Effects of Craniofacial Morphology on Nasal Respiratory Function and Upper Airway Morphology

Xu, Gaoqiang; Li, Weiran; Gao, Xuemei

doi:10.1097/scs.0000000000004638

Cited by 15 publications

(10 citation statements)

References 15 publications

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“…Recently, a group of authors used CBCT to study the upper airway. 4 Although magnetic resonance imaging has higher soft tissue resolution than CBCT, this imaging modality has key disadvantages of limited access and expensive equipment. 27 Thus, in the present study, we used CBCT and ITK-SNAP and Meshmixer software programs to evaluate and study the airway morphology in different skeletal malocclusion classes.…”

Section: Discussionmentioning

confidence: 99%

“…Nasal airflow and nasal resistance are significantly higher in patients with skeletal class III malocclusion than in individuals with class I or class II malocclusion. 4 Certain skeletal characteristics, such as maxillary and mandibular retrusion or vertical maxillary excess in hyperdivergent patients, may be associated with smaller airway dimensions. 5 Patients with obstructive sleep apnea have lower pharyngeal resistance to collapse, and lateral and posterior wall collapse is also common among these patients.…”

Section: Introductionmentioning

confidence: 99%

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Position of the hyoid bone and its correlation with airway dimensions in different classes of skeletal malocclusion using cone-beam computed tomography

et al. 2020

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Purpose: This study investigated the position of the hyoid bone and its relationship with airway dimensions in different skeletal malocclusion classes using cone-beam computed tomography (CBCT). Materials and Methods: CBCT scans of 180 participants were categorized based on the A point-nasion-B point angle into class I, class II, and class III malocclusions. Eight linear and 2 angular hyoid parameters (H-C3, H-EB, H-PNS, H-Me, H-X, H-Y, H-[C3-Me], C3-Me, H-S-Ba, and H-N-S) were measured. A 3-dimensional airway model was designed to measure the minimum cross-sectional area, volume, and total and upper airway length. The mean crosssectional area, morphology, and location of the airway were also evaluated. Data were analyzed using analysis of variance and the Pearson correlation test, with P values <0.05 indicating statistical significance. Results: The mean airway volume differed significantly among the malocclusion classes (P<0.05). The smallest and largest volumes were noted in class II (2107.8±844.7 mm 3 ) and class III (2826.6±2505.3 mm 3 ), respectively. The means of most hyoid parameters (C3-Me, C3-H, H-Eb, H-Me, H-S-Ba, H-N-S, and H-PNS) differed significantly among the malocclusion classes. In all classes, H-Eb was correlated with the minimum cross-sectional area and airway morphology, and H-PNS was correlated with total airway length. A significant correlation was also noted between H-Y and total airway length in class II and III malocclusions and between H-Y and upper airway length in class I malocclusions. Conclusion:The position of the hyoid bone was associated with airway dimensions and should be considered during orthognathic surgery due to the risk of airway obstruction.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Position of the hyoid bone and its correlation with airway dimensions in different classes of skeletal malocclusion using cone-beam computed tomography

et al. 2020

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“…Thus, it can be highlighted that the main pathophysiological characteristic of OSAS is high stenosis caused by apnea or restricted ventilation during sleep, causing nocturnal hypoxemia, resulting in chronic damage to multiple organs of the body [6,13]. Longterm presence may cause or aggravate respiratory failure, or cerebrovascular risk factors for accidents, myocardial infarction, and hypertension [14][15][16].…”

Section: Major Clinical Findingsmentioning

confidence: 99%

Major clinical results of orthognathic surgery and maxillomandibular advancement in obstructive sleep apnea syndrome

Morais¹,

Silva²,

Costa³

et al. 2023

MedNEXT

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Introduction: Obstructive sleep apnea involves obstruction or narrowing of an individual's airway during sleep and is associated with several comorbidities. Management can be surgical or nonsurgical, and Phase II of the Stanford Protocol for surgical management involves maxillomandibular advancement. Objective: It was to carry out a concise systematic review to present the main considerations and clinical results of orthognathic surgery in obstructive sleep apnea syndrome. Methods: The systematic review rules of the PRISMA Platform were followed. The research was carried out from September to November 2022 in Scopus, PubMed, Science Direct, Scielo, and Google Scholar databases. The quality of the studies was based on the GRADE instrument and the risk of bias was analyzed according to the Cochrane instrument. Results and Conclusion: A total of 270 articles were found, 47 articles were evaluated and 23 were included in this systematic review. Considering the Cochrane tool for risk of bias, the overall assessment resulted in 35 studies at high risk of bias and 125 studies that did not meet the GRADE. Most studies showed homogeneity in their results, with I2 =95.9% >50%. Maxillomandibular advancement surgery is a successful treatment for obstructive sleep apnea, but there are still concerns about the aesthetic results due to the great advances involved. The bimaxillary advancement osteotomy significantly increases the oropharyngeal volume and constricted surface areas, which remains stable between 6 months to 1 year postoperatively.

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“…Gender and age are two important patient characteristics used in DAFNE as part of treatment selection and AI in the pediatric and adult populations. Jones et al (1994) found cephalometric development in kids and rhinomanometric measurements to be statistically significant specifically when measuring mandibular prognathism that also correlated to intranasal pressures and mean resistance [33,34]. Juliet et al concluded the lower age limit for testing rhinomanometry at five years old with the reference pressures with the most appropriate pressures at 75 and 100 Pascals [35].…”

Section: Ethnicity Gender and Agementioning

confidence: 99%

Development and Validation of DAFNE: A Web Based Tool for Determining Airway Treatment Options for OSA and Nasal Breathing Disorders

Davidson¹,

Harrell²

2023

Preprint

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Background: The diagnosis of nasal airway disorders relies on questionnaires, subjective data, and objective data. Interpretation of objective data obtained from measurement technology is not well understood by providers and researchers who use the equipment to test nasal airway function, justifying the need to cre-ate a new clinical tool. The Davidson Airway Function & Nasal Evaluation (DAFNE) Scoring System is a web-based scoring system that allows healthcare providers (MDs, PAs, PTs, APRNs, DMDs, DDSs, SLPs, and DCs) and researchers who treat nasal obstruction and breathing disorders to make more accurate diagnostic decisions, select the appropriate treatment for individualized patient care, monitor treatment progression and outcomes, and show how to approach a collaborative care model with other healthcare professionals. The current technologies, such as 4-phase rhinomanometry, use a simple approach that relies on a measurement tracing intersecting a color-coded y-axis on a four-quadrant graph with diagnostic numeric data output de-scribing nasal airflow and resistance. This is a good source of biofeedback demonstrating abnormal nasal breathing patterns but lacks interpretation guidelines to describe the severity of disease. The more sophisti-cated proprietary DAFNE approach uses multiple parameters which include airflow restriction, speed, vol-ume, and patient characteristics to identify patients’ disease progression much more accurately. Additionally, it explains how to segregate patients into appropriate treatment options which minimizes risks and compli-cations associated with sleep and breathing disorders while improving patient outcomes. Methods: Electronic searches of PubMed, MEDLINE, EMBASE Cochrane Library, and Scopus of publications between 1988-2022 were necessary to identify studies which determined the ranges of nasal function measurement parameters among three airway measurement technologies used in writing the DAFNE Score algorithm. The performance of DAFNE was evaluated compared to the research data and patient demographics used in previous studies. Results: By using primary outcome measurements from the literature, we were able to create a reliable, re-peatable, and validated tool to facilitate patient identification, treatment stratification, and collaboration for sleep and nasal breathing dysfunction. Subsequently, we found DAFNE could be used to identify the appro-priateness of a sleep study. Conclusions: DAFNE Scoring System has demonstrated the ability to detect high risk patients in the pediatric and adult populations susceptible of sleep apnea and breathing dysfunction needing a sleep study and treatment to improve nasal airway function and sleep. DAFNE Scoring System should be used as an adjunct tool in routine clinical practice and research to further understand the technol-ogy data output, identify patients at risk, stratify treatment options, progress, and stabilization after treatment, and how to collaborate with other healthcare providers to improve patient outcomes.

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Effects of Craniofacial Morphology on Nasal Respiratory Function and Upper Airway Morphology

Abstract: Craniofacial skeletal morphology may affect nasal respiratory function and the upper airway.

Cited by 15 publications

References 15 publications

Position of the hyoid bone and its correlation with airway dimensions in different classes of skeletal malocclusion using cone-beam computed tomography

Position of the hyoid bone and its correlation with airway dimensions in different classes of skeletal malocclusion using cone-beam computed tomography

Major clinical results of orthognathic surgery and maxillomandibular advancement in obstructive sleep apnea syndrome

Development and Validation of DAFNE: A Web Based Tool for Determining Airway Treatment Options for OSA and Nasal Breathing Disorders

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