title: The relationship between obesity and craniofacial structure in obstructive sleep apnea.
abstract: OBJECTIVE
  To evaluate the interaction between craniofacial structure and obesity in male patients with obstructive sleep apnea (OSA).
  
  
  METHODS
  Retrospective analysis of a cohort of OSA patients. The relationships between neck circumference (NC), body mass index, apnea severity, and craniofacial and upper airway soft-tissue measurements from upright lateral cephalometry were examined. Patients were divided into groups; small to normal NC (group A), intermediate NC (group B), or large NC (group C).
  
  
  METHODS
  A university teaching hospital and tertiary sleep referral center.
  
  
  METHODS
  A consecutive series of patients with OSA who underwent polysomnography and lateral cephalometry.
  
  
  RESULTS
  Group A patients were less obese and had more craniofacial abnormalities such as a smaller mandible and maxilla and a more retrognathic mandible. Group B patients had both upper airway soft-tissue and craniofacial abnormalities. Group C patients were more obese with larger tongues and soft palates, and an inferiorly placed hyoid. Group C patients also had fewer craniofacial abnormalities than group A or B patients. There was no difference in airway size among the three groups.
  
  
  CONCLUSIONS
  We conclude that there is a spectrum of upper airway soft-tissue and craniofacial abnormalities among OSA patients: obese patients with increased upper airway soft-tissue structures, nonobese patients with abnormal craniofacial structure, and an intermediate group of patients with abnormalities in both craniofacial structure and upper airway soft-tissue structures.
authors.affiliation: Division of Respiratory Medicine, University of British Columbia, Vancouver, Canada.
authors.forename: K A
authors.initials: KA
authors.lastname: Ferguson
authors.forename: T
authors.initials: T
authors.lastname: Ono
authors.forename: A A
authors.initials: AA
authors.lastname: Lowe
authors.forename: C F
authors.initials: CF
authors.lastname: Ryan
authors.forename: J A
authors.initials: JA
authors.lastname: Fleetham
mesh_terms: D000328:Adult; D000704:Analysis of Variance; D002508:Cephalometry / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D005147:Facial Bones / Q000002:abnormalities / Q000000981:diagnostic imaging*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000033:anatomy & histology; D009765:Obesity / Q000150:complications*; D017286:Polysomnography / Q000295:instrumentation / Q000379:methods / Q000706:statistics & numerical data; D011859:Radiography; D012189:Retrospective Studies; D012886:Skull / Q000002:abnormalities / Q000000981:diagnostic imaging*; D012891:Sleep Apnea Syndromes / Q000175:diagnosis / Q000209:etiology*