Prediction of uvulopalatopharyngoplasty response using cephalometric radiographs.
OBJECTIVE
To evaluate the relationship between facial cephalometric measures and response to uvulopalatopharyngoplasty (UPPP).


METHODS
Retrospective analysis of skeletal cephalometric measures obtained from a consecutive sample of 43 patients with obstructive sleep apnea syndrome (OSAS) who underwent body mass index (BMI) measures, UPPP, upright lateral cephalometric radiographs, and preoperative and postoperative polysomnography. Significant clinical effect by uvulopalatopharyngoplasty was arbitrarily defined as having a 50% reduction in the respiratory disturbance index (RDI). The cephalometric measurements used were based solely on skeletal landmarks.


RESULTS
No skeletal measurement predicted response to UPPP for the entire study population. When the patients were classified on the basis of retrognathia, 33 were identified without retrognathia. In that group, posterior airway length was the greatest predictor of response to UPPP (P < or = .05; odds ratio, 83.2). The distance between hyoid and mandible and the maxillary-mandibular relationship were also predictive of response (P < or = .05).


CONCLUSIONS
The skeletal anatomy supporting the airway directly impacts the response to UPPP. Prediction of response requires stratification by skeletal subtype.
Woodson
B T
BT
Department of Otolaryngology and Human Communication, Medical College of Wisconsin, Milwaukee, USA.
Conley
S F
SF
D015992:Body Mass Index; D002508:Cephalometry; D006801:Humans; D010159:Palate / Q000601:surgery*; D010614:Pharynx / Q000601:surgery*; D017286:Polysomnography; D011184:Postoperative Period; D011859:Radiography; D012119:Respiration; D012189:Retrospective Studies; D012886:Skull / Q000000981:diagnostic imaging*; D012891:Sleep Apnea Syndromes / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome; D014609:Uvula / Q000601:surgery*