Hyoid bone position as an indicator of severe obstructive sleep apnea

Abstract

Background The objective of this study was to evaluate the relationship between hyoid bone position and severity of obstructive sleep apnea (OSA), and to investigate its value as a complementary diagnostic method. Methods A total of 133 patients who were diagnosed as OSA with an apnea-hypopnea index ≥ 5 were included. Clinical examination, level I polysomnography (PSG) and lateral cephalographic analysis were done. Comprehensive PSG characteristics were compared according to hyoid bone position and the predictive power of the distance between the mandible and hyoid was assessed. Results The distance between the hyoid bone and mandibular plane was significantly longer in the severe OSA group (p = 0.013). The distance from hyoid bone to third vertebrae (C3) and hyoid bone to mentum were also longer in the severe OSA group but the difference did not reach statistical significance. The distance between hyoid bone and mandibular plane was effective in predicting severe OSA, with a cut-off value of 19.45 mm (AUC = 0.623, p = 0.040). When grouped according to a distance cut-off value of 19.45 mm, those with a longer distance between the hyoid bone and mandibular plane showed more respiratory disturbance, lower oxygen saturation levels, less deep slow wave sleep, and more fragmented sleep with arousals. Conclusions The distance between the hyoid bone and mandibular plane derived from cephalometric analysis can be a valuable diagnostic parameter that can be easily applied in differentiating severe OSA patients.

Characteristics and Mechanism of Upper Airway Collapse Revealed by Dynamic MRI During Natural Sleep in Patients with Severe Obstructive Sleep Apnea

“…Previous imaging studies related OSA have confirmed that the hyoid position in OSA patients differs from that of healthy individuals, and the severity of OSA is related to the size of the downward position of the hyoid. 29,30 This is consistent with our opinion that hyoid plays an important role in the development of OSA. Our study extends upon this and shows that the hyoid location is also a key factor in distinguishing among different types of airway obstruction in OSA patients.…”

Cephalometry as an aid in the diagnosis of pediatric obstructive sleep apnoea: A systematic review and meta-analysis

“… 12 The location of the hyoid bone can influence the position and support of the upper airway structures, whereas the mandibular plane angle can suggest the inclination of the mandible and the upper airway's stability. 13 Further, craniofacial parameters offer useful data regarding the dimension and form of the upper airway and can be employed to recognise abnormal development that contributes to OSA. The McNamara and Ricketts analyses are the two commonly used cephalometric assessments for evaluating OSA.…”

Comparison of invisalign mandibular advancement and twin-block on upper airway and hyoid bone position improvements for skeletal class II children: a retrospective study

“…There is a complex relationship among growth and development abnormalities of the maxilla and mandible, position changes of the hyoid bone, and morphology alterations of the upper airway. Currently, there are many studies focusing on this area [ 4 – 7 ]. Changes in the sagittal and vertical dimensions and positions of the mandible will affect the position of the hyoid bone.…”