Anatomical balance of the upper airway and obstructive sleep apnea.
BACKGROUND
Obesity and craniofacial abnormalities such as small maxilla and mandible are common features of patients with obstructive sleep apnea (OSA). The authors hypothesized that anatomical imbalance between the upper airway soft-tissue volume and the craniofacial size (rather than each alone) may result in pharyngeal airway obstruction during sleep, and therefore development of OSA.


METHODS
Blind measurements of tongue cross-sectional area and craniofacial dimensions were performed through lateral cephalograms in 50 adult male patients with OSA and 55 adult male non-OSA subjects with various craniofacial dimensions.


RESULTS
Maxillomandibular dimensions were matched between OSA and non-OSA groups. While the tongue was significantly larger in subjects with larger maxillomandible dimensions, OSA patients had a significantly larger tongue for a given maxillomandible size than non-OSA subjects. The hypothesis was also supported in subgroups matched for both body mass index and maxillomandible dimensions.


CONCLUSIONS
Upper airway anatomical imbalance is involved in the pathogenesis of OSA.
Tsuiki
Satoru
S
Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan.
Isono
Shiroh
S
Ishikawa
Teruhiko
T
Yamashiro
Yoshihiro
Y
Tatsumi
Koichiro
K
Nishino
Takashi
T
D000328:Adult; D000368:Aged; D001837:Body Weights and Measures / Q000379:methods*; D005147:Facial Bones / Q000033:anatomy & histology*; D006801:Humans; D007830:Larynx / Q000033:anatomy & histology*; D008297:Male; D008488:Medical Illustration; D008875:Middle Aged; D010614:Pharynx / Q000033:anatomy & histology*; D017286:Polysomnography; D012016:Reference Values; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000209:etiology*; D014059:Tongue / Q000033:anatomy & histology*