The prevalence of calcified carotid artery atheromas in patients with obstructive sleep apnea syndrome.
OBJECTIVE
Persons with obstructive sleep apnea syndrome (OSAS) suffer cerebrovascular accidents at three to six times the rate of other Americans. Atherosclerosis of the cervical portion of the carotid artery has been suggested as a possible cause of these strokes. Lateral cephalometric radiographs used to determine the site of upper airway obstruction in sleep apnea patients can also image calcified cervical carotid artery atheromas. However, their prevalence in this group of patients has not been previously reported.


METHODS
The radiographs of 47 male subjects (mean age 59.2 years, range 45 to 77 years) diagnosed as having OSAS (apnea/hypopnea index [AHI] of > or = 15 and a history of snoring and excessive daytime sleepiness) were assessed for calcified carotid atheromas. Healthy, age-matched (+/-18 months) controls were likewise assessed.


RESULTS
The radiographs of the subjects with OSAS showed that 21.3% had calcified atheromas. The radiographs of the controls showed that only 2.5% had calcified atheromas. This finding was statistically significant (P = < .000001). The lesions seen in both populations were similar, and located within the soft tissues of the neck at the level of C3 and C4. The lesions were superimposed over these tissues, the prevertebral fascia, and the pharyngeal airspace.


CONCLUSIONS
The results of this study seem to indicate that persons with OSAS have a greater prevalence of calcified carotid artery atheromas than healthy, age-matched persons. These lesions, a possible cause of future stroke, can be detected on lateral cephalometric radiographs.
Friedlander
A H
AH
Dental Service, Veterans Affairs Southern California System of Clinics, Sepulveda, CA 91343, USA.
Yueh
R
R
Littner
M R
MR
D000368:Aged; D000402:Airway Obstruction / Q000150:complications / Q000000981:diagnostic imaging; D001161:Arteriosclerosis / Q000150:complications* / Q000000981:diagnostic imaging; D002114:Calcinosis / Q000150:complications* / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000150:complications* / Q000000981:diagnostic imaging; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D002343:Carotid Artery, Internal / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D002508:Cephalometry; D002561:Cerebrovascular Disorders / Q000209:etiology; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging; D005205:Fascia / Q000000981:diagnostic imaging; D006801:Humans; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000098:blood supply; D010614:Pharynx / Q000000981:diagnostic imaging; D017286:Polysomnography; D015995:Prevalence; D011859:Radiography; D012891:Sleep Apnea Syndromes / Q000150:complications* / Q000000981:diagnostic imaging; D012894:Sleep Stages; D012913:Snoring / Q000150:complications / Q000000981:diagnostic imaging