A cephalometric and electromyographic study of upper airway structures in the upright and supine positions

Pae, Eung‐Kwon; Lowe, Alan A.; Sasaki, Keiichi; Price, C. H. G.; Tsuchiya, Masafumi; Fleetham, John A.

doi:10.1016/s0889-5406(94)70021-4

Cited by 179 publications

(139 citation statements)

References 21 publications

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“…A 36.5% decrease in oropharyngeal area has been previously reported in obstructive sleep apnea patients with a positional change from upright (standing) to supine. 36 Although supine CBCT scans would have ideally been utilized, it would be unethical to expose growing patients to the radiation of multiple scans. Since a 30% variation in airway volume has been demonstrated with positional change, 37 our findings can be extrapolated.…”

Section: Discussionmentioning

confidence: 99%

Changes in the oropharyngeal airway of Class II patients treated with the mandibular anterior repositioning appliance

Rizk¹,

Kulbersh

Al-Qawasmi

2015

The Angle Orthodontist

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Objective: To evaluate the effects of functional appliance treatment on the oropharyngeal airway volume, airway dimensions, and anteroposterior hyoid bone position of growing Class II patients. Materials and Methods: Twenty Class II white patients (mean age, 11.7 6 1.75 years) treated with the MARA followed by fixed appliances were matched to an untreated control sample by cervical vertebrae maturation stage at pretreatment (T1) and posttreatment (T2) time points. Cone beam computed tomography scans were taken at T1 and T2. Dolphin3D imaging software was used to determine oropharyngeal airway volume, dimensions, and anteroposterior hyoid bone position. Results: Multivariate ANOVA was used to evaluate changes between T1 and T2. Oropharyngeal airway volume, airway dimensions, and A-P position of the hyoid bone increased significantly with functional appliance treatment. SNA and ANB decreased significantly in the experimental group (P # .05). Changes in SNB and Sn-GoGn failed to reach statistical significance. Conclusions: Functional appliance therapy increases oropharyngeal airway volume, airway dimensions, and anteroposterior hyoid bone position in growing patients. (Angle Orthod. 2016;86:955-961.)

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Section: Discussionmentioning

confidence: 99%

Changes in the oropharyngeal airway of Class II patients treated with the mandibular anterior repositioning appliance

Rizk¹,

Kulbersh

Al-Qawasmi

2015

The Angle Orthodontist

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“…In the supine position, the oropharyngeal airway decreases while the thickness of both the tongue and soft palate increases due to either gravitational force or changes in upper airway reflexes, which may predispose to increased collapsibility of the upper airway. 19,20 The nasopharynx is surrounded by bony structures, whereas the oropharyngeal airway is surrounded by soft tissues, 21 which probably explains why the oropharynx is more predisposed to external factors such as posture. A supine MRI thus provides more physiologic information since it is obtained in the usual sleeping posture.…”

Section: Discussionmentioning

confidence: 99%

Validity of upper airway assessment in children:A clinical, cephalometric, and MRI study

Pirilä-Parkkinen

Löppönen

Nieminen

et al. 2011

The Angle Orthodontist

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Objective: To test the hypothesis that the capability of two-dimensional lateral cephalogram in recognizing pharyngeal obstruction is poor compared with the capability of three-dimensional magnetic resonance imaging (MRI) and clinical observation of tonsillar size. Materials and Methods: The study participants were 36 prepubertal children (19 male, 17 female; mean age 7.3 6 1.43 years, range 4.8-9.8 years) with sleep-disordered breathing diagnosed by nocturnal polygraphy. Pharyngeal airway was imaged with a low-field open-configuration MRI scanner. Tonsillar size was clinically determined and lateral skull radiographs were taken and measured. Pearson correlation coefficients were calculated between the clinical, cephalometric, and MRI variables. Results: Nasopharyngeal and retropalatal cephalometric variables had a significant positive correlation with the MRI findings. Both techniques showed the narrowest measurement to be located in the retropalatal region. Clinical assessment of tonsillar size correlated inversely with MRI findings such as minimal retropalatal cross-sectional airway area (P 5 .000), minimal retroglossal cross-sectional airway area (P 5 .015), and intertonsillar airway width (P 5 .000). Cephalometric soft palate and tonsillar area correlated with clinical tonsillar size (P 5 .001). Conclusions: The hypothesis is rejected. The findings confirm that the lateral cephalogram is a valid method for measuring dimensions of the nasopharyngeal and retropalatal region. When evaluating oropharyngeal size, clinical assessment of tonsillar size is a relatively reliable method. (Angle Orthod. 2011;81:433-439.)

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“…Since patients were examined and measured in supine position as in the sleep position, the study findings regarding positional variables should be considered with caution in comparison with traditional 2D and 3D cephalometry performed in upright or sitting positions [13]. This work based on CBCT shows how anatomical parameters differ in OSA and non-OSA patients, whether considering the soft tissues or the bony structures.…”

Section: [ ( F I G _ 4 ) T D $ F I G ]mentioning

confidence: 99%

Three-dimensional analysis of craniofacial bones and soft tissues in obstructive sleep apnea using cone beam computed tomography

Bruwier

Poirrier

Albert

et al. 2016

International Orthodontics

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A cephalometric and electromyographic study of upper airway structures in the upright and supine positions

Cited by 179 publications

References 21 publications

Changes in the oropharyngeal airway of Class II patients treated with the mandibular anterior repositioning appliance

Changes in the oropharyngeal airway of Class II patients treated with the mandibular anterior repositioning appliance

Validity of upper airway assessment in children:A clinical, cephalometric, and MRI study

Three-dimensional analysis of craniofacial bones and soft tissues in obstructive sleep apnea using cone beam computed tomography

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