title: Relationship between craniofacial abnormalities and sleep-disordered breathing in Marfan's syndrome.
abstract: OBJECTIVE
  To examine the prevalence and nature of craniofacial abnormalities in patients with Marfan's syndrome and to investigate the relationship between craniofacial abnormalities and obstructive sleep apnea (OSA) severity in these patients.
  
  
  METHODS
  Cross-sectional.
  
  
  METHODS
  Marfan's syndrome clinic in a tertiary teaching hospital.
  
  
  METHODS
  Fifteen consecutive adult patients (7 men and 8 women; mean [+/- SD] age, 34.8 +/- 13.2 years) who had Marfan's syndrome.
  
  
  RESULTS
  Apneic status was determined from standard overnight polysomnography testing. Measurements from standardized lateral cephalometric radiographs were compared to normative data. Thirteen patients had OSA, which was defined as an apnea/hypopnea index (AHI) of > 5 episodes per hour (mean AHI, 22 +/- 15 episodes per hour). A high prevalence of craniofacial abnormalities was found with significant gender differences for some of the variables. Significant abnormalities for the entire group were bimaxillary retrusion, a reduced maxillary length, an increased total anterior face height, a long lower anterior face height, an obtuse gonial angle, a steep mandibular plane, a reduced posterior nasal airway height, a reduced posterior airway space, and an increased distance from the mandibular plane to the hyoid bone. Univariate analysis revealed significant correlations among the total anterior face height, the upper anterior and posterior face heights, the mandibular length, and AHI. There was a significant correlation between the rank of the number of cephalometric abnormalities per patient and AHI in those patients with OSA.
  
  
  CONCLUSIONS
  Craniofacial abnormalities are common in patients with Marfan's syndrome. The relationship between some cephalometric parameters and apnea severity suggests a potential role of craniofacial structure in the pathogenesis of OSA in these patients.
authors.affiliation: Sleep Disorders Center, Department of Respiratory Medicine, St George Hospital, University of New South Wales, Sydney, Australia. p.cistulli@unsw.edu.au
authors.forename: P A
authors.initials: PA
authors.lastname: Cistulli
authors.forename: H
authors.initials: H
authors.lastname: Gotsopoulos
authors.forename: C E
authors.initials: CE
authors.lastname: Sullivan
mesh_terms: D000328:Adult; D002508:Cephalometry; D019465:Craniofacial Abnormalities / Q000150:complications* / Q000000981:diagnostic imaging; D003430:Cross-Sectional Studies; D005147:Facial Bones / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008297:Male; D008382:Marfan Syndrome / Q000150:complications* / Q000000981:diagnostic imaging; D017286:Polysomnography; D011859:Radiography; D012886:Skull / Q000000981:diagnostic imaging; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000209:etiology*