate the relationship between gender-specific and obesity-related airway anatomy in patients with obstructive sleep apnea (OSA) by using cephalometric analyses. Methods We retrospectively evaluated 206 patients with suspected OSA undergoing polysomnography and anthropometric measurements such as body mass index, neck circumference, and waist-hip ratio. We checked lateral cephalometry to measure tissue landmarks including angle from A point to nasion to B point (ANB), soft palate length (SPL), soft palate thickness (SPT), retropalatal space (RPS), retrolingual space (RLS), and mandibular plane to hyoid (MPH). Results Male with OSA showed significantly increased SPL (P = .006) compared with controls. SPL and MPH had significant correlation with apnea-hypopnea index (AHI) and central obesity. Female with OSA showed significantly increased ANB (P = .013) and SPT (P = .004) compared with controls. The receiver operating characteristic curves revealed that SPT in male and ANB and SPT in female were significant in model 1 (AHI ≥ 5) and model 2 (AHI ≥ 15). MPH was also significant for male in model 2. Conclusion Male and female with OSA had distinct anatomic features of the upper airway and different interactions among soft palate, mandible, and hyoid bone.

scholarly journals Elevated Hyoid Bone Position in Response to Mandibular Advancing Appliance Predicts Effectiveness of the Appliance for Obstructive Sleep Apnea

2021 ◽  
Vol 2 ◽  
Author(s):  
Eung-Kwon Pae ◽  
Ronald M. Harper
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Hyoid Bone ◽  
Upper Airway ◽  
Correlation Coefficients ◽  
Oropharyngeal Airway ◽  
Obstructive Sleep ◽  
Lateral Cephalograms ◽  
Before And After ◽  
Airway Morphology

The objective was to determine whether hyoid bone elevation induced by an anterior mandibular positioning appliance (AMP) predicts the effectiveness of the AMP in patients with obstructive sleep apnea (OSA). Fifteen patients (12 males and 3 females) underwent polysomnographic recordings and lateral cephalograms before and after AMP use of at least 6 months. Measurements of sleep variables and upper airway morphology were compared between pre-AMP and with-AMP states. The AMP appliance reduced apnea-hypopnea indices (AHI) ~53% (33.77 ± 3.29 vs. 15.85 ± 3.78, P = 0.0013). Cephalograms of the oropharyngeal airway showed that the hyoid bone moved superiorly toward the inferior mandibular border (Δ H-MP) ~5 mm (23.4 ± 1.44 vs. 18.27 ± 1.86, P = 0.0377), with the AMP inserted in the oral cavity; no airway measurement other than hyoid bone position changed. No significant correlations emerged between AHI improvement (Δ AHI) and amounts of hyoid elevation (Δ H-MP) when all patients were pooled. However, when the samples were subcategorized, the correlation coefficients increased significantly (P < 0.01) in both subgroups. This outcome suggests the presence of two distinct types among the “Good-Responders” to AMP appliance use. Overall use of the AMP appliance is effective; however, the effectiveness of the appliance appears to depend on the mode of hyoid elevations, likely resulting from muscle responsiveness in patients with AMP use. The results suggest that Δ H-MP measurements may be a useful marker to segregate patients with tongue and hyoid muscles responsive to AMP from those not-so-responsive.

scholarly journals A retrospective study: does upper airway morphology differ between non-positional and positional obstructive sleep apnea?

PeerJ ◽  
2017 ◽  
Vol 5 ◽  
pp. e3918 ◽  
Author(s):  
Xiao Jiao ◽  
Jianyin Zou ◽  
Suru Liu ◽  
Jian Guan ◽  
Hongliang Yi ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Retrospective Study ◽  
Sleep Apnea ◽  
Soft Palate ◽  
Upper Airway ◽  
Cross Sectional Area ◽  
Sectional Area ◽  
Cross Sectional ◽  
Obstructive Sleep ◽  
Airway Morphology

Objective The objective of this study was to explore the differences in upper airway morphology between positional (POSA) and non-positional (NPOSA) obstructive sleep apnea. Methods This retrospective study enrolled 75 patients (45 NPOSA and 30 POSA) who underwent polysomnography (PSG) and computed tomography (CT). The differences in, and relationships of, the PSG values and CT data between POSA and NPOSA were analyzed. Results Significant (p < 0.05) differences between the two groups were found in the apnea/hypopnea index (AHI), lateral-AHI (L-AHI), soft palate length (SPL), cross-sectional palatopharyngeal area, and the coronal diameter (CD) of the palatopharyngeal area at the narrowest part of the glossopharynx, which were all higher in POSA, except for SPL, AHI, and L-AHI. L-AHI was correlated with the cross-sectional area (r =  − 0.306, p = 0.008) and CD (r =  − 0.398, p < 0.001) of the palatopharyngeal area, the cross-sectional area (r =  − 0.241, p = 0.038) and CD (r =  − 0.297, p = 0.010) of the narrowest level of the glossopharynx, the CD of the glossopharynx (r = 0.284, p = 0.013), body mass index (BMI, r = 0.273, p = 0.018), SPL (r = 0.284, p = 0.014), and vallecula-tip of tongue (r = 0.250, p = 0.030). The SPL and CD at the narrowest part of the glossopharynx were included in the simplified screening model. Conclusions In NPOSA, the CD of the upper airway was smaller, and the soft palate was longer, than in POSA. These differences may play significant roles in explaining the main differences between NPOSA and POSA.

scholarly journals Developmental features and predicting airway failure risk in critically ill children with mandibular hypoplasia using 3D computational tomographic analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Doo-Hwan Kim ◽  
Eunseo Gwon ◽  
Junheok Ock ◽  
Jong-Woo Choi ◽  
Jee Ho Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Difficult Airway ◽  
Hyoid Bone ◽  
Three Dimensional ◽  
Upper Airway ◽  
Critically Ill Children ◽  
Healthy Controls ◽  
Mandibular Hypoplasia ◽  
Tongue Position ◽  
Developmental Features

AbstractIn children with mandibular hypoplasia, airway management is challenging. However, detailed cephalometric assessment data for this population are sparse. The aim of this study was to find risk factors for predicting difficult airways in children with mandibular hypoplasia, and compare upper airway anatomical differences using three-dimensional computed tomography (3D CT) between children with mandibular hypoplasia and demographically matched healthy controls. There were significant discrepancies in relative tongue position (P < 0.01) and anterior distance of the hyoid bone (P < 0.01) between patients with mandibular hypoplasia and healthy controls. All mandibular measures were significantly different between the two groups, except for the height of the ramus of the mandible. After adjusting for age and sex, the anterior distance of hyoid bone and inferior pogonial angle were significantly associated with a difficult airway (P = 0.01 and P = 0.02). Quantitative analysis of upper airway structures revealed significant discrepancies, including relative tongue position, hyoid distance, and mandible measures between patients with mandibular hypoplasia and healthy controls. The anterior distance of the hyoid bone and inferior pogonial angle may be risk factors for a difficult airway in patients with mandibular hypoplasia.

scholarly journals Computed tomographic evaluation of the role of craniofacial and upper airway morphology in obstructive sleep apnea in Chinese

2004 ◽  
Vol 98 (4) ◽  
pp. 301-307 ◽  
Author(s):  
Bing Lam ◽  
Clara G.C Ooi ◽  
Wilfred C.G Peh ◽  
I Lauder ◽  
Kenneth W.T Tsang ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Upper Airway ◽  
Computed Tomographic ◽  
Obstructive Sleep ◽  
Airway Morphology

scholarly journals Evaluation of the upper airway dimensions following Herbst appliance treatment in adolescents: A retrospective study

2020 ◽  
Vol 10 ◽  
pp. 153-163
Author(s):  
Min Gu ◽  
Yifan Lin ◽  
Colman Patrick Joseph McGrath ◽  
Urban Hägg ◽  
Ricky Wing Kit Wong ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Soft Palate ◽  
Upper Airway ◽  
Class Ii Malocclusion ◽  
Growth Data ◽  
Herbst Appliance ◽  
Downward Movement ◽  
Dimensional Changes ◽  
Lateral Cephalograms ◽  
Airway Dimensions

Objectives: This retrospective study investigated dimensional changes in the upper airway following Herbst appliance therapy in adolescents with Class II malocclusion and compared those changes with growth data. Materials and Methods: Lateral cephalograms from 44 Herbst-treated adolescents (23 boys, mean age = 13.3 ± 1.1 years, and 21 girls, mean age = 12.6 ± 1.1 years) were analyzed for the changes in the upper airway and craniofacial variables. Longitudinal cephalometric data of 34 untreated adolescents (15 boys, mean age = 12.6 ± 0.3 years, and 19 girls, mean age = 12.9 ± 0.4 years) were used as growth data for comparison. Results: Following treatment, significant changes were noted in most of the variables. Boys displayed greater downward movement of the hyoid bone than girls did (P = 0.021). Compared with the growth data, a greater increase in retroglossal oropharyngeal depth and hypopharyngeal depth was observed in boys and girls, respectively. Both displayed a decrease in the inclination of the soft palate and a smaller change in nasopharyngeal depth. Conclusion: Herbst appliance therapy enlarges the upper airway dimensions at two dissimilar sites in girls (oropharynx) and boys (hypopharynx). Boys display a greater increase in anterior and posterior facial heights than girls do, potentially accounting for the site dissimilarities. Moreover, a Herbst appliance improves the inclination of the soft palate and restricts the growth of the nasopharynx in both boys and girls.

scholarly journals Angiofibrolipoma of the soft palate: A very rare cause of upper air way obstruction in an infant.

2020 ◽  
Vol 6 (1) ◽  
pp. 45-48
Author(s):  
Sonam Gyamtsho
Keyword(s):  
Case Report ◽  
Airway Obstruction ◽  
Soft Palate ◽  
Rare Case ◽  
Upper Airway ◽  
Female Child ◽  
Airway Compromise ◽  
Bipolar Cautery ◽  
History Of ◽  
Infant Case

Introduction: Infants and children are very prone to air way obstruction due to smaller and immature air ways. There are multiple causes of upper airway obstruction in infants like infections, congenital lesions and rarely tumours of the upper airway. However, angiofibrolipoma, a rare variant of lipoma causing intermittent respiratory distress in an infant has not been reported until now. Objective: To report a very rare case of angiofibrolipoma arising from the soft palate in an infant. Case report: Two and half months old female child reported to the department of otolaryngology with a history of intermittent airway obstruction since one month of age. After evaluation she was found to have a fleshy polypoidal mass above the laryngeal inlet arising from soft palate causing airway compromise. She underwent surgical excison with bipolar cautery under general anaesthesia. Conclusion: Few cases of angiofibrolipoma has been reported in adults but none has been reported in children. This is to report a case of angiofibrolipoma in child causing airway obstruction.

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