Facial phenotyping by quantitative photography reflects craniofacial morphology measured on magnetic resonance imaging in Icelandic sleep apnea patients.
OBJECTIVE
(1) To determine whether facial phenotype, measured by quantitative photography, relates to underlying craniofacial obstructive sleep apnea (OSA) risk factors, measured with magnetic resonance imaging (MRI); (2) To assess whether these associations are independent of body size and obesity.


METHODS
Cross-sectional cohort.


METHODS
Landspitali, The National University Hospital, Iceland.


METHODS
One hundred forty patients (87.1% male) from the Icelandic Sleep Apnea Cohort who had both calibrated frontal and profile craniofacial photographs and upper airway MRI. Mean ± standard deviation age 56.1 ± 10.4 y, body mass index 33.5 ± 5.05 kg/m(2), with on-average severe OSA (apnea-hypopnea index 45.4 ± 19.7 h(-1)).


METHODS
N/A.


RESULTS
Relationships between surface facial dimensions (photos) and facial bony dimensions and upper airway soft-tissue volumes (MRI) was assessed using canonical correlation analysis. Photo and MRI craniofacial datasets related in four significant canonical correlations, primarily driven by measurements of (1) maxillary-mandibular relationship (r = 0.8, P < 0.0001), (2) lower face height (r = 0.76, P < 0.0001), (3) mandibular length (r = 0.67, P < 0.0001), and (4) tongue volume (r = 0.52, P = 0.01). Correlations 1, 2, and 3 were unchanged when controlled for weight and neck and waist circumference. However, tongue volume was no longer significant, suggesting facial dimensions relate to tongue volume as a result of obesity.


CONCLUSIONS
Significant associations were found between craniofacial variable sets from facial photography and MRI. This study confirms that facial photographic phenotype reflects underlying aspects of craniofacial skeletal abnormalities associated with OSA. Therefore, facial photographic phenotyping may be a useful tool to assess intermediate phenotypes for OSA, particularly in large-scale studies.
Center for Sleep Health and Research, Department of Respiratory Medicine, Royal North Shore Hospital, Sydney, Australia ; NHMRC Centre for Integrated Research and Understanding of Sleep (CIRUS), The University of Sydney, Sydney, Australia.
Kate
K
Sutherland
Center for Sleep and Circadian Neurobiology, University of Pennsylvania School of Medicine, Philadelphia, PA ; Division of Sleep Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Richard J
RJ
Schwab
Division of Sleep Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Greg
G
Maislin
Center for Sleep Health and Research, Department of Respiratory Medicine, Royal North Shore Hospital, Sydney, Australia ; Department of Respiratory Medicine, Gosford Hospital, Gosford, Australia ; School of Medicine and Public Health, University of Newcastle, Newcastle, Australia.
Richard W W
RW
Lee
Faculty of Medicine, University of Iceland, Reykjavik, Iceland ; Department of Respiratory Medicine and Sleep, Landspitali University Hospital Fossvogi, Reykjavik, Iceland.
Bryndis
B
Benedikstdsottir
Center for Sleep and Circadian Neurobiology, University of Pennsylvania School of Medicine, Philadelphia, PA ; Division of Sleep Medicine, Department of Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA.
Allan I
AI
Pack
Faculty of Medicine, University of Iceland, Reykjavik, Iceland ; Department of Respiratory Medicine and Sleep, Landspitali University Hospital Fossvogi, Reykjavik, Iceland.
Thorarinn
T
Gislason
Department of Otolaryngology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland.
Sigurdur
S
Juliusson
Center for Sleep Health and Research, Department of Respiratory Medicine, Royal North Shore Hospital, Sydney, Australia ; NHMRC Centre for Integrated Research and Understanding of Sleep (CIRUS), The University of Sydney, Sydney, Australia.
Peter A
PA
Cistulli
D015992:Body Mass Index; D049628:Body Size; D001835:Body Weight; D019465:Craniofacial Abnormalities / Q000150:complications* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005145:Face / Q000033:anatomy & histology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007055:Iceland; D008279:Magnetic Resonance Imaging; D008297:Male; D008334:Mandible / Q000033:anatomy & histology / Q000503:physiopathology; D008875:Middle Aged; D009333:Neck / Q000033:anatomy & histology / Q000503:physiopathology; D009765:Obesity / Q000150:complications / Q000503:physiopathology; D010641:Phenotype; D010781:Photography; D012137:Respiratory System / Q000033:anatomy & histology / Q000503:physiopathology; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000503:physiopathology*; D014059:Tongue / Q000033:anatomy & histology / Q000503:physiopathology
craniofacial morphology; obstructive sleep apnea; phenotyping