Craniofacial profile in Asian and white subjects with obstructive sleep apnoea.
BACKGROUND
Clinical detection of structural narrowing of the upper airway may facilitate early recognition of obstructive sleep apnoea (OSA). To determine whether the craniofacial profile predicts the presence of OSA, the upper airway and craniofacial structure of 239 consecutive patients (164 Asian and 75 white subjects) referred to two sleep centres (Hong Kong and Vancouver) were prospectively examined for suspected sleep disordered breathing.


METHODS
All subjects underwent a history and physical examination with measurements of anthropometric parameters and craniofacial structure including neck circumference, thyromental distance, thyromental angle, and Mallampati oropharyngeal score. OSA was defined as an apnoea-hypopnoea index (AHI) of > or = 5/hour on full overnight polysomnography.


RESULTS
Discriminant function analysis indicated that the Mallampati score (F = 0.70), thyromental angle (F = 0.60), neck circumference (F = 0.54), body mass index (F = 0.53), and age (F = 0.53) were the best predictors of OSA. After controlling for ethnicity, body mass index and neck circumference, patients with OSA were older, had larger thyromental angles, and higher Mallampati scores than non-apnoeic subjects. These variables remained significantly different between OSA patients and controls across a range of cut-off values of AHI from 5 to 30/hour.


CONCLUSIONS
A crowded posterior oropharynx and a steep thyromental plane predict OSA across two different ethnic groups and varying degrees of obesity.
Lam
B
B
University of Hong Kong, Hong Kong SAR, China.
Ip
M S M
MS
Tench
E
E
Ryan
C F
CF
D000704:Analysis of Variance; D044466:Asian People / Q000208:ethnology*; D001955:British Columbia / Q000208:ethnology; D002508:Cephalometry / Q000592:standards; D003395:Craniology; D005145:Face / Q000473:pathology*; D005260:Female; D006723:Hong Kong / Q000208:ethnology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009960:Oropharynx; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D012886:Skull / Q000473:pathology*; D020181:Sleep Apnea, Obstructive / Q000208:ethnology / Q000473:pathology*; D044465:White People / Q000208:ethnology*