title: Static craniofacial measurements and dynamic airway collapse patterns associated with severe obstructive sleep apnoea: a sleep MRI study.
abstract: OBJECTIVE
  Using sleep MRI, we aimed to identify static craniofacial measurements and dynamic upper airway collapse patterns associated with severe obstructive sleep apnoea (OSA) during natural sleep in age and BMI-matched patients.
  
  
  METHODS
  Nested case-control study.
  
  
  METHODS
  Sleep MRI images (3.0 Tesla scanner) and synchronised acoustic recording were used to observe patterns of dynamic airway collapse in subjects with mild and severe OSA. Midsagittal images were also used for static craniofacial measurements.
  
  
  METHODS
  Fifteen male subjects with severe OSA (mean AHI 70.3 ± 23 events/h) were matched by age and BMI to 15 subjects with mild OSA (mean AHI 7.8 ± 1.4 events/h). Subjects were selected from a consecutive sleep MRI study cohort.
  
  
  METHODS
  Static craniofacial measurements selected a priori included measurements that represent maxillomandibular relationships and airway morphology. Axial, sagittal and coronal views of the airway were rated for dynamic collapse at retropalatal, retroglossal and lateral pharyngeal wall regions by blinded reviewers. Bivariate analysis was used to correlate measures associated with severity of OSA using AHI. Statistical significance was set at P < 0.01.
  
  
  RESULTS
  Lateral pharyngeal wall collapse from dynamic sleep MRI (β = 51.8, P < 0.001) and upper airway length from static MRI images (β = 27.2, P < 0.001) positively correlated with severity of OSA.
  
  
  CONCLUSIONS
  Lateral pharyngeal wall collapse and upper airway length are significantly associated with severe OSA based on sleep MRI. Assessment of these markers can be readily translated to routine clinical practice, and their identification may direct targeted surgical treatment.
authors.affiliation: Division of Sleep Surgery, Department of Otolaryngology-Head & Neck Surgery, Stanford University Medical Center, Stanford, CA, USA.|School of Medicine, Stanford University, Stanford, CA, USA.
authors.forename: Stanley Yung-Chuan
authors.initials: SY
authors.lastname: Liu
authors.affiliation: School of Medicine, Stanford University, Stanford, CA, USA.|Department of Otolaryngology-Head &Neck Surgery, Cathay General Hospital, Taipei, Taiwan.|School of Medicine, Fu Jen Catholic University, Taipei, Taiwan.
authors.forename: Leh-Kiong
authors.initials: LK
authors.lastname: Huon
authors.affiliation: Department of Biomedical Sciences and Engineering, National Central University, Taoyuan, Taiwan.
authors.forename: Men-Tzung
authors.initials: MT
authors.lastname: Lo
authors.affiliation: Department of Biomedical Sciences and Engineering, National Central University, Taoyuan, Taiwan.
authors.forename: Yi-Chung
authors.initials: YC
authors.lastname: Chang
authors.affiliation: Division of Sleep Surgery, Department of Otolaryngology-Head & Neck Surgery, Stanford University Medical Center, Stanford, CA, USA.
authors.forename: Robson
authors.initials: R
authors.lastname: Capasso
authors.affiliation: Department of Dental Medicine, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Yunn-Jy
authors.initials: YJ
authors.lastname: Chen
authors.affiliation: Department of Medical Imaging, National Taiwan University, Taipei, Taiwan.
authors.forename: Tiffany Ting-Fang
authors.initials: TT
authors.lastname: Shih
authors.affiliation: Department of Otolaryngology-Head &Neck Surgery, Cathay General Hospital, Taipei, Taiwan.|School of Medicine, Fu Jen Catholic University, Taipei, Taiwan.|Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan.
authors.forename: Pa-Chun
authors.initials: PC
authors.lastname: Wang
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D002508:Cephalometry; D005147:Facial Bones; D006801:Humans; D006928:Hyoid Bone; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010614:Pharynx / Q000000981:diagnostic imaging*; D017286:Polysomnography; D020181:Sleep Apnea, Obstructive / Q000000981:diagnostic imaging* / Q000209:etiology; D013624:Taiwan