Ihsan Kuzucu1, Izzet Selcuk Parlak2, Deniz Baklaci3, Ismail Guler1, Rauf Oguzhan Kum1, Muge Ozcan1. 1. Department of Otolaryngology, Numune Training and Research Hospital, 931st Avenue 945 Street No: 5/3, Ilker, Ankara, Turkey. 2. Department of Radiology, Numune Training and Research Hospital, Ankara, Turkey. 3. Department of Otolaryngology, Numune Training and Research Hospital, 931st Avenue 945 Street No: 5/3, Ilker, Ankara, Turkey. doktorent@gmail.com.
Abstract
PURPOSE: Many anatomical factors are known to cause obstructive sleep apnea syndrome (OSAS), but only few studies have examined the relationship between the morphology of pterygoid hamulus (PH), upper airway, and OSAS severity. This study aimed to investigate the relationship between the severity of OSAS and PH morphology and other anatomical variations of the upper airway. METHODS: The data of the patients who underwent polysomnography and diagnosed with OSAS were retrospectively reviewed, and those who underwent paranasal sinus computed tomography were determined. The patients were divided into three groups according to the apnea-hypopnea index (AHI) scores obtained from the polysomnography (mild, moderate, and severe). The relationship between PH thickness, length and interpterygoid distance, and the severity of AHI was investigated. RESULTS: Seventy-four patients were included in the study. In patients with severe OSAS (1.83 ± 0.29 mm), the PH bone thickness was significantly thicker compared to those with mild OSAS (1.59 ± 0.36 mm) (p = 0.03). When the interpterygoid distance and its ratio to the velopharyngeal length were examined, it was found significantly shorter in patients with severe OSAS than mild cases (p < 0.001; p = 0.045, respectively). CONCLUSION: Our results showed that OSAS severity was associated with hamulus thickness, interpterygoid distance, and the ratio of interpterygoid distance to VL. Our study provides further insight into the pathophysiology of sleep apnea, suggesting that morphometric evaluation of the pterygoid hamulus and upper airway measurements can assist clinicians in stratifying and determining the best treatment options for patients with OSAS.
PURPOSE: Many anatomical factors are known to cause obstructive sleep apnea syndrome (OSAS), but only few studies have examined the relationship between the morphology of pterygoid hamulus (PH), upper airway, and OSAS severity. This study aimed to investigate the relationship between the severity of OSAS and PH morphology and other anatomical variations of the upper airway. METHODS: The data of the patients who underwent polysomnography and diagnosed with OSAS were retrospectively reviewed, and those who underwent paranasal sinus computed tomography were determined. The patients were divided into three groups according to the apnea-hypopnea index (AHI) scores obtained from the polysomnography (mild, moderate, and severe). The relationship between PH thickness, length and interpterygoid distance, and the severity of AHI was investigated. RESULTS: Seventy-four patients were included in the study. In patients with severe OSAS (1.83 ± 0.29 mm), the PH bone thickness was significantly thicker compared to those with mild OSAS (1.59 ± 0.36 mm) (p = 0.03). When the interpterygoid distance and its ratio to the velopharyngeal length were examined, it was found significantly shorter in patients with severe OSAS than mild cases (p < 0.001; p = 0.045, respectively). CONCLUSION: Our results showed that OSAS severity was associated with hamulus thickness, interpterygoid distance, and the ratio of interpterygoid distance to VL. Our study provides further insight into the pathophysiology of sleep apnea, suggesting that morphometric evaluation of the pterygoid hamulus and upper airway measurements can assist clinicians in stratifying and determining the best treatment options for patients with OSAS.
Authors: Francesco Baratta; Daniele Pastori; Mario Fabiani; Valerio Fabiani; Fabrizio Ceci; Rossella Lillo; Valeria Lolli; Marco Brunori; Gaetano Pannitteri; Elena Cravotto; Corrado De Vito; Francesco Angelico; Maria Del Ben Journal: Eur J Clin Invest Date: 2018-03-03 Impact factor: 4.686
Authors: M M Rodrigues; M F R Gabrielli; O A Garcia Junior; V A Pereira Filho; L A Passeri Journal: Int J Oral Maxillofac Surg Date: 2017-06-13 Impact factor: 2.789
Authors: Carlos Fernando de Mello Junior; Hélio Antonio Guimarães Filho; Camila Albuquerque de Brito Gomes; Camila Caroline de Amorim Paiva Journal: J Bras Pneumol Date: 2013 Jan-Feb Impact factor: 2.624