title: Craniofacial phenotyping in obstructive sleep apnea--a novel quantitative photographic approach.
abstract: OBJECTIVE
  To compare the craniofacial morphological phenotype of subjects with and without obstructive sleep apnea (OSA) using a quantitative photographic analysis technique.
  
  
  METHODS
  Case-control study; subgroup matched for body mass index (BMI) and sex.
  
  
  METHODS
  Sleep investigation unit in a university teaching hospital.
  
  
  METHODS
  114 subjects (93% Caucasian) with OSA (apnea-hypopnea index [AHI] > or = 10/h) and 66 controls (AHI < 10/h).
  
  
  METHODS
  Standardized frontal-profile craniofacial photographic imaging performed prior to polysomnography. Photographs were analyzed for the computation of linear, angular, area and polyhedral volume measurements representing dimensions and relationships of the various craniofacial regions.
  
  
  RESULTS
  Photographic craniofacial phenotypic differences were demonstrated between OSA and control subjects, including a range of measurements of the face, mandible, maxilla, eyes, nose, head and neck. After 1-for-1 subgroup matching for BMI and sex (51 subjects in each group), mandibular length 1 (6.21 +/- 0.08 [mean +/- SEM] vs. 6.58 +/- 0.08 cm, P = 0.006), mandibular-nasion angle 1 (35.0 +/- 0.48 vs. 36.7 +/- 0.37 degrees, P = 0.006) and anterior neck space area (10.2 +/- 0.53 vs. 12.2 +/- 0.52 cm2, P = 0.01) remained smaller in the OSA group. Mandibular width-length angle (88.0 +/- 0.75 vs. 85.3 +/- 0.54 degrees, P = 0.005) and face width-midface depth angle (72.3 +/- 0.44 vs. 70.7 +/- 0.39 degrees, P = 0.01) remained larger in the OSA group, whereas mandibular triangular area (39.2 +/- 0.63 vs. 41.7 +/- 0.74 cm2, P = 0.01) was smaller.
  
  
  CONCLUSIONS
  Craniofacial phenotypic differences in OSA in Caucasian subjects can be demonstrated using a photographic analysis technique.
authors.affiliation: Centre for Sleep Health and Research, Department ofRespiratory Medicine, Royal North Shore Hospital, NSW, Australia.
authors.forename: Richard W W
authors.initials: RW
authors.lastname: Lee
authors.forename: Andrew S L
authors.initials: AS
authors.lastname: Chan
authors.forename: Ronald R
authors.initials: RR
authors.lastname: Grunstein
authors.forename: Peter A
authors.initials: PA
authors.lastname: Cistulli
mesh_terms: D000328:Adult; D000368:Aged; D000886:Anthropometry; D015992:Body Mass Index; D002508:Cephalometry / Q000379:methods*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D008297:Male; D008875:Middle Aged; D010641:Phenotype; D010780:Photogrammetry / Q000379:methods*; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*; D049629:Waist-Hip Ratio