Analyse de la morphologie buccofaciale et des voies aériennes supérieures chez des porteurs de prothèses complètes souffrant des troubles du sommeil
Problematic: Controversy concerning the relationship between between anatomical parameters of the upper airways and obstructive sleep apnea exist in the literature. Although some studies have shown a correlation between some of these parameters and the presence or severity of obstructive sleep apnea, other studies have not demonstrated any association. Despite the current use of three-dimensional radiology technology, the full potential of available information does not appear to have been totally explored. Objectives: The main objective of this study was to assess the strength of the correlation between various upper airway parameters and the obstructive sleep apnea and to determine to what extent anatomical parameters can predict the presence of sleep apnea. Methods: The study used a descriptive analytical design and was nested in a large randomized controlled study on the impact of nocturnal wear of the prosthesis on the sleep apnea. Data were obtained from 28 completely edentate individuals (65≥) who had an apnea hypopnea index (AHI) ≥ 10. Obstructive sleep apnea was measured by the use of polysomnography. The information regarding the upper airway anatomical parameters and sociodemographic data were obtained by the use of Cone beam computed tomography (CBCT) and auto-adiminstered questionnaires consecutively. Bivariate statistical analyses and linear regression models were used to analyse the data.. A p ≤ 0.05 was considered statistically significant. Results: The study participants mean AHI was 21.0 ± 10.6. Any association was found between the individual upper airway anatomical parameters (unaffected by the contact between the uvula and the posterior wall of the pharynx) and the apnea hypopnea index. The automatic regression model showed that 38% of the variance of AHI could be predicted by a combination of anatomical parameters (p = 0.004) including planes passing through the posterior nasal spine and through the tops of the uvula and epiglottis into a sagittal plan. Conclusion: A combination of anatomical parameters rather than individual parameters seems to be associated with obstructive sleep apnea. Keywords: sleep disorders, obstructive sleep apnea, edentulism, complete prostheses, upper airway, buccofacial morphology, polysomnography, conical beam volume tomography, CBCT, radiology.
sleep disorders obstructive sleep apnea edentulism complete prostheses upper airway buccofacial morphology polysomnography conical beam volume tomography CBCT radiology