Three-dimensional evaluation of upper airway in patients with obstructive sleep apnea syndrome during oral appliance therapy

Gianguido Cossellu, Roberto Biagi, Michele Sarcina, Carmen Mortellaro, Giampietro Farronato

Research output: Contribution to journalArticle

Abstract

Obstructive sleep apnea syndrome (OSAS) represents a frequent and common respiratory disease characterized by repeated episodes of complete and/or partial obstruction of upper airways during sleep, normally associated with reduction of oxygen saturation in blood. The oral appliances (OAs) are considered to be an effective treatment modality thanks to the upper airway enlargement. Lateral cephalometry has been used for the 2-dimensional evaluation of upper airway form with several limits. We obtained an accurate 3-dimensional (3D) volume analyses with cone beam computed tomography (CBCT) scans to confirm the effects of OA on the upper airway in patients with OSAS. Ten Italian patients with moderate or severe OSA (3 males and 7 females, 53.4 ± 11.3 years of age, and BMI 24.5 ± 2.7), who cannot tolerate continuous positive air pressure therapy and rejected a surgical approach, were treated with non-adjustable customized OAs and evaluated with CBCT and polysomnography. Upper airway form was examined in the presence and absence of OA and the volume was measured and compared in 2 different areas. Specific planes have been considered to match the data and calculate the benefit obtained with therapy. Nine out of ten patients showed an improvement of total upper airway volume and an improvement in apnea-hypopnea index. Volume increased both in the posterior soft palate region and in the posterior tongue region. In the inferior area, we observed greater differences. 3D image reconstruction accurately confirmed morphological changes in the upper airway during OA therapy. The use of this 3D evaluation is expected to improve the results of OA therapy in the future.

Original languageEnglish
Pages (from-to)745-748
Number of pages4
JournalJournal of Craniofacial Surgery
Volume26
Issue number3
DOIs
Publication statusPublished - May 1 2015

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Obstructive Sleep Apnea
Cone-Beam Computed Tomography
Cephalometry
Air Pressure
Therapeutics
Soft Palate
Computer-Assisted Image Processing
Polysomnography
Apnea
Airway Obstruction
Tongue
Sleep
Oxygen

ASJC Scopus subject areas

  • Medicine(all)

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Three-dimensional evaluation of upper airway in patients with obstructive sleep apnea syndrome during oral appliance therapy. / Cossellu, Gianguido; Biagi, Roberto; Sarcina, Michele; Mortellaro, Carmen; Farronato, Giampietro.

In: Journal of Craniofacial Surgery, Vol. 26, No. 3, 01.05.2015, p. 745-748.

Research output: Contribution to journalArticle

Cossellu, Gianguido ; Biagi, Roberto ; Sarcina, Michele ; Mortellaro, Carmen ; Farronato, Giampietro. / Three-dimensional evaluation of upper airway in patients with obstructive sleep apnea syndrome during oral appliance therapy. In: Journal of Craniofacial Surgery. 2015 ; Vol. 26, No. 3. pp. 745-748.
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