OUAS’lı Hastalarda Dil Boyutlarının Lateral Kafa Grafisi ile İncelenmesi
Yıl 2024,
Cilt: 17 Sayı: 1, 137 - 146, 28.03.2024
Elif Çelik
,
Samih Diyarbakır
,
Edhem Ünver
,
Fatih Çelik
Öz
Amaç: Bu makalede, lateral sefalometrik radyografi kullanarak hastalarda dil boyutlarını inceleyerek, dil boyutlarındaki farklılıkların Obstrüktif Uyku Apnesi Sendromuna (OUAS) potansiyel etkisini araştırmak amaçlanmıştır. Bu çalışmada elde edilen veriler OUAS’ın ortaya çıkmasında etkili olan risk faktörlerinin daha iyi anlaşılmasına katkı sağlayabilir. Dolayısıyla tedavi planlamasının bu bilgiler ışığında daha doğru bir şekilde yapılmasına olanak sağlar.
Yöntemler: Bu çalışmaya 34 kadın 46 erkekten oluşan 80 hasta dahil edildi. Bu hastalardan OUAS’ı olan 48’i hasta grubunu, 32’ si ise AHİ<5 olan kontrol grubunu oluşturmaktaydı. Hastalara ait lateral sefalometrik radyografilerde dil boyutları ölçüldü ve gruplar arasında bu değerler karşılaştırıldı.
Bulgular: Çalışmamızda OUA hastalarında dil boyunda ve dil alanında istatistiksel olarak anlamlı bir artış gözlenmiştir (p <0.05). Fakat dil kalınlığındaki artış anlamlı derecede değildir.
Sonuç: Çalışmamız, OUA hastalarının genellikle daha büyük bir dile sahip olduğunu göstermektedir. Daha büyük bir dil, uyku sırasında hava yolunun tıkanmasına katkıda bulunabilir, bu da OUAS şiddetinin artmasına yol açabilir. Bu bilgi, klinisyenlere OUA hastaları için tedavi stratejilerini uyarlamada yardımcı olabilir ve tedavi sonuçlarını potansiyel olarak iyileştirebilir.
Etik Beyan
Etik onay, 21 Şubat 2022 tarihinde Erzincan Binali Yıldırım Üniversitesi Klinik Araştırma Etik Komitesi toplantısında 15/04 kararıyla alınmıştır.
Kaynakça
- [1] N. M. Punjabi, The Epidemiology of Adult Obstructive Sleep Apnea, Proc Am Thorac Soc 5, 136 (2008).
- [2] J. A. Dempsey, S. C. Veasey, B. J. Morgan, and C. P. O’Donnell, Pathophysiology of Sleep Apnea, Physiological Reviews 90, 47 (2010).
- [3] J. L. Hossain and C. M. Shapiro, The Prevalence, Cost Implications, and Management of Sleep Disorders: An Overview, Sleep Breath 06, 85 (2002).
- [4] H. Ölmez, M. Tosun, E. Ünver, R. Çoşkun, G. S. Yalçın, M. Doğan, and Y. K. Arslan,
Can Biomarkers Predict the Risk of Cardiovascular Disease in Patients with Obstructive Sleep Apnea Syndrome? Biomarkers in Obstructive Sleep Apnea Syndrome, Journal of Surgery and Medicine 7, 2 (2023).
- [5] F. Xia and M. Sawan, Clinical and Research Solutions to Manage Obstructive Sleep Apnea: A Review, Sensors 21, 5 (2021).
- [6] J. B. Schellenberg, G. Maislin, and R. J. Schwab, Physical Findings and the Risk for Obstructive Sleep Apnea, Am J Respir Crit Care Med 162, 740 (2000).
- [7] K. Bagai, Obstructive Sleep Apnea, Stroke, and Cardiovascular Diseases, The Neurologist 16, 329 (2010).
- [8] M. Barnes, R. D. McEvoy, S. Banks, N. Tarquinio, C. G. Murray, N. Vowles, and R. J. Pierce, Efficacy of Positive Airway Pressure and Oral Appliance in Mild to Moderate Obstructive Sleep Apnea, Am J Respir Crit Care Med 170, 656 (2004).
- [9] I. Bouloukaki, E. Daskalaki, E. Mavroudi, V. Moniaki, S. E. Schiza, and I. Tsiligianni,
A Dietary and Lifestyle Intervention Improves Treatment Adherence and Clinical Outcomes in Overweight and Obese Patients with Obstructive Sleep Apnea: A Randomized, Controlled Trial, Life 13, 8 (2023).
- [10] H.-P. Chang, Y.-F. Chen, and J.-K. Du, Obstructive Sleep Apnea Treatment in Adults, The Kaohsiung Journal of Medical Sciences 36, 7 (2020).
- [11] R. W. Riley, N. B. Powell, K. K. Li, R. J. Troell, and C. Guilleminault, Surgery and Obstructive Sleep Apnea: Long-Term Clinical Outcomes, Otolaryngol Head Neck Surg 122, 415 (2000).
- [12] A. M. Kim, B. T. Keenan, N. Jackson, E. L. Chan, B. Staley, H. Poptani, D. A. Torigian, A. I. Pack, and R. J. Schwab, Tongue Fat and Its Relationship to Obstructive Sleep Apnea, Sleep 37, 1639 (2014).
- [13] B. C. Neelapu, O. P. Kharbanda, H. K. Sardana, R. Balachandran, V. Sardana, P. Kapoor, A. Gupta, and S. Vasamsetti, Craniofacial and Upper Airway Morphology in AdultObstructive Sleep Apnea Patients: A Systematic Review and Meta-Analysis of Cephalometric Studies, Sleep Medicine Reviews 31, 79 (2017).
- [14] R. L. Horner, R. H. Mohiaddin, D. G. Lowell, S. A. Shea, E. D. Burman, D. B. Longmore, and A. Guz, Sites and Sizes of Fat Deposits around the Pharynx in Obese Patients with Obstructive Sleep Apnoea and Weight Matched Controls, European Respiratory Journal 2, 613 (1989).
- [15] S. H. Wang, B. T. Keenan, A. Wiemken, Y. Zang, B. Staley, D. B. Sarwer, D. A. Torigian, N. Williams, A. I. Pack, and R. J. Schwab, Effect of Weight Loss on Upper Airway Anatomy and the Apnea–Hypopnea Index. The Importance of Tongue Fat, Am J Respir Crit Care Med 201, 718 (2020).
- [16] T. H. Kim, B. S. Chun, H. W. Lee, and J. S. Kim, Differences of Upper Airway Morphology According to Obesity: Study with Cephalometry and Dynamic MD-CT, Clin Exp Otorhinolaryngol 3, 147 (2010).
- [17] R. J. Schwab, M. Pasirstein, R. Pierson, A. Mackley, R. Hachadoorian, R. Arens, G. Maislin, and A. I. Pack, Identification of Upper Airway Anatomic Risk Factors for Obstructive Sleep Apnea with Volumetric Magnetic Resonance Imaging, Am J Respir Crit Care Med 168, 522 (2003).
- [18] Y.-A. Lu, C.-J. Wang, Y.-T. Chiang, and H.-Y. Li, Volumetric Changes after Coblation Ablation Tongue (CAT) in Obstructive Sleep Apnea Patients, Journal of Clinical Medicine 11, 14 (2022).
- [19] K. L. Do, H. Ferreyra, J. F. Healy, and T. M. Davidson, Does Tongue Size Differ Between Patients With and Without Sleep-Disordered Breathing?, The Laryngoscope 110, 1552 (2000).
- [20] Y. Shigeta, T. Ogawa, E. Ando, G. T. Clark, and R. Enciso, Influence of Tongue/Mandible Volume Ratio on Oropharyngeal Airway in Japanese Male Patients with Obstructive Sleep Apnea, Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 111, 239 (2011).
- [21] C. Iida-Kondo, N. Yoshino, T. Kurabayashi, S. Mataki, M. Hasegawa, and N. Kurosaki,
Comparison of Tongue Volume/Oral Cavity Volume Ratio between Obstructive Sleep Apnea Syndrome Patients and Normal Adults Using Magnetic Resonance Imaging, Journal of Medical and Dental Sciences 53, 119 (2006).
- [22] A. Johal, S. I. PaTEL, and J. M. Battagel, The Relationship between Craniofacial Anatomy and Obstructive Sleep Apnoea: A Case-Controlled Study, Journal of Sleep Research 16, 319 (2007).
- [23] C. Stipa, M. Cameli, G. Sorrenti, D. R. Ippolito, I. Pelligra, and G. Alessandri-Bonetti,
Relationship between Cephalometric Parameters and the Apnoea–Hypopnoea Index in OSA Patients: A Retrospective Cohort Study, European Journal of Orthodontics 42, 101 (2020).
- [24] J. M. Battagel and P. R. L’Estrange, The Cephalometric Morphology of Patients with
Obstructive Sleep Apnoea (OSA), European Journal of Orthodontics 18, 557 (1996).
- [25] R. Bharadwaj, A. Ravikumar, and N. R. Krishnaswamy, Evaluation of Craniofacial Morphology in Patients with Obstructive Sleep Apnea Using Lateral Cephalometry and Dynamic MRI, Indian Journal of Dental Research 22, 739 (2011).
- [26] Y. Wang, I. Fietze, M. Salanitro, and T. Penzel, Comparison of the Value of the STOP- BANG Questionnaire with Oxygen Desaturation Index in Screening Obstructive Sleep Apnea in Germany, Sleep Breath 27, 1315 (2023).
Examining Tongue Size in OSA Patients with Lateral Cephalometric Radiography
Yıl 2024,
Cilt: 17 Sayı: 1, 137 - 146, 28.03.2024
Elif Çelik
,
Samih Diyarbakır
,
Edhem Ünver
,
Fatih Çelik
Öz
Aim: This article aims to investigate tongue dimensions in patients using lateral cephalometric radiography, examining the potential impact of differences in tongue size on Obstructive Sleep Apnea Syndrome (OSAS). The data obtained in this study may contribute to a better understanding of the risk factors involved in the development of OSAS.
Methods: This study included 80 patients, with 34 females and 46 males. Among these patients, 48 were in the patient group with OSA, and 32 were in the control group AHI<5. Tongue dimensions were measured in lateral cephalometric radiographs of the patients, and these measurements were compared between the groups.
Results: In our study, a statistically significant increase was observed in tongue length and tongue area in OSA patients (p < 0.05). However, the increase in tongue thickness was not statistically significant.
Conclusion: Our study shows that OSA patients tend to have larger tongues. A larger tongue may contribute to airway obstruction during sleep, leading to increased OSA severity. This information could aid clinicians in tailoring treatment strategies for OSA patients, potentially improving therapeutic outcomes.
Kaynakça
- [1] N. M. Punjabi, The Epidemiology of Adult Obstructive Sleep Apnea, Proc Am Thorac Soc 5, 136 (2008).
- [2] J. A. Dempsey, S. C. Veasey, B. J. Morgan, and C. P. O’Donnell, Pathophysiology of Sleep Apnea, Physiological Reviews 90, 47 (2010).
- [3] J. L. Hossain and C. M. Shapiro, The Prevalence, Cost Implications, and Management of Sleep Disorders: An Overview, Sleep Breath 06, 85 (2002).
- [4] H. Ölmez, M. Tosun, E. Ünver, R. Çoşkun, G. S. Yalçın, M. Doğan, and Y. K. Arslan,
Can Biomarkers Predict the Risk of Cardiovascular Disease in Patients with Obstructive Sleep Apnea Syndrome? Biomarkers in Obstructive Sleep Apnea Syndrome, Journal of Surgery and Medicine 7, 2 (2023).
- [5] F. Xia and M. Sawan, Clinical and Research Solutions to Manage Obstructive Sleep Apnea: A Review, Sensors 21, 5 (2021).
- [6] J. B. Schellenberg, G. Maislin, and R. J. Schwab, Physical Findings and the Risk for Obstructive Sleep Apnea, Am J Respir Crit Care Med 162, 740 (2000).
- [7] K. Bagai, Obstructive Sleep Apnea, Stroke, and Cardiovascular Diseases, The Neurologist 16, 329 (2010).
- [8] M. Barnes, R. D. McEvoy, S. Banks, N. Tarquinio, C. G. Murray, N. Vowles, and R. J. Pierce, Efficacy of Positive Airway Pressure and Oral Appliance in Mild to Moderate Obstructive Sleep Apnea, Am J Respir Crit Care Med 170, 656 (2004).
- [9] I. Bouloukaki, E. Daskalaki, E. Mavroudi, V. Moniaki, S. E. Schiza, and I. Tsiligianni,
A Dietary and Lifestyle Intervention Improves Treatment Adherence and Clinical Outcomes in Overweight and Obese Patients with Obstructive Sleep Apnea: A Randomized, Controlled Trial, Life 13, 8 (2023).
- [10] H.-P. Chang, Y.-F. Chen, and J.-K. Du, Obstructive Sleep Apnea Treatment in Adults, The Kaohsiung Journal of Medical Sciences 36, 7 (2020).
- [11] R. W. Riley, N. B. Powell, K. K. Li, R. J. Troell, and C. Guilleminault, Surgery and Obstructive Sleep Apnea: Long-Term Clinical Outcomes, Otolaryngol Head Neck Surg 122, 415 (2000).
- [12] A. M. Kim, B. T. Keenan, N. Jackson, E. L. Chan, B. Staley, H. Poptani, D. A. Torigian, A. I. Pack, and R. J. Schwab, Tongue Fat and Its Relationship to Obstructive Sleep Apnea, Sleep 37, 1639 (2014).
- [13] B. C. Neelapu, O. P. Kharbanda, H. K. Sardana, R. Balachandran, V. Sardana, P. Kapoor, A. Gupta, and S. Vasamsetti, Craniofacial and Upper Airway Morphology in AdultObstructive Sleep Apnea Patients: A Systematic Review and Meta-Analysis of Cephalometric Studies, Sleep Medicine Reviews 31, 79 (2017).
- [14] R. L. Horner, R. H. Mohiaddin, D. G. Lowell, S. A. Shea, E. D. Burman, D. B. Longmore, and A. Guz, Sites and Sizes of Fat Deposits around the Pharynx in Obese Patients with Obstructive Sleep Apnoea and Weight Matched Controls, European Respiratory Journal 2, 613 (1989).
- [15] S. H. Wang, B. T. Keenan, A. Wiemken, Y. Zang, B. Staley, D. B. Sarwer, D. A. Torigian, N. Williams, A. I. Pack, and R. J. Schwab, Effect of Weight Loss on Upper Airway Anatomy and the Apnea–Hypopnea Index. The Importance of Tongue Fat, Am J Respir Crit Care Med 201, 718 (2020).
- [16] T. H. Kim, B. S. Chun, H. W. Lee, and J. S. Kim, Differences of Upper Airway Morphology According to Obesity: Study with Cephalometry and Dynamic MD-CT, Clin Exp Otorhinolaryngol 3, 147 (2010).
- [17] R. J. Schwab, M. Pasirstein, R. Pierson, A. Mackley, R. Hachadoorian, R. Arens, G. Maislin, and A. I. Pack, Identification of Upper Airway Anatomic Risk Factors for Obstructive Sleep Apnea with Volumetric Magnetic Resonance Imaging, Am J Respir Crit Care Med 168, 522 (2003).
- [18] Y.-A. Lu, C.-J. Wang, Y.-T. Chiang, and H.-Y. Li, Volumetric Changes after Coblation Ablation Tongue (CAT) in Obstructive Sleep Apnea Patients, Journal of Clinical Medicine 11, 14 (2022).
- [19] K. L. Do, H. Ferreyra, J. F. Healy, and T. M. Davidson, Does Tongue Size Differ Between Patients With and Without Sleep-Disordered Breathing?, The Laryngoscope 110, 1552 (2000).
- [20] Y. Shigeta, T. Ogawa, E. Ando, G. T. Clark, and R. Enciso, Influence of Tongue/Mandible Volume Ratio on Oropharyngeal Airway in Japanese Male Patients with Obstructive Sleep Apnea, Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology 111, 239 (2011).
- [21] C. Iida-Kondo, N. Yoshino, T. Kurabayashi, S. Mataki, M. Hasegawa, and N. Kurosaki,
Comparison of Tongue Volume/Oral Cavity Volume Ratio between Obstructive Sleep Apnea Syndrome Patients and Normal Adults Using Magnetic Resonance Imaging, Journal of Medical and Dental Sciences 53, 119 (2006).
- [22] A. Johal, S. I. PaTEL, and J. M. Battagel, The Relationship between Craniofacial Anatomy and Obstructive Sleep Apnoea: A Case-Controlled Study, Journal of Sleep Research 16, 319 (2007).
- [23] C. Stipa, M. Cameli, G. Sorrenti, D. R. Ippolito, I. Pelligra, and G. Alessandri-Bonetti,
Relationship between Cephalometric Parameters and the Apnoea–Hypopnoea Index in OSA Patients: A Retrospective Cohort Study, European Journal of Orthodontics 42, 101 (2020).
- [24] J. M. Battagel and P. R. L’Estrange, The Cephalometric Morphology of Patients with
Obstructive Sleep Apnoea (OSA), European Journal of Orthodontics 18, 557 (1996).
- [25] R. Bharadwaj, A. Ravikumar, and N. R. Krishnaswamy, Evaluation of Craniofacial Morphology in Patients with Obstructive Sleep Apnea Using Lateral Cephalometry and Dynamic MRI, Indian Journal of Dental Research 22, 739 (2011).
- [26] Y. Wang, I. Fietze, M. Salanitro, and T. Penzel, Comparison of the Value of the STOP- BANG Questionnaire with Oxygen Desaturation Index in Screening Obstructive Sleep Apnea in Germany, Sleep Breath 27, 1315 (2023).