title: Association between pterygoid hamulus length and apnea hypopnea index in patients with obstructive sleep apnea: a combined three-dimensional cone beam computed tomography and polysomnographic study.
abstract: OBJECTIVE
  The purpose of this study was to investigate the relationships among the pterygoid hamulus (PH), the maxillo-mandibular complex to the pharynx, the upper airway, and the soft palate and a possible connection to sleep apnea severity as assessed by polysomnography.
  
  
  METHODS
  A total of 100 left and right sides of the PH were retrospectively measured by two observers from 50 cone beam computed tomography images by using three-dimensional rendering program in patients with obstructive sleep apnea (33 males and 17 females, with a mean age of 56.8 years; range 32-82 years).
  
  
  RESULTS
  The mean apnea hypopnea index was 30.2 (range 0-95). A linear regression analysis on the apnea hypopnea index with the total length of the PH adjusted for gender, body mass index, neck circumference, and age showed a statistically significant association: (-0.234(∗); P = .005). None of the other variables reached formal significance.
  
  
  CONCLUSIONS
  The pterygoid hamulus length is inversely associated with sleep apnea severity. Our study provides further insight into the pathophysiology of sleep apnea, with the result that PH length could be a future supplementary measurement to help clinicians to stratify and determine the best treatment options for patients with obstructive sleep apnea.
authors.affiliation: Department of Orthodontics, School of Dentistry, Near East University, Nicosia, Northern Cyprus. Electronic address: Ulasoz@gmail.com.
authors.forename: Ulas
authors.initials: U
authors.lastname: Oz
authors.affiliation: Department of Dento-Maxillo-Facial Radiology, Ankara University, Ankara, Turkey.
authors.forename: Kaan
authors.initials: K
authors.lastname: Orhan
authors.affiliation: Department of Dento-Maxillo-Facial Radiology, Near East University, Nicosia, Northern Cyprus.
authors.forename: Secil
authors.initials: S
authors.lastname: Aksoy
authors.affiliation: Ankara University School of Medicine Chest Disease Department, Ankara, Turkey.
authors.forename: Fatma
authors.initials: F
authors.lastname: Ciftci
authors.affiliation: Ear, Nose, and Throat Department, Near East University Hospital, Nicosia, Northern Cyprus.
authors.forename: Tunis
authors.initials: T
authors.lastname: Özdoğanoğlu
authors.affiliation: Department of Allergy, Sleep and Respiratory Diseases and Cyprus Sleep Center, Near East University Hospital, Nicosia, Northern Cyprus.
authors.forename: Finn
authors.initials: F
authors.lastname: Rasmussen
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D054893:Cone-Beam Computed Tomography / Q000379:methods*; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D009960:Oropharynx / Q000000981:diagnostic imaging*; D010160:Palate, Soft / Q000000981:diagnostic imaging*; D017286:Polysomnography; D012189:Retrospective Studies; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D013100:Sphenoid Bone / Q000000981:diagnostic imaging*