title: Computed tomography cephalometric and upper airway measurements in patients with OSA and erectile dysfunction.
abstract: OBJECTIVE
  Erectile dysfunction (ED) has been linked to obstructive sleep apnea (OSA). This study used computed tomography (CT) to identify cephalometric and upper airway anatomic features in patients with OSA that correlate with the presence of ED.
  
  
  METHODS
  In this prospective study, 20 CT cephalometric and upper airway measurements, most commonly associated with OSA, were analyzed in 53 age- and BMI-matched consecutive eligible subjects. Twenty-two were diagnosed with OSA and ED (OSA+/ED+), 17 with OSA without ED (OSA+/ED-), and 14 without OSA and ED (OSA-/ED-) serving as a control group.
  
  
  RESULTS
  Although OSA+/ED+ did not differentiate significantly in CT measurements from OSA+/ED-, they showed more alterations when compared to OSA-/ED-, which included narrower bony oropharynx, longer soft palate and uvula (PNS-P), and narrower retropalatal and retrolingual airway diameter (p < 0.05). Binary forward stepwise model analysis showed that PNS-P was the only significant variable in the predictive model for ED in patients with OSA (OR = 1.129, 95 % CI = 1.0005-1.268, p = 0.041). In the OSA+/ED+ group, PNS-P correlated with the percentage of total sleep time with oxygen saturation <90 % (r = 0.61, p < 0.01) and was the only determinant in the relevant predictive model (n = 22, model R = 0.612, adjusted R (2) = 0.337, F = 10.167, p < 0.005).
  
  
  CONCLUSIONS
  Characteristics of the craniofacial and upper airway structures suggest that a longer soft palate and uvula may be important risk factors for the concurrence of ED in patients with OSA. Only OSA+/ED+ showed significant narrowing in the retropalatal, retrolingual, and bony oropharynx level when compared with BMI-matched OSA-/ED-.
authors.affiliation: Department of Pulmonology, University Hospital of Patras, Rio, Patra, 26504, Greece. panagis.drakatos@gstt.nhs.uk.
authors.forename: Panagis
authors.initials: P
authors.lastname: Drakatos
authors.affiliation: Department of Pulmonology, University Hospital of Patras, Rio, Patra, 26504, Greece.
authors.forename: Kiriakos
authors.initials: K
authors.lastname: Karkoulias
authors.affiliation: Department of Urology, University Hospital of Patras, Rio, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Giannitsas
authors.affiliation: Department of Radiology, University Hospital of Patras, Rio, Greece.
authors.forename: Christina
authors.initials: C
authors.lastname: Kalogeropoulou
authors.affiliation: Department of Radiology, University Hospital of Patras, Rio, Greece.
authors.forename: Nikos
authors.initials: N
authors.lastname: Papapanagiotou
authors.affiliation: Department of Pulmonology, University Hospital of Patras, Rio, Patra, 26504, Greece.
authors.forename: Dimosthenis
authors.initials: D
authors.lastname: Lykouras
authors.affiliation: Department of Pulmonology, University Hospital of Patras, Rio, Patra, 26504, Greece.
authors.forename: Fotis
authors.initials: F
authors.lastname: Sampsonas
authors.affiliation: Department of Radiology, University Hospital of Patras, Rio, Greece.
authors.forename: Theodoros
authors.initials: T
authors.lastname: Petsas
authors.affiliation: Department of Urology, University Hospital of Patras, Rio, Greece.
authors.forename: Petros
authors.initials: P
authors.lastname: Perimenis
authors.affiliation: Department of Pulmonology, University Hospital of Patras, Rio, Patra, 26504, Greece.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Spiropoulos
mesh_terms: D000368:Aged; D000403:Airway Resistance / Q000502:physiology*; D002508:Cephalometry; D007172:Erectile Dysfunction / Q000175:diagnosis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009960:Oropharynx / Q000000981:diagnostic imaging*; D010159:Palate / Q000000981:diagnostic imaging*; D010160:Palate, Soft / Q000000981:diagnostic imaging*; D017286:Polysomnography; D011446:Prospective Studies; D012307:Risk Factors; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis*; D013223:Statistics as Topic; D014057:Tomography, X-Ray Computed
keywords: Cephalometric measurements; Computed tomography (CT); Erectile dysfunction (ED); Obstructive sleep apnea (OSA); Upper airway