The effect of head posture on the pharyngeal airway space (PAS)

Muto, Toshikata; Takeda, Shigehiro; Kanazawa, M.; Yamazaki, A.; Fujiwara, Yushi; Mizoguchi, Itaru

doi:10.1054/ijom.2002.0279

Cited by 167 publications

(115 citation statements)

References 22 publications

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“…Few studies have evaluated the effects of maxillary expansion in the oropharynx, and none of them found significant changes in the dimensions of this region after maxillary expansion. 19,23 In this study, we observed a significant increase in this region in all variables (Table 4). It is important to mention that several studies in the literature correlate head posture with dimension changes of the upper airways, especially in the oropharynx.…”

Section: Discussionsupporting

confidence: 56%

“…It is important to mention that several studies in the literature correlate head posture with dimension changes of the upper airways, especially in the oropharynx. 23 Ingman et al 24 suggested that the change in the oropharynx may be associated with the change in head position. However, the present study showed no statistically significant correlation between the craniocervical inclination as measured by the angle C2i SN.C2s-SN-C2s-C41, volume change, and the axial area of the oropharynx.…”

Section: Discussionmentioning

confidence: 99%

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Upper airway expansion after rapid maxillary expansion evaluated with cone beam computed tomography

Ribeiro

Paiva

Rino-Neto

et al. 2012

The Angle Orthodontist

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Objective: Cone-beam computed tomography (CBCT) is a reliable method of assessing the oral cavity and upper airways. We conducted this study to examine the changes introduced by rapid maxillary expansion in the nasal cavity, nasopharynx, and oropharynx as seen with images obtained by CBCT. Materials and Methods: We evaluated 15 patients with maxillary width deficiency treated with RME. Patients were subjected to CBCT at the beginning of RME and after the retention period of 4 months. Results: The nasal cavity presented a significant transverse increase in the lower third, in the anterior (1.08 mm 6 0.15), medium (1.28 mm 6 0.15), and posterior regions (0.77 mm 6 0.12). No significant change occurred in the nasopharynx in volume (P 5 .11), median sagittal area (P 5 .33), or lower axial area (P 5 .29) resulting from the RME. A significant change was noted in the oropharynx in volume (P 5 .05), median sagittal area (P 5 .01), and lower axial area (P 5 .04) before and immediately after the RME. Conclusions: RME is able to increase the transverse width of the nasal cavity, but it does not have the same effect in the nasopharynx. Changes noted in the oropharynx may be due to the lack of a standardized position of the head and tongue at the time of image acquisition. (Angle Orthod. 2012;82:458-463.)

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Section: Discussionsupporting

confidence: 56%

Section: Discussionmentioning

confidence: 99%

Upper airway expansion after rapid maxillary expansion evaluated with cone beam computed tomography

Ribeiro

Paiva

Rino-Neto

et al. 2012

The Angle Orthodontist

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“…Furthermore, airway dimensions are influenced by dynamic variables such as respiration state of the patient, 1,3 head posture 1,41,42 and mobility of the soft tissues. 1,3 Patient positioning for the scan is very important.…”

Section: Discussionmentioning

confidence: 99%

Proposal of new upper airway margins in children assessed by CBCT

Anandarajah¹,

Abdalla²,

Dudhia³

et al. 2015

Dentomaxillofacial Radiology

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Objectives: Recently, studies have performed three-dimensional analyses of upper airways in children. However, there was a lack of airway delineation according to anatomical boundaries and/or easily mobile soft-tissue landmarks were used. The aim of the present study was to define new upper airway margins in children on CBCT according to anatomical bony landmarks and to validate the method. Methods: 25 scans were randomly selected from a larger database containing CBCT scans of children prior to orthodontic treatment (14 girls and 11 boys; mean age, 10.9 ± 2.5 years). Scans were evaluated by two observers. Specific head positioning and virtual orientation protocols were adopted and greyscale thresholding was established for each patient. Volume and minimum cross-sectional area of the oropharynx were calculated. Intra-and interobserver reliability were assessed by reassessment of the CBCTs 2 weeks later. Results: The new airway margins were defined superiorly by a line passing through the palatal plane (anterior nasal spine to posterior nasal spine) extending to the posterior wall of the pharynx, inferiorly by a line passing from the anterosuperior edge of C4 to menton, anteriorly by a line passing from the soft palate to menton, posteriorly and laterally by the respective pharyngeal walls. Method error for airway volume and minimal cross-sectional area was #2.00%, and intra-and interobserver reliability ranged from 0.99 to 1.00. Conclusions: The proposed protocol utilizes easily identifiable bony landmarks to delineate the upper airway on cone beam scans of children and was found to be reliable and reproducible.

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“…The second method is to evaluate the position of the cervical spine [4,12]. Muto et al [13] reported that the degree of craniocervical inclination affected the dimensions of the PAS. Although it is important to understand this relationship, investigating it raises ethical problems because it requires the acquisition of several CT scans.…”

Section: Discussionmentioning

confidence: 99%

Relationships between Airway Morphology and Sleep Breathing Indices in Jaw Deformity Patients

Nakano¹,

Mishima²,

Nakano³

et al. 2015

J Sleep Disord Ther

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Purpose: The purpose of this study was to clarify how sleep breathing indices and airway morphology vary according to skeletal classification and the relationships between airway morphology and sleep breathing indices.Method: Forty-four non-syndromic female Japanese patients, who were diagnosed with jaw deformities and underwent surgical orthodontic treatment were enrolled in this study. Using the Alice 5 diagnostic sleep system (Philips Respironics; Murrysville, PA), the apnea hypopnea index (AHI), apnea index (AI), and 4% oxygen desaturation index (4%ODI) were evaluated in each patient before they underwent orthognathic surgery. The following dimensions were measured on 2D CT images: the cross-sectional area at the level of the hard palate (HP), the cross-sectional area at the top of the uvula (TU), the cross-sectional area at the base of the tongue (BE). The following volumes were measured on 3D CT images: the volume of the upper airway (total volume), the volume of the region between the level of the hard palate and the top of the uvula (HP-TU volume), the volume of the region between the top of the uvula and the base of the epiglottis (TP-BE volume).Result: There were no significant differences in airway morphology or sleep breathing indices among the three groups. Negative correlations were detected between HP-TU volume and 4%ODI, and between the HP area and AHI (p<0.05). Conclusion:Our results establish that upper airway morphology also has important effects on the nocturnal breathing of jaw deformity patients.

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The effect of head posture on the pharyngeal airway space (PAS)

Cited by 167 publications

References 22 publications

Upper airway expansion after rapid maxillary expansion evaluated with cone beam computed tomography

Upper airway expansion after rapid maxillary expansion evaluated with cone beam computed tomography

Proposal of new upper airway margins in children assessed by CBCT

Relationships between Airway Morphology and Sleep Breathing Indices in Jaw Deformity Patients

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