[Changes of upper airway morphology induced by mandibular advancement in patients with obstructive sleep apnea syndrome].
OBJECTIVE
To determine the changes of upper airway morphology induced by mandible position from central relation to advancement position in patients with obstructive sleep apnea syndrome.


METHODS
Nineteen patients (17 males and 2 females) suffering from obstructive sleep apnea syndrome were confirmed with polysomnography. Occlusal wax record was made with mandible in advancement position. Helical computed tomography was performed on each patient in central relation and mandibular advancement position with wax record in situ respectively. On each slice, anteroposterior and transverse diameters were obtained. Airway shape was expressed as the anteroposterior/transverse (AP/T) diameter ratio. Paired-samples t test was employed to compare the measurements.


RESULTS
With mandibular advancement, average and minimal diameters of glossopharynx and hypopharynx were increased significantly. Compared with it, the change of transverse diameter was more prominent. All segments of upper airway were increased significantly except hypopharynx laterally. Moreover, the change of velopharynx shape was observed on axial planes. Ellipse with transversal long axis became more compressed.


CONCLUSIONS
Upper airway morphology of all segments was influenced by mandibular advancement whether in the sagittal or transverse plane of space, or airway shape. Not only anatomic connection but also regulation of the nerve system and other still unknown mechanism make contribution to the changes of upper airway morphology in patients with obstructive sleep apnea syndrome. The changes of upper airway morphology above mentioned constitute the rationale of treatment of obstructive sleep apnea syndrome with oral appliances.
Jia
Peizeng
P
Department of Orthodontics, Peking University School of Stomatology, Beijing 100081, China. jiapeiz@sina.com
Fu
Minkui
M
Zeng
Xianglong
X
D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D019186:Mandibular Advancement; D008875:Middle Aged; D009971:Orthodontics, Corrective; D010614:Pharynx / Q000473:pathology*; D020181:Sleep Apnea, Obstructive / Q000473:pathology / Q000628:therapy*; D036542:Tomography, Spiral Computed