Value Of Cephalometric And Volumetric Measurements Performed By Multi-Level Three-Dimensional Computed Tomography In Patients With Obstructive Sleep Apnea Syndrome

Abstract

Objective: Upper airway narrowing plays an important role in obstructive sleep apnea syndrome (OSAS) etiology. Computed tomography (CT) provides a three-dimensional image and can be obtained in the supine body position. The main objectives of this study were to determine the correlation between the dimensions of upper airway structures and OSAS by reconstructing the nasal, pharyngeal and oropharyngeal airway using CT. Methods: The study was carried out on a total of 95 consecutive subjects with maxillofacial CT, including 59 OSAS patients and 36 healthy participants. CT data of the study subjects were obtained in the supine position with the Philips Ingeniuty Core 2017 model CT device. Volumetric and cross-sectional area measurements of upper airway were obtained in three dimensions. Results: Retrolingual area and retrouvulal area were significantly lower in the patient group (p <0.001 for two). The mean values of soft palate volume, tongue volume and concha volumes of both sides were found to be significantly higher in the patient group (p = 0.005 for lower right turbinate, p <0.001 for others). Total nasal passage volume averages were significantly lower in the patient group, however naso-pharyngeal volume averages were significantly lower in the control group (p<0,001, p=0,004 respectively). Both uvula thickness and soft palate length averages were significantly higher in the patient group (p <0.001 for both). Conclusion: Cephalometric analysis of patients with OSAS with CT scans provides objective evaluation of skeletal and soft tissue abnormalities. We believe that all surgical procedures should follow precise cephalometric measurements, including detailed measurements.