Comparison of hyoid bone morphology between obstructive sleep apnea patients and healthy individuals

Abstract

Objective We aimed to find morphological properties of the hyoid bone, which are predominant among the patients diagnosed with obstructive sleep apnoea (OSA), and compare them with healthy individuals. Methods A total of 67 cone‐beam computed tomography (CBCT) image sequences of patients (44 males, 23 females) diagnosed with OSA and a total of 70 multislice computed tomography (MSCT) data of non‐OSA patients (45 males, 25 females) were selected in this study. DICOM images were imported into InVivo 5.1.2 (Anatomage) software. The position of the hyoid bone relative to the C3 and C4 cervical vertebrae, as well as its morphological type (B, V, U, H, D, HK‐type) and its total volume was determined. Results The volumetric values of the hyoid bone of OSA patients (2384.49 ± 682.073 mm3) were significantly (P < .001) lower compared to the values derived from non‐OSA patients (2952.96 ± 932.5 mm3). The difference was independent of gender, and volumetric values showed a strong significant (P < .01) difference between male OSA and non‐OSA (2709.18 ± 608.05; 3157.87 ± 926.5 mm3) and female OSA and non‐OSA patients (1763 ± 242.51 2584; 2584.12 ± 840.21 mm3), as well. In the case of B and V‐types, the volumetric values showed significant differences (P < .05), when the OSA (2300,77 ± 622; 2166 ± 312 mm3) and non‐OSA patients were compared (2823,48 ± 780; 3216 ± 463 mm3). Conclusion Our results suggest that the volume of the hyoid bone might be a potential biological marker for OSA, especially in the case of B and V hyoid bone types.

Hyoid bone position as an indicator of severe obstructive sleep apnea

“…So, its position plays an important role in the pathophysiology of pharyngeal airway obstruction through muscle force vectors which could be associated with increased upper airway collapsibility [ 17 ]. A recent study has suggested volumetric differences of the hyoid bone as a potential biological marker for OSA [ 18 ]. The hyoid bone is relatively easy to identify on radiographs compared to other landmarks reducing the influence of an examiner’s aptitude [ 16 ].…”

Cephalometric Evaluation in Patients with Obstructive Sleep Apnea undergoing Lateral Pharyngoplasty

“…In a study involving this analysis, Salles et al 31 (2005) assessed individuals with OSA and showed that the hyoid bone is located at the level of the C4-C6 cervical vertebrae, which increases the HMP to about 27.8 mm, while in healthy individuals the average distance is of 12 mm. Kurbanova et al 33 (2021) correlated cephalometric facial pattern measurements with the position of the hyoid bone using computed tomography (CT) in adults diagnosed with OSA, and they suggested that the hyoid bone could be a potential biological marker for OSA. In line with the present study, Ryu et al 26 (2015) and Soares et al 32 (2020) found a direct correlation between inferiorization of the hyoid bone and the AHI, using the HMP.…”

Assessment of posterior tilting of the hyoid bone in relation to carotid atherosclerosis: a CBCT study

“…The hyoid bone with its body and greater and lesser horns, is often an overlooked small anatomical structure, although it gives attachment to several muscles and ligaments of the neck and plays a vital role in the craniomandibular functions (23). Hyoid bone position has been frequently studied in relation to oropharyngeal space dimensions (24), facial growth patterns (25), craniofacial anomalies (20), obstructive sleep apnea syndrome (26), myofascial pain (27), atypical deglutition (28), and temporomandibular joint disc displacement (29). The hyoid position in relation to carotid artery diseases as its proximity to the carotid bifurcation level is a rarely studied phenomenon, although there are several case reports describing CVAs due to unilateral compression of the hyoid bone through its greater horn (9,11,12,23,30).…”