title: Cephalometric predictors of therapeutic response to multilevel surgery in patients with obstructive sleep apnea.
abstract: OBJECTIVE
  The present study investigated whether cephalometric measurements can predict the therapeutic efficacy of multilevel phase I surgery for patients with obstructive sleep apnea (OSA).
  
  
  METHODS
  Among 210 patients with OSA who underwent multilevel phase I surgery, 85 were recruited on the basis of the baseline polysomnography, body mass index, and lateral cephalogram recordings. The patients were divided into 2 groups according to the degree of change in the apnea-hypopnea index before and 6 months after multilevel surgery: good responders (>50% decrease in apnea-hypopnea index) and poor responders (0% to 50% decrease or increase in apnea-hypopnea index). Cephalometric analysis was performed to identify the relevant variables, with division into 5 compartments: craniofacial, soft palate, tongue, hyoid bone, and upper airway variables.
  
  
  RESULTS
  In the craniofacial compartment, poor responders represented skeletal Class II with a more retrognathic mandible, and a hyperdivergent vertical pattern with a larger mandibular plane angle, longer lower facial height, and steeper occlusal plane than good responders. In the upper airway compartment, poor responders had narrower middle and inferior airway spaces and a longer upper airway length than good responders. No significant differences were found in the soft palate, tongue, and hyoid measurements between the 2 groups.
  
  
  CONCLUSIONS
  Some preoperative cephalometric measurements were verified retrospectively to predict the therapeutic response to the multilevel surgery in patients with OSA. This study would contribute not only to establishing selective criteria for the surgical approach to patients with OSA in ear-nose-throat practice but also in deciding on the referral to orthodontists or maxillofacial surgeons.
authors.affiliation: Department of Orthodontics, Oral Biology Research Institute, Kyung Hee University School of Dentistry, Seoul, Korea.
authors.forename: Su-Jung
authors.initials: SJ
authors.lastname: Kim
authors.forename: Young-Suk
authors.initials: YS
authors.lastname: Kim
authors.forename: Jeong-Ho
authors.initials: JH
authors.lastname: Park
authors.forename: Sung-Wan
authors.initials: SW
authors.lastname: Kim
mesh_terms: D000328:Adult; D000402:Airway Obstruction / Q000601:surgery*; D015992:Body Mass Index; D002508:Cephalometry; D005147:Facial Bones / Q000002:abnormalities; D006801:Humans; D006928:Hyoid Bone / Q000033:anatomy & histology; D008312:Malocclusion, Angle Class II / Q000473:pathology; D008334:Mandible / Q000002:abnormalities; D008875:Middle Aged; D009666:Nose / Q000033:anatomy & histology; D021362:Palate, Hard / Q000601:surgery; D010160:Palate, Soft / Q000033:anatomy & histology / Q000601:surgery; D018579:Patient Selection; D010614:Pharynx / Q000473:pathology / Q000601:surgery; D017286:Polysomnography; D011237:Predictive Value of Tests; D012044:Regression Analysis; D063173:Retrognathia; D012189:Retrospective Studies; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000601:surgery*; D014059:Tongue / Q000033:anatomy & histology; D016896:Treatment Outcome; D014716:Vertical Dimension