Comparison of Ricketts analysis and Downs‐Northwestern analysis for the evaluation of obstructive sleep apnea cephalograms

Higurashi, Naoki; Kikuchi, Makoto; Miyazaki, Soichiro; Itasaka, Yoshiaki

doi:10.1046/j.1440-1819.2001.00850.x

Cited by 13 publications

(11 citation statements)

References 3 publications

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“…Analyses of lateral cephalograms of male Japanese OSA patients and non-OSA using Ricketts method indicated that the facial patterns of OSA patients are dolico, where the hyoid bone is positioned low, the soft palate is longer and the width of the airway is narrower than that of the non-OSA controls (7). In contrast, Downs-Northwestern analysis can not detect significant differences between Japanese OSA patients and non-OSA controls (19). The facial pattern with a downward mandible development, characteristic of OSA patients, is confirmed in another comparison study (20).…”

Section: Discussionmentioning

confidence: 80%

Facial Axis Angle as a Risk Factor for Obstructive Sleep Apnea

et al. 2005

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Objective Many Japanese patients with obstructive sleep apnea (OSA) are less obese than Caucasian OSA patients despite their similar severity of OSA, suggesting that their etiology of OSA may differ. The purpose of this study was to identify bony factors associated with OSA in the Japanese population.Methods The clinical records of study subjects were retrospectively reviewed, and cephalometric measurements based on Sella-Nasion references and the Ricketts method were statistically compared.Patients Two hundred and six consecutive Japanese men complaining of habitual snoring and daytime sleepiness were enrolled in the study. All subsequently underwent an overnight polysomnographic examination.Results Multiple regression analysis showed that the body mass index (p<0.0001) and facial axis angle (p=0.007) were the dominant overall determinants for the apnea hypopnea index. The sella to nasion to subspinale angle (SNA) and sella to nasion to supramentale angle (SNB) were lower in the non-obese, severe group than for non-obese, mild and moderate patients with OSA (p=0.0047 and 0.0016, respectively).Conclusion The risk factors for OSA in Japanese men may be obesity and the dolico facial pattern seen by the Ricketts method. In addition, a smaller SNA and SNB seem to be associated with the severity of OSA in nonobese patients.

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Section: Discussionmentioning

confidence: 80%

Facial Axis Angle as a Risk Factor for Obstructive Sleep Apnea

et al. 2005

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“…We selected some parameters not only from the Downs–North–Western analysis, but also from the Rikett's analysis. The facial axis can be used to estimate the facial length 28,29 . While the mean value of the facial axis in normal Caucasian subjects is 90°, the mean value is 86° in Japanese patients, 30 which means that the Japanese are a long‐faced race in comparison with Caucasians.…”

Section: Discussionmentioning

confidence: 99%

Cephalometric analysis parameters related to the severity of sleep-breathing disorders

Chiba

Sugisaki

Tanabe

et al. 2004

Sleep and Biological Rhythms

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The purpose of this study is to demonstrate the cephalometric parameters of craniomandibular characteristics, which are indicators of the severity of sleep-breathing disorders (SBD). Eighty-eight subjects who were evaluated by using all-night polygraphy (PSG) and underwent a lateral cephalogram were included. We used logistic regression analysis to determine the cephalometric parameters. The apnea-hypopnea index (AHI), respiratory related arousal (RERA), and 90% > SpO 2 were applied to the severity of SBD as a dependent variable. The angle measurement from the sella to N to point A (SNA), the distance from N to the anterior nasal spine (N-ANS), the distance from the ANS to gnathion (Gn) (ANS-Gn), the posterior airway space (PAS), the distance from the mandibular plane to the hyoid bone (MP-H), the distance from the posterior nasal spine to the tip of the soft palate (PNS-P), and the facial-axis were applied as independent variables. Only the facial-axis demonstrated an odds ratio of 0.191 with a significant difference. The results indicate that when the facial axis was £ 85.0 ∞ , it was indicative of severe SBD. We conclude that the facial axis was useful for evaluating the severity of SBD.

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“…However, we [47] analyzed cephalograms of OSA patients and controls by Ricketts analysis and Downs-Northwestern analysis. We found out through Ricketts analysis that OSA patients had a Dolico facial pattern (increased anterior facial height) and a tendency to have a retropositioned mandible, long soft palate, decreased airway space, and lowered position of the hyoid bone.…”

Section: Craniofacial Pattern Of Osamentioning

confidence: 99%

Orthodontic treatment in children to prevent sleep-disordered breathing in adulthood

Kikuchi¹

2005

Sleep Breath

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The purpose of this article is to review human craniofacial growth and development, especially the growth of the mandible, to clarify the relationship between obstructive sleep apnea (OSA) syndrome and craniofacial abnormality, and finally, to propose the hypothesis that negative pressure produced in the chest of the OSA child inhibits the growth of the mandible. Recently, the development of diagnosis and treatment of OSA syndrome has progressed rapidly; however, the prevention of OSA syndrome was merely seen. Craniofacial abnormality is reported as one of the causes of OSA syndrome. If craniofacial abnormality is determined only by genetics, it is difficult to manage the craniofacial skeleton to prevent OSA syndrome. The role of epigenetic factors on craniofacial growth and development is still controversial. However, if we stand on the functional matrix hypothesis, we can manage not only growth of the mandible but also the craniofacial skeleton as a whole. The author proposes the hypothesis that the negative pressure produced in the chest prohibits the growth of the mandible even if the patients have a capacity for growth and development; therefore, if this negative pressure disappears because of the removal of the tonsil and/or adenoids or by an orthodontic treatment to make a patency of the airway, the mandible may grow normally, and we can prevent or reduce a number of OSA syndromes in the future.

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Comparison of Ricketts analysis and Downs‐Northwestern analysis for the evaluation of obstructive sleep apnea cephalograms

Cited by 13 publications

References 3 publications

Facial Axis Angle as a Risk Factor for Obstructive Sleep Apnea

Facial Axis Angle as a Risk Factor for Obstructive Sleep Apnea

Cephalometric analysis parameters related to the severity of sleep-breathing disorders

Orthodontic treatment in children to prevent sleep-disordered breathing in adulthood

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