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Airway changes in obstructive sleep apnoea patients associated with a supine versus an upright position examined using cone beam computed tomography

Published online by Cambridge University Press:  27 August 2014

M Camacho ,
R Capasso  and
S Schendel
M Camacho*
Affiliation:
Department of Sleep Medicine – Stanford Hospitals and Clinics, Redwood City, California, USA
R Capasso
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Stanford Hospitals and Clinics, Stanford, California, USA
S Schendel
Affiliation:
Department of Plastic Surgery, Stanford Hospitals and Clinics, Stanford, California, USA
*
Address for correspondence: Dr Macario Camacho, Department of Sleep Medicine, Stanford Hospitals and Clinics, 450 Broadway St, Pavilion B, 2nd floor, Redwood City, California 94063, USA Fax: +1 650 723 6685 E-mail: [email protected]
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Abstract

Objective:

This study aimed to describe total volume and cross-sectional area measurement changes in obstructive sleep apnoea patients associated with a supine versus an upright position.

Method:

A retrospective chart review of patients who underwent cone beam computed tomography in upright and supine positions was performed, and the images were analysed.

Results:

Five obstructive sleep apnoea patients (all male) underwent both upright and supine cone beam computed tomography imaging. Mean age was 35.0 ± 9.3 years, mean body mass index was 28.1 ± 2.7 kg/m2 and mean apnoea–hypopnoea index was 39.3 ± 23.0 per hour. The airway was smaller when patients were in a supine compared with an upright position, as reflected by decreases in the following airway measurements: total volume; posterior nasal spine, uvula tip, retrolingual and tongue base (not significant) cross-sectional areas; and site of the minimum cross-sectional area (of the overall airway). Total airway volume decreased by 32.6 per cent and cross-sectional area measurements decreased between 32.3 and 75.9 per cent when patients were in a supine position.

Conclusion:

In this case series, the airway of obstructive sleep apnoea patients was significantly smaller when patients were in a supine compared with an upright position.

Keywords

Obstructive Sleep ApneaCone Beam Computed TomographyPatient PositioningSupine PositionImaging, Three-DimensionalStatistics & Numerical DataPharynxUvulaPathology
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 128 , Issue 9 , September 2014 , pp. 824 - 830
Copyright
Copyright © JLO (1984) Limited 2014. This is a Work of the U.S. Government and is not subject to copyright protection in the United States. 

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References

1Young, T, Palta, M, Dempsey, J, Skatrud, J, Weber, S, Badr, S. The occurrence of sleep-disordered breathing among middle-aged adults. N Engl J Med 1993;328:1230–5Google Scholar
2He, J, Kryger, MH, Zorick, FJ, Conway, W, Roth, T. Mortality and apnea index in obstructive sleep apnea. Experience in 385 male patients. Chest 1988;94:9–14Google Scholar
3Partinen, M, Jamieson, A, Guilleminault, C. Long-term outcome for obstructive sleep apnea syndrome patients. Mortality. Chest 1988;94:1200–4Google Scholar
4Punjabi, NM, Shahar, E, Redline, S, Gottlieb, DJ, Givelber, R, Resnick, HE. Sleep-disordered breathing, glucose intolerance, and insulin resistance: the Sleep Heart Health Study. Am J Epidemiol 2004;160:521–30Google Scholar
5Schendel, SA, Hatcher, D. Automated 3-dimensional airway analysis from cone-beam computed tomography data. J Oral Maxillofac Surg 2010;68:696–701Google Scholar
6Friedman, M, Tanyeri, H, La Rosa, M, Landsberg, R, Vaidyanathan, K, Pieri, S et al. Clinical predictors of obstructive sleep apnea. Laryngoscope 1999;109:1901–7Google Scholar
7Barrera, JE, Holbrook, AB, Santos, J, Popelka, GR. Sleep MRI: novel technique to identify airway obstruction in obstructive sleep apnea. Otolaryngol Head Neck Surg 2009;140:423–5Google Scholar
8Bharadwaj, R, Ravikumar, A, Krishnaswamy, NR. Evaluation of craniofacial morphology in patients with obstructive sleep apnea using lateral cephalometry and dynamic MRI. Indian J Dent Res 2011;22:739–48CrossRefGoogle ScholarPubMed
9Ingman, T, Nieminen, T, Hurmerinta, K. Cephalometric comparison of pharyngeal changes in subjects with upper airway resistance syndrome or obstructive sleep apnoea in upright and supine positions. Eur J Orthod 2004;26:321–6Google Scholar
10Sutthiprapaporn, P, Tanimoto, K, Ohtsuka, M, Nagasaki, T, Iida, Y, Katsumata, A. Positional changes of oropharyngeal structures due to gravity in the upright and supine positions. Dent Maxillo Fac Rad 2008;37:130–5Google Scholar
11Tsuiki, S, Almeida, FR, Lowe, AA, Su, J, Fleetham, JA. The interaction between changes in upright mandibular position and supine airway size in patients with obstructive sleep apnea. Am J Orthod Dentofacial Orthop 2005;128:504–12Google Scholar
12Van Holsbeke, CS, Verhulst, SL, Vos, WG, De Backer, JW, Vinchurkar, SC, Verdonck, PR et al. Change in upper airway geometry between upright and supine position during tidal nasal breathing. J Aerosol Med Pulm Drug Deliv 2014;27:51–7CrossRefGoogle ScholarPubMed
13Ono, T, Lowe, AA, Ferguson, KA, Fleetham, JA. Associations among upper airway structure, body position, and obesity in skeletal Class I male patients with obstructive sleep apnea. Am J Orthod Dentofacial Orthop 1996;109:625–34Google Scholar
14Roberts, JA, Drage, NA, Davies, J, Thomas, DW. Effective dose from cone beam CT examinations in dentistry. Br J Radiol 2009;82:35–40Google Scholar