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Transverse Maxillary Deficiency Predicts Increased Upper Airway Collapsibility during Drug‐Induced Sleep Endoscopy

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dc.contributor.author Thuler, Eric
dc.contributor.author Seay, Everett G.
dc.contributor.author Woo, John
dc.contributor.author Lee, Jane
dc.contributor.author Jafari, Niusha
dc.contributor.author Keenan, Brendan T.
dc.contributor.author Dedhia, Raj C.
dc.contributor.author Schwartz, Alan R.
dc.date.accessioned 2023-03-23T15:49:34Z
dc.date.available 2023-03-23T15:49:34Z
dc.date.issued 2023
dc.identifier.uri https://hdl.handle.net/20.500.12866/13282
dc.description.abstract To examine the relationship between craniofacial skeletal anatomy and objective measures of pharyngeal collapse obtained during drug‐induced sleep endoscopy. We hypothesized that transverse maxillary deficiency and an increased pharyngeal length will be associated with higher levels of pharyngeal collapsibility. Cross‐sectional analysis in a prospective cohort. University Hospital. A cross‐sectional analysis was conducted in a cohort of consecutive patients from the positive airway pressure (PAP) alternatives clinic who underwent computed tomography (CT) analysis and drug‐induced sleep endoscopy for characterization of upper airway collapsibility. PAP titration was used to determine pharyngeal critical pressure (PCRIT) and pharyngeal opening pressure (PhOP). CT metrics included: Transverse maxillary dimensions (interpremolar and intermolar distances) and pharyngeal length (posterior nasal spine to hyoid distance). The cohort (n = 103) of severe obstructive sleep apnea (Apnea and Hipopnea Index 32.1 ± 21.3 events/h) was predominantly male (71.8%), Caucasian (81.6%), middle‐aged (54.4 ± 14.3 years), and obese (body mass index [BMI] = 30.0 ± 4.9 kg/m2). Reduced transverse maxillary dimensions were associated with higher PCRIT (intermolar distance: β [95% confidence interval, CI] = −.25 [−0.14, −0.36] cmH2O/mm; p = .03) and PhOP (Interpremolar distance: β = −.25 [−0.14, −0.36] cmH2O/mm; p = .02). Longer pharyngeal length was also associated with higher PCRIT (β = .11 [0.08, 0.14] cmH2O/mm, p = .04) and PhOP (β [95% CI] = .06 [0.03, 0.09] cmH2O/mm, p = .04). These associations persisted after adjustments for sex, age, height, and BMI. Our results further the concept that skeletal restriction in the transverse dimension and hyoid descent are associated with elevations in pharyngeal collapsibility during sleep, suggesting a role of transverse deficiency in the pathogenesis of airway obstruction. en_US
dc.language.iso eng
dc.publisher Wiley
dc.relation.ispartofseries Otolaryngology–Head and Neck Surgery
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject craniofacial analysis en_US
dc.subject CT scan en_US
dc.subject maxillary transverse deficiency en_US
dc.subject sleep apnea en_US
dc.subject upper airway collapse en_US
dc.subject.mesh Tomografía Computarizada por Rayos X
dc.subject.mesh Maxilar
dc.subject.mesh Síndromes de la Apnea del Sueño
dc.title Transverse Maxillary Deficiency Predicts Increased Upper Airway Collapsibility during Drug‐Induced Sleep Endoscopy en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1002/ohn.258
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.23
dc.relation.issn 1097-6817


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