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Obstrüktif uyku apneli ve horlayan erişkin erkek hastaların dentofasiyal özelliklerinin değerlendirilmesi

Yıl 2011, Cilt: 14 Sayı: 3, 155 - 163, 23.09.2011

Banu Saglam Aydinatay , Tulin Taner Cenk Akcan Erdinc Baharoglu , Ahmet Demir , Omer Yucel Oguz Ogretmenoglu Metin Onerci Ahmet Sahin

Öz

ÖZET

Amaç: Bu çalışmanın amacı obstrüktif uyku apne sendromu (OUAS) olan erişkin erkek hastaların kraniofasiyal morfolojik özellikleri değerlendirmektir.

Gereç ve Yöntem: Çalışmada 80 erkek hastanın (60 OUAS, 20 horlama hastası) lateral sefalogramları değerlendirildi. Bireyler Grup 1: horlama (AHİ<5); Grup 2: hafif OUAS (5£ AHİ<15); Grup 3: orta OUAS(15£ AHİ<30) ; Grup 4: şiddetli OUAS (AHİ ³30) olarak değerlendirildi. Sefalogramlar üzerinde hyoid, dil kökü ve yumuşak damak konumu, kranioservikal postür ve havayolu genişliğini belirleyen ölçümler yapıldı. Gruplar arasındaki farklar normal dağılım gösteren değişkenlerde tek yönlü varyans analizi ve Duncan testiyle, normal dağılım göstermeyen değişkenlerde Kruskal Wallis testi  ve Bonferroni düzeltmesi uygulanarak Mann Whitney U testiyle yapıldı.

Bulgular: Gruplar karşılaştırıldığında hyoid pozisyonu, yumuşak damak konumu, kranioservikal postür ve havayolu genişliğini gösteren ölçümlerde istatistiksel anlamlılık gösteren bir fark bulunmadı (p>0.05). Dil kökü konumunu gösteren PNS-V (mm) değeri şiddetli OUAS grubu ile diğer gruplar arasında istatistiksel olarak anlamlı fark gösterdi (p<0.05). Dil kökü ile ilgili diğer ölçümlerde ise gruplar arasında anlamlı fark bulunmadı (p>0.05).

Sonuçlar: İncelenen popülasyonda şiddetli OUAS grubunda dil kökünün daha aşağıda konumlandığı belirlenmiş, diğer kraniofasiyal değişkenlerde gruplar arasında fark görülmemiştir.

Anahtar kelimeler: Obstrüktif uyku apnesi sendromu, horlama, sefalometri, kraniofasiyal.

ABSTRACT

Objectives: The aim of this study was to evaluate the craniofacial morphology of adult male patients with obstructive sleep apnea syndrome (OSAS).

Materials and Methods: Cephalograms of 80 male patients (60 OSAS, 20 snoring) were evaluated. Subjects were grouped as, Group 1: snoring (AHI<5); Group 2: mild OSA (5£ AHI<15);  Group 3: moderate OSA (15£ AHI<30) ; Group 4: severe OSA (AHI ³30). Measurements were made to evaluate hyoid bone position, tongue base and soft palate, craniocervical extension and the airway width. Statistical significance was determined with one-way ANOVA and Duncan test for variables showing normal distribution. Kruskal Wallis test and Mann Whitney U test with Bonferroni correction were used to evaluate the variables that were not normally distibuted.

Results: No significant differences were found in hyoid bone position, soft palate position, craniocervical extension and the airway width (p>0.05). PNS-V (mm), was significantly different between severe OSA group and the other groups (p<0.05). The other measurements on tongue base showed no difference between groups (p>0.05).

Conclusions: In this study population, the tongue base was more inferiorly positioned in the severe OSA group whereas the other craniofacial variables showed no difference between groups.

Key words: Obstructive sleep apnea syndrome, snoring, cephalometry, craniofacial.

Anahtar Kelimeler

Obstrüktif uyku apnesi sendromu horlama sefalometri kraniofasiyal

Kaynakça

  • 1. Guilleminault C, Connolly SJ, Winkle RA. Cardiac arrhythmia and conduction disturbances during sleep in 400 patients with sleep apnea syndrome. Am J Cardiol 1983;52(5):490-494.
  • 2. Hoffstein V, Mateika S. Cardiac arrhythmias, snoring, and sleep apnea. Chest 1994;106(2):466-471.
  • 3. Hoffstein V, Mateika J. Evening-tomorning blood pressure variations in snoring patients with and without obstructive sleep apnea. Chest 1992;101(2):379-384.
  • 4. Peppard PE, Young T, Palta M, Skatrud J. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 2000;342(19):1378-1384.
  • 5. Nieto FJ, Young TB, Lind BK, Shahar E, Samet JM, Redline S, et al. Association of sleep-disordered breathing, sleep apnea, and hypertension in a large communitybased study. Sleep Heart Health Study. Jama 2000;283(14):1829- 1836.
  • 6. Leung RS, Bradley TD. Sleep apnea and cardiovascular disease. Am J Respir Crit Care Med 2001;164(12):2147-2165.
  • 7. Hung J, Whitford EG, Parsons RW, Hillman DR. Association of sleep apnoea with myocardial infarction in men. Lancet 1990;336(8710):261- 264.
  • 8. Partinen M, Guilleminault C. Daytime sleepiness and vascular morbidity at seven-year follow-up in obstructive sleep apnea patients. Chest 1990;97(1):27-32.
  • 9. Smirne S, Palazzi S, Zucconi M, Chierchia S, Ferini-Strambi L. Habitual snoring as a risk factor for acute vascular disease. Eur Respir J 1993;6(9):1357-1361.
  • 10. Ulfberg J, Carter N, Edling C. Sleep-disordered breathing and occupational accidents. Scand J Work Environ Health 2000;26(3):237-242.
  • 11. Masa JF, Rubio M, Findley LJ. Habitually sleepy drivers have a high frequency of automobile crashes associated with respiratory disorders during sleep. Am J Respir Crit Care Med 2000;162(4):1407-1412.
  • 12. Hoekema A, Hovinga B, Stegenga B, De Bont LGM. Craniofacial morphology and obstructive sleep apnoea: a cephalometric analysis. J Oral Rehabil 2003;30(7):690-696.
  • 13. Cistulli PA. Craniofacial abnormalities in obstructive sleep apnea: implications for treatment. Respirology 1996;1(3):167-174.
  • 14. Johal A, Patel SI, Battagel JM. The relationship between craniofacial anatomy and obstructive sleep apnoea: a case-controlled study. J Sleep Res 2007;16(3):319-326.
  • 15. Battagel JM, L'Estrange PR. The cephalometric morphology of patients with obstructive sleep apnoea. Eur J Ortho d 1996;18(6):557–569.
  • 16. de Berry-Borowiecki B, Kukwa A, Blanks RH, Irvine CA. Cephalometric analysis for diagnosis and treatment of obstructive sleep apnea. Laryngoscope 1988;98(2):226–234.
  • 17. Hochban W, Brandenburg U. Morphology of the viscerocranium in obstructive sleep apnea syndrome: cephalometric evaluation of 400 patients. J Craniomaxillofac Surg 1994;22(4):205–213.
  • 18. Davies RJ, Stradling JR. The relationship between neck circumference, radiographic pharyngeal anatomy and the obstructive sleep apnoea syndrome. Eur Respir J 1990;3(5):509–514.
  • 19. Tallgren A, Solow B. Head posture and craniofacial morphology. Am J Phys Anthropol 1976;44(3):417–436.
  • 20. Lyberg T, Krogstad O, Djupesland G. Cephalometric analysis in patients with obstructive sleep apnoea syndrome. Part II. Soft tissues. J Laryngol Otol 1989;103(3):293–297.
  • 21. Pracharktam N, Hans MG, Strohl KP, Redline S. Upright and supine cephalometric evaluation of obstructive sleep apnea syndrome and snoring subjects. Angle Orthod 1994;64(1):63–72.
  • 22. Yücel A, Ünlü M, Haktanır A, Acar M, Fidan F. Evaluation of the upper airway cross-sectional area changes in different degrees of severity of obstructive sleep apnea syndrome: cephalometric and dynamic CT study. AJNR Am J Neuroradiol 2005;26(10):2624-2629.
  • 23. Hou HM, Hägg U, Sam K, Rabie AB, Wong RW, Lam B, Ip MS. Dentofacial characteristics of Chinese obstructive sleep apnea patients in relation to obesity and severity. Angle Orthod 2006;76(6):962-969.
  • 24. Verin E, Tardif C, Buffet X, Marie JP, Lacoume Y, AndrieuGuitrancourt J, Pasquis P. Comparison between anatomy and resistance of upper airway in normal subjects, snorers and OSAS patients. Respir Physiol 2002;129(3):335-343.
  • 25. Johal A, Conaghan C. Maxillary morphology in obstructive sleep apnea: A cephalometric and model study. Angle Orthod 2004;74(5):648- 56.
  • 26. Salles C, Campos PS, de Andrade NA, Daltro C. Obstructive sleep apnea and hypopnea syndrome: cephalometric analysis. Braz J Otorhinolaryngol 2005;71(3):369- 372.
  • 27. Iber C, Ancoli-Israel S, Chesson AL, Quan SF. The AASM manual for the scoring of sleep and associated events: rules, terminology, and technical specifications (1st ed.), American Academy of Sleep Medicine, Westchester, IL (2007).
  • 28. Houston WJ. The analysis of errors in orthodontic measurement. Am J Orthod 1983;83(5):382-390.
  • 29. Young T. The occurence of sleepdisordered breathing among middleaged adults. N Engl J Med 1993;328(17):1230-1235.
  • 30. Quintana-Gallego E,Carmon-Bernal C, Capote F, Sánchez-Armengol A, Botebol-Benhamou G, Polo-Padillo J, Castillo-Gómez J. Gender differences in obstructive sleep apnea syndrome: a clinical study of 1166 patients. Respir Med 2004;98(10):984-989.
  • 31. Ryan CM, Bradley TD. Pathogenesis of obstructive sleep apnea. J Appl Physiol 2005;99(6):2440-2450.
  • 32. Sakakibara H, Tong M, Matsushita K, Hirata M, Konishi Y, Suetsugu S. Cephalometric abnormalities in nonobese and obese patients with obstructive sleep apnea. Eur Respir J 1999;13(2):403-410.
  • 33. Yu X, Fujimoto K, Urushibata K, Matsuzawa Y, Kubo K. Cephalometric analysis in obese and nonobese patients with obstructive sleep apnea syndrome. Chest 2003;124(1):212-218.
  • 34. Ferguson KA, Ono T, Lowe AA, Ryan CF, Fleetham JA. The relationship between obesity and craniofacial structure in obstructive sleep apnea. Chest 1995; 108(2):375- 381.
  • 35. Lowe AA, Fleetham JA, Adachi S, Ryan CF. Cephalometric and computed tomographic predictors of obstructive sleep apnea severity. Am J Orthod Dentofacial Orthop 1995;107(6):589-595.
  • 36. Hui DS, Ko FW, Chu AS, Chan MC, Li TS, Choy DK, Lai CK, Ahuja A, Ching AS. Cephalometric assessment of craniofacial morphology in Chinese patients with obstructive sleep apnoea. Respir Med 2003;97(6):640-646.
  • 37. Jamieson A, Guilleminault C, Partinen M, Quera-Salva MA. Obstructive sleep apneic patients have craniomandibular abnormalities. Sleep 1986; 9(4):469- 477.
  • 38. Tsuchiya M, Lowe AA, Pae EK, Fleetham JA. Obstructive sleep apnea subtypes by cluster analysis. Am J Orthod Dentofacial Orthop 1992;101(6):533-542.
  • 39. Tangugsorn V, Skatvedt O, Krogstad O, Lyberg T. Obstructive sleep apnoea: a cephalometric study. Part I. Cervico-craniofacial skeletal morphology. Eur J Orthod 1995;17(1):45-56.
  • 40. Miles PG, Vig PS, Weyant RJ, Forrest TD, Rockette HE Jr. Craniofacial structure and obstructive sleep apnea syndrome--a qualitative analysis and meta-analysis of the literature. Am J Orthod Dentofacial Orthop 1996;109(2):163-172

Obstrüktif uyku apneli ve horlayan erişkin erkek hastaların dentofasiyal özelliklerinin değerlendirilmesi

Yıl 2011, Cilt: 14 Sayı: 3, 155 - 163, 23.09.2011

Banu Saglam Aydinatay , Tulin Taner Cenk Akcan Erdinc Baharoglu , Ahmet Demir , Omer Yucel Oguz Ogretmenoglu Metin Onerci Ahmet Sahin

Öz

Amaç: Bu çalışmanın amacı obstrüktif uyku apne sendromu (OUAS) olan erişkin erkek hastaların kraniofasiyal morfolojik özellikleri değerlendirmektir. Gereç ve Yöntem: Çalışmada 80 erkek hastanın (60 sefalogramları değerlendirildi. Bireyler Grup 1: horlama (AHİ5); Grup 2: hafif OUAS (5AHİ15); Grup 3: orta OUAS(15 AHİ30) ; Grup 4: şiddetli OUAS (AHİ30) olarak değerlendirildi. Sefalogramlar üzerinde hyoid, dil kökü ve yumuşak damak konumu, kranioservikal postür ve havayolu genişliğini belirleyen ölçümler yapıldı. Gruplar arasındaki farklar normal dağılım gösteren değişkenlerde tek yönlü varyans analizi ve Duncan testiyle, normal dağılım göstermeyen değişkenlerde Kruskal düzeltmesi uygulanarak Mann Whitney U testiyle yapıldı

Anahtar Kelimeler

Obstrüktif uyku apnesi sendromu horlama sefalometri kraniofasiyal

Kaynakça

  • 1. Guilleminault C, Connolly SJ, Winkle RA. Cardiac arrhythmia and conduction disturbances during sleep in 400 patients with sleep apnea syndrome. Am J Cardiol 1983;52(5):490-494.
  • 2. Hoffstein V, Mateika S. Cardiac arrhythmias, snoring, and sleep apnea. Chest 1994;106(2):466-471.
  • 3. Hoffstein V, Mateika J. Evening-tomorning blood pressure variations in snoring patients with and without obstructive sleep apnea. Chest 1992;101(2):379-384.
  • 4. Peppard PE, Young T, Palta M, Skatrud J. Prospective study of the association between sleep-disordered breathing and hypertension. N Engl J Med 2000;342(19):1378-1384.
  • 5. Nieto FJ, Young TB, Lind BK, Shahar E, Samet JM, Redline S, et al. Association of sleep-disordered breathing, sleep apnea, and hypertension in a large communitybased study. Sleep Heart Health Study. Jama 2000;283(14):1829- 1836.
  • 6. Leung RS, Bradley TD. Sleep apnea and cardiovascular disease. Am J Respir Crit Care Med 2001;164(12):2147-2165.
  • 7. Hung J, Whitford EG, Parsons RW, Hillman DR. Association of sleep apnoea with myocardial infarction in men. Lancet 1990;336(8710):261- 264.
  • 8. Partinen M, Guilleminault C. Daytime sleepiness and vascular morbidity at seven-year follow-up in obstructive sleep apnea patients. Chest 1990;97(1):27-32.
  • 9. Smirne S, Palazzi S, Zucconi M, Chierchia S, Ferini-Strambi L. Habitual snoring as a risk factor for acute vascular disease. Eur Respir J 1993;6(9):1357-1361.
  • 10. Ulfberg J, Carter N, Edling C. Sleep-disordered breathing and occupational accidents. Scand J Work Environ Health 2000;26(3):237-242.
  • 11. Masa JF, Rubio M, Findley LJ. Habitually sleepy drivers have a high frequency of automobile crashes associated with respiratory disorders during sleep. Am J Respir Crit Care Med 2000;162(4):1407-1412.
  • 12. Hoekema A, Hovinga B, Stegenga B, De Bont LGM. Craniofacial morphology and obstructive sleep apnoea: a cephalometric analysis. J Oral Rehabil 2003;30(7):690-696.
  • 13. Cistulli PA. Craniofacial abnormalities in obstructive sleep apnea: implications for treatment. Respirology 1996;1(3):167-174.
  • 14. Johal A, Patel SI, Battagel JM. The relationship between craniofacial anatomy and obstructive sleep apnoea: a case-controlled study. J Sleep Res 2007;16(3):319-326.
  • 15. Battagel JM, L'Estrange PR. The cephalometric morphology of patients with obstructive sleep apnoea. Eur J Ortho d 1996;18(6):557–569.
  • 16. de Berry-Borowiecki B, Kukwa A, Blanks RH, Irvine CA. Cephalometric analysis for diagnosis and treatment of obstructive sleep apnea. Laryngoscope 1988;98(2):226–234.
  • 17. Hochban W, Brandenburg U. Morphology of the viscerocranium in obstructive sleep apnea syndrome: cephalometric evaluation of 400 patients. J Craniomaxillofac Surg 1994;22(4):205–213.
  • 18. Davies RJ, Stradling JR. The relationship between neck circumference, radiographic pharyngeal anatomy and the obstructive sleep apnoea syndrome. Eur Respir J 1990;3(5):509–514.
  • 19. Tallgren A, Solow B. Head posture and craniofacial morphology. Am J Phys Anthropol 1976;44(3):417–436.
  • 20. Lyberg T, Krogstad O, Djupesland G. Cephalometric analysis in patients with obstructive sleep apnoea syndrome. Part II. Soft tissues. J Laryngol Otol 1989;103(3):293–297.
  • 21. Pracharktam N, Hans MG, Strohl KP, Redline S. Upright and supine cephalometric evaluation of obstructive sleep apnea syndrome and snoring subjects. Angle Orthod 1994;64(1):63–72.
  • 22. Yücel A, Ünlü M, Haktanır A, Acar M, Fidan F. Evaluation of the upper airway cross-sectional area changes in different degrees of severity of obstructive sleep apnea syndrome: cephalometric and dynamic CT study. AJNR Am J Neuroradiol 2005;26(10):2624-2629.
  • 23. Hou HM, Hägg U, Sam K, Rabie AB, Wong RW, Lam B, Ip MS. Dentofacial characteristics of Chinese obstructive sleep apnea patients in relation to obesity and severity. Angle Orthod 2006;76(6):962-969.
  • 24. Verin E, Tardif C, Buffet X, Marie JP, Lacoume Y, AndrieuGuitrancourt J, Pasquis P. Comparison between anatomy and resistance of upper airway in normal subjects, snorers and OSAS patients. Respir Physiol 2002;129(3):335-343.
  • 25. Johal A, Conaghan C. Maxillary morphology in obstructive sleep apnea: A cephalometric and model study. Angle Orthod 2004;74(5):648- 56.
  • 26. Salles C, Campos PS, de Andrade NA, Daltro C. Obstructive sleep apnea and hypopnea syndrome: cephalometric analysis. Braz J Otorhinolaryngol 2005;71(3):369- 372.
  • 27. Iber C, Ancoli-Israel S, Chesson AL, Quan SF. The AASM manual for the scoring of sleep and associated events: rules, terminology, and technical specifications (1st ed.), American Academy of Sleep Medicine, Westchester, IL (2007).
  • 28. Houston WJ. The analysis of errors in orthodontic measurement. Am J Orthod 1983;83(5):382-390.
  • 29. Young T. The occurence of sleepdisordered breathing among middleaged adults. N Engl J Med 1993;328(17):1230-1235.
  • 30. Quintana-Gallego E,Carmon-Bernal C, Capote F, Sánchez-Armengol A, Botebol-Benhamou G, Polo-Padillo J, Castillo-Gómez J. Gender differences in obstructive sleep apnea syndrome: a clinical study of 1166 patients. Respir Med 2004;98(10):984-989.
  • 31. Ryan CM, Bradley TD. Pathogenesis of obstructive sleep apnea. J Appl Physiol 2005;99(6):2440-2450.
  • 32. Sakakibara H, Tong M, Matsushita K, Hirata M, Konishi Y, Suetsugu S. Cephalometric abnormalities in nonobese and obese patients with obstructive sleep apnea. Eur Respir J 1999;13(2):403-410.
  • 33. Yu X, Fujimoto K, Urushibata K, Matsuzawa Y, Kubo K. Cephalometric analysis in obese and nonobese patients with obstructive sleep apnea syndrome. Chest 2003;124(1):212-218.
  • 34. Ferguson KA, Ono T, Lowe AA, Ryan CF, Fleetham JA. The relationship between obesity and craniofacial structure in obstructive sleep apnea. Chest 1995; 108(2):375- 381.
  • 35. Lowe AA, Fleetham JA, Adachi S, Ryan CF. Cephalometric and computed tomographic predictors of obstructive sleep apnea severity. Am J Orthod Dentofacial Orthop 1995;107(6):589-595.
  • 36. Hui DS, Ko FW, Chu AS, Chan MC, Li TS, Choy DK, Lai CK, Ahuja A, Ching AS. Cephalometric assessment of craniofacial morphology in Chinese patients with obstructive sleep apnoea. Respir Med 2003;97(6):640-646.
  • 37. Jamieson A, Guilleminault C, Partinen M, Quera-Salva MA. Obstructive sleep apneic patients have craniomandibular abnormalities. Sleep 1986; 9(4):469- 477.
  • 38. Tsuchiya M, Lowe AA, Pae EK, Fleetham JA. Obstructive sleep apnea subtypes by cluster analysis. Am J Orthod Dentofacial Orthop 1992;101(6):533-542.
  • 39. Tangugsorn V, Skatvedt O, Krogstad O, Lyberg T. Obstructive sleep apnoea: a cephalometric study. Part I. Cervico-craniofacial skeletal morphology. Eur J Orthod 1995;17(1):45-56.
  • 40. Miles PG, Vig PS, Weyant RJ, Forrest TD, Rockette HE Jr. Craniofacial structure and obstructive sleep apnea syndrome--a qualitative analysis and meta-analysis of the literature. Am J Orthod Dentofacial Orthop 1996;109(2):163-172
Toplam 40 adet kaynakça vardır.

Ayrıntılar

Birincil Dil Türkçe
Bölüm Original Research Articles
Yazarlar

Banu Saglam Aydinatay

Tulin Taner

Cenk Akcan

Erdinc Baharoglu

Ahmet Demir

Omer Yucel

Oguz Ogretmenoglu

Metin Onerci

Ahmet Sahin

Yayımlanma Tarihi 23 Eylül 2011
Gönderilme Tarihi 20 Aralık 2010
Yayımlandığı Sayı Yıl 2011Cilt: 14 Sayı: 3

Kaynak Göster

EndNote Saglam Aydinatay B, Taner T, Akcan C, Baharoglu E, Demir A, Yucel O, Ogretmenoglu O, Onerci M, Sahin A (01 Eylül 2011) Obstrüktif uyku apneli ve horlayan erişkin erkek hastaların dentofasiyal özelliklerinin değerlendirilmesi. Cumhuriyet Dental Journal 14 3 155–163.

Cumhuriyet Dental Journal (Cumhuriyet Dent J, CDJ) is the official publication of Cumhuriyet University Faculty of Dentistry. CDJ is an international journal dedicated to the latest advancement of dentistry. The aim of this journal is to provide a platform for scientists and academicians all over the world to promote, share, and discuss various new issues and developments in different areas of dentistry. First issue of the Journal of Cumhuriyet University Faculty of Dentistry was published in 1998. In 2010, journal's name was changed as Cumhuriyet Dental Journal. Journal’s publication language is English.


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