title: Obstructive sleep apnea syndrome: hooked appearance of the soft palate in awake patients--cephalometric and CT findings.
abstract: OBJECTIVE
  To determine whether a hooked appearance of the soft palate can be seen in awake patients with snoring with or without obstructive sleep apnea syndrome (OSAS) on cephalometric radiographs and computed tomographic (CT) scans.
  
  
  METHODS
  One hundred thirty-one patients with snoring underwent cephalometric radiography, with which the posterior airway space, soft palate length and width, and distance between the hyoid bone and mandibular plane were measured, and/or pharyngeal CT, with which the luminal areas of the airway at the naso-, oro-, and hypopharyngeal levels were measured.
  
  
  RESULTS
  Of the 131 patients, 96 had OSAS, and 35 had snoring. Nine of 96 patients with OSAS had soft palate hooking on awake pharyngeal CT or cephalometric images. No patient with snoring alone had hooking. Patients with hooking had a larger posterior airway space than did patients with OSAS without hooking (P = .05), and an enlarged (> or = 15-mm) posterior airway space was more frequent in patients with hooking (eight of nine patients) than in those without hooking (34 of 87) (P < .01). Oropharyngeal and hypopharyngeal areas were significantly larger in patients with hooking than in patients without hooking or in patients with snoring (P < or = .04).
  
  
  CONCLUSIONS
  Cephalometric radiography and CT can demonstrate hooking of the soft palate in awake patients. This finding indicates a high risk for OSAS.
authors.affiliation: Department of Respiratory Medicine, Centre Hôpitalier Universitaire de Grenoble, France.
authors.forename: J L
authors.initials: JL
authors.lastname: Pépin
authors.forename: D
authors.initials: D
authors.lastname: Veale
authors.forename: G R
authors.initials: GR
authors.lastname: Ferretti
authors.forename: P
authors.initials: P
authors.lastname: Mayer
authors.forename: P A
authors.initials: PA
authors.lastname: Lévy
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002508:Cephalometry; D006801:Humans; D008297:Male; D008875:Middle Aged; D010160:Palate, Soft / Q000000981:diagnostic imaging* / Q000473:pathology; D010614:Pharynx / Q000000981:diagnostic imaging / Q000473:pathology; D012891:Sleep Apnea Syndromes / Q000000981:diagnostic imaging* / Q000473:pathology; D014057:Tomography, X-Ray Computed