Abstract
Obstructive sleep apnoea (OSA) is a growing problem, where the diagnosis and management are rapidly evolving. The investigative tools and limited resources in developing countries pose an extra challenge in optimally treating patients with OSA.Polysomnography and drug induced sleep endoscopy are important diagnostic parameters. Cephalometric parameters are an emerging tool in the diagnostic workup, where no data is available in Sri Lankan population where surgery features as a popular treatment option. Objectives: To identify a correlation between DISE, AHI and cephalometric parameters in a Sri Lankan population and identify common levels of obstruction in the upper airway , which influence treatment outcomes. Results: CircumferentialVelopharyngeal and oropharyngeal obstruction aremore prevalent levels of obstruction. Statistically significant correlation between oropharyngeal collapse with SNB angle and epiglottic collapse with SNB angle and MP-H distance were seen. No correlation between DISE findings and SNA angles. No significant correlation between cephalometry and AHI. Post op symptomatic relief based on ESS and VAS score is statistically significant. Conclusion: Cephalometric findings are complimentary to DISE and AHI findings, but not superior in our population. Extremes from the standard deviations of cephalometric data should be treated with caution when selecting treatment options.
Highlights
Obstructive sleep apnoea (OSA) is a growing problem that is heavily underdiagnosed and causes a significant disease burden to society, where attention needs to be given to further develop the diagnosis and management.Sleep medicine is an important and emerging branch of medicine in the South Asian subcontinent
Materials and methods Objectives The main objective of this study is to find a corelation between Drug Induced Sleep Endoscopy (DISE), Apnoea Hypopnoea index (AHI) and cephalometric anthropometry in a Sri Lankan population
Correlation between Pre-treatment and post Treatment ESS Mean Pre surgical Epworth Sleepiness score (ESS) was 14.83 and post-operative ESS showed a drop of mean ESS to 4.5(p
Summary
Obstructive sleep apnoea (OSA) is a growing problem that is heavily underdiagnosed and causes a significant disease burden to society, where attention needs to be given to further develop the diagnosis and management.Sleep medicine is an important and emerging branch of medicine in the South Asian subcontinent. When considering the anatomical structures, the hard bony framework and the soft tissue structures within5,6 , both play an important role in the outcome following surgical intervention. Cephalometry, being a cheap investigation[9], it has multitudeof measurements that could be taken on a two-dimensional plane, between soft tissue structures as well as bony landmarks, where some parameters have tried to associate with OSA10, and more importantly outcome of surgery[11]. Limited studies are available when it comes to cephalometric analysis with DISE or sleep endoscopy and published data are mainly associated with Caucasian and east Asian populations[12]. This data is limited in the south Asian population, where facial morphisms are quite different to the Caucasians and Chinese[13,14]
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