Craniofacial structure in patients with obstructive sleep apnoea

Obstructive sleep apnoea (OSA) is characterised by at least five 10-s episodes of apnoea or markedly shallow breathing per 1 h of sleep, which can lead to severe, sometimes life-threatening complications. It is essential to determine the specific features of the affected patients' craniofacial structure, thus enabling their allocation to risk groups. The aim of the study was to assess the craniofacial structure in OSA patients, comparing the findings with Hasund's and Segner's cephalometric normal values. In addition, the sagittal dimensions of the upper airways, measured at two levels, were compared to McNamara's normal values.

The study covered 41 patients diagnosed polysomno-graphically with OSA. Lateral cephalograms with cephalometric analysis and the measurements of the upper and lower sagittal dimensions of the upper airways were taken for each patient.

The only feature of the patents' facial skeleton that significantly diverged from the normal range was the SNB angle (p = 0.004). Other angles, i.e. SNA, ANB, NL/NSL, NL/ML and NSL/ML, were not significantly different from normal. The average upper cross-sectional area of the upper airways was 10.4 mm; in 97.6% patients, this measurement was below McNamara's normal values. In the majority of patients (75.6%), the average lower sagittal dimension of the upper airways (10.4 mm) was also below the normal.

Mandibular retrognathia, manifested by the reduced SNB angle, and the narrowed upper and lower sagittal dimensions of the upper airways can be considered one of OSA prognostic factors.