Cephalometric analysis with magnetic resonance imaging in patients with obstructive sleep apnea syndrome

Abstract

Objectives: The study aimed to assess soft tissues and bony structures in patients with snoring and obstructive sleep apnea syndrome (OSAS) by magnetic resonance imaging (MRI) cephalometry and to investigate the correlation between the degree of OSAS with cephalometric measures. Patients and Methods: The prospective study included 137 adult patients (86 males, 51 females; mean age: 44.2±11.8; range 21 to 70 years) admitted with complaints of snoring or witnessed apnea between December 2020 and June 2023. Polysomnography and MRI cephalometry were performed for each patient. According to the polysomnography results, patients were assigned to one of the following groups: simple snorers [apnea-hypopnea index (AHI) <5; n=25], mild OSAS (AHI between 5 and 15; n=37), moderate OSAS (AHI between 15 and 30; n=36), and severe OSAS (AHI >30; n=39). The SNA (sella, nasion-point A), SNB (sella, nasion-point B), submental fat thickness, retropalatal and retro glossal distance, tongue, uvula, basion, and hyoid-related cephalometric measurements were evaluated with MRI cephalometry. Results: The H-A (hyoid-point A) values were found to be higher in the severe OSAS patients than in other groups (p<0.001, p<0.001 and p<0.05, respectively). The PNS-UT (posterior nasal spine-uvula tip) values of the patients in the severe OSAS group were found to be higher than patients in both the snoring and moderate OSAS groups (p<0.001). The SNB values of the patients in the mild OSAS group were found to be higher than the patients in the snoring group (p<0.05). In the parameters of UW (uvula thickness), PAS-RG (posterior airway space-retroglossal distance), and H-B (hyoid-point B), statistically meaningful differences were found only between the simple snorers group and the group with severe OSAS. Conclusion: In OSAS patients, some important distances, angles, and lengths can be evaluated by avoiding ionizing radiation with MRI cephalometry.