測顱術於睡眠呼吸障礙之診斷－299名病例分析

Cephalometry in the Diagnosis of Sleep - Disordered Breathing - Analysis of 299 Cases

劉德雄(Te-Hsiung Liu) ； 洪嘉駿(Chia-Chun Hung)

《台灣耳鼻喉頭頸外科雜誌》 39卷2期 (2004/04) Pp. 50-58

https://doi.org/10.6286/2004.39.2.50

摘要

BACKGROUND: Cephalometric airway analysis has been proven essential in diagnosis and prognostic prediction for surgical outcome of sleep-disordered breathing (SDB). Most literature relating to cephalometic analysis uses different ethnic populations but reports of Asian samples are rare. The purpose of this study was to establish a database for cephalometric measurement in a Taiwanese population, and to test the statistical relationship with respiratory disturbance index (RDI).
METHODS: From March 1999 to December 2001, lateral cephalometric measurements were obtained from 299 patients with polysomnography (PSG) diagnosed SDB. Cephalometric parameters used were: angle from sella to nasion to subspinale (SNB); angle from sella to nasion to supramentale (SNB), distance from the posterior nasal spine to the tip of the soft palate (PNS-P); width of the posterior airway space (PAS); and, distance of the mandibular plane to the hyoid bone (MPH). The polysomnographic results were statistically analyzed. SDB patients were divided into four groups based on RDI: primary snore (A); mild (B); moderate (C); and, severe (D). The statistical relationship between the results of the cephalometric analysis and RDI were tested to determine predictive value of parameters of cephalometry.
RESULTS: Statistically significant differences were demonstrated for SNB, PNS-P, PAS, and MPH comparing selected groups: A vs. D in SNB; A vs. C and B vs. C in PNS-P; A vs. C in PAS; A vs. C, A vs. D, B vs. C, and B vs. D in MPH. The correlation coefficients for the relationships between RDI and SNA, SNB, PNS-P, PAS and MPH were -0.202, -0.239, 0.183, -0.153, 0.261, with all classified as low correlations.
CONCLUSION: We established a preliminary cephalometric-measurement database using a Taiwanese SDB population. Statistically significant differences were demonstrated for SNB, NS-P, PAS and MPH comparing selected groups. Correlation coefficients derived for the relationship between RDI and the cephalometric parameters SNA, SNB, PNS-P, PAS and MPH were low, contributions to elevated RDI may be multifactorial. Cephalometric measurement can be useful for: evaluation of SDB patients; determining craniofacial anomaly that interrupts patency of the upper airway, and, assisting pre-operative evaluation and management. (J Taiwan Otolaryngol Head Neck Surg 2004;39:50-58)

關鍵字

測顱術 ； 睡眠呼吸障礙 ； 阻塞性睡眠呼吸障礙徵候群

並列摘要

BACKGROUND: Cephalometric airway analysis has been proven essential in diagnosis and prognostic prediction for surgical outcome of sleep-disordered breathing (SDB). Most literature relating to cephalometic analysis uses different ethnic populations but reports of Asian samples are rare. The purpose of this study was to establish a database for cephalometric measurement in a Taiwanese population, and to test the statistical relationship with respiratory disturbance index (RDI).
METHODS: From March 1999 to December 2001, lateral cephalometric measurements were obtained from 299 patients with polysomnography (PSG) diagnosed SDB. Cephalometric parameters used were: angle from sella to nasion to subspinale (SNB); angle from sella to nasion to supramentale (SNB), distance from the posterior nasal spine to the tip of the soft palate (PNS-P); width of the posterior airway space (PAS); and, distance of the mandibular plane to the hyoid bone (MPH). The polysomnographic results were statistically analyzed. SDB patients were divided into four groups based on RDI: primary snore (A); mild (B); moderate (C); and, severe (D). The statistical relationship between the results of the cephalometric analysis and RDI were tested to determine predictive value of parameters of cephalometry.
RESULTS: Statistically significant differences were demonstrated for SNB, PNS-P, PAS, and MPH comparing selected groups: A vs. D in SNB; A vs. C and B vs. C in PNS-P; A vs. C in PAS; A vs. C, A vs. D, B vs. C, and B vs. D in MPH. The correlation coefficients for the relationships between RDI and SNA, SNB, PNS-P, PAS and MPH were -0.202, -0.239, 0.183, -0.153, 0.261, with all classified as low correlations.
CONCLUSION: We established a preliminary cephalometric-measurement database using a Taiwanese SDB population. Statistically significant differences were demonstrated for SNB, NS-P, PAS and MPH comparing selected groups. Correlation coefficients derived for the relationship between RDI and the cephalometric parameters SNA, SNB, PNS-P, PAS and MPH were low, contributions to elevated RDI may be multifactorial. Cephalometric measurement can be useful for: evaluation of SDB patients; determining craniofacial anomaly that interrupts patency of the upper airway, and, assisting pre-operative evaluation and management. (J Taiwan Otolaryngol Head Neck Surg 2004;39:50-58)

並列關鍵字

cephalometry ； sleep-disordered breathing ； obstructive sleep apnea syndrome