폐쇄성 수면 무호흡 환자의 측모 두부방사선계측사진 및 치아모형 연구 = A cephalometric and dental cast study of obstructive sleep apnea patients

국문 초록 (Abstract)

폐쇄성 수면 무호흡증이란 수면도중 주기적으로 호흡이 멈추는 증상을 말한다. 상악과 하악이 후퇴되어 있거나 하악이 작으며 수평적으로 기도 폭경이 좁고 혀가 후방에 위치하는 등 폐쇄성 수면 무호흡 환자의 전후방적인 악골 및 연조직 특성에 대한 평가는 많았으나 치열 및 악궁에 대한 평가가 부족하여 폐쇄성 수면 무호흡증 환자의 골격적 특징과 악궁의 폭경과 구개깊이와 수면무호흡지수와의 상관관계를 알아보고자 하였다. 계명대학교 의과대학 동산의료원 수면클리닉에 수면장애를 주소로 내원한 환자 중 수면다원검사와 측모 두부방사선계측사진과 치아모형이 갖추어진 38명의 남자를 대상으로 하여 치아모형과 측모 두부방사선계측사진, 수면무호흡지수와 체질량지수를 비교하였다. 수면무호흡지수와 악궁의 횡폭경, 구개깊이, 수직피개량 및 수평피개량과는 상관관계가 없었으며 수면무호흡군에서 상기도 폭경은 좁고, 하기도 폭경은 넓은 경향이 있었다. 수면무호흡지수와 상기도 폭경은 미약한 음의 상관관계를 가졌으나 하기도 폭경은 미약한 양의 상관관계를 가졌고, 수면무호흡지수가 클수록 하악 하연으로터 설골까지의 거리도 멀었다.

다국어 초록 (Multilingual Abstract)

To evaluate the cephalometric and dental characteristics of obstructive sleep apnea (OSA) patients, 23 OSA patients and 15 control, non-OSA, patients who visited the Sleep Disorder Clinic Center, Keimyung University were investigated. Patients who suffered from apnea-hypopnea episodes over 10 times per hour were diagnosed as having OSA after polysomnograph testing. Impressions were taken with alginate. Cephalometric radiographs were taken at maximum intercuspation. The dental cast measurements, including transpalatal width, intercanine width, intermolar width and palatal depth did not differ between the control and OAS groups and did not have a positive correlation with the apnea-hypopnea index (AHI). Upper airway width was statistically narrower than the control group. Upper airway width had a low negative correlation with AHI, but, lower airway width had a low positive correlation, and, the higher the AHI score, the longer the mandibular border to hyoid distance.

참고문헌 (Reference)

1 "폐쇄성 수면 무호흡환자의 안면 및 혀의 크기에 대한 연구" 27 : 865-870, 1997

2 "Upper airway morphology in patients with idiopathic obstructive sleep apnea" 129 : 355-360, 1984

3 "The occurrence of sleep-disordered breathing among middle-aged adults" 328 : 1230-1235, 1993

4 "The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome" 19 : 156-177, 1996

5 "Surgical correction of anatomic abnormalities in obstructive sleep apnea syndrome: uvulopalatopharyngoplasty" 89 : 923 -934, 1981

6 "Sleep-related breathing disorders in adults: recommendation for syndrome definition and measurement techniques in clinical research. The report of an American Academy of Sleep Medicine Task Force" 22 : 667-689, 1999

7 "Sleep apnoea in acromegaly" 280 : 894-897, 1980

8 "Sleep apnea in acromegaly" 69 : 615-618, 1980

9 "Prevalence of sleep-disordered breathing in ages 40-64 years: a population-based survey" 20 : 65-76, 1997

10 "Obstructive sleep apneic patients have craniomandibular abnormalities" 9 : 469-477, 1986

11 "Obstructive sleep apnea associated with tonsillar hypertrophy in adults" 141 : 990-992, 1981

12 "Obstructive sleep apnea and obesity" 23 : 751-760, 1990

13 "Mortality and apnea index in obstructive sleep apnea. Experience in 385 male patients" 94 : 9-14, 1988

14 "Identifying the patient with sleep apnea: upper airway assessment and physical examination" 31 : 919-930, 1998

15 "Hypersomnolence and intermittent upper airway obstruction. Occurrence caused by micrognathia" 237 : 2740-2742, 1977

16 "Frontal and lateral cephalometry in patients with sleep-disordered breathing" 111 : 634-641, 2001

17 "Facial morphology and obstructive sleep apnea" 90 : 484-491, 1986

18 "Exacerbation of upper airway sleep apnea by lymphocytic lymphoma" 77 : 689-690, 1980

19 "Evaluation of the upper airway in patients with obstructive sleep apnea" 14 : 361-371, 1991

20 "Dentoskeletal and tongue soft tissue correlates: a cephalometric analysis of rest position" 88 : 333-341, 1985

21 "Comparison of the severity of sleep-disordered breathing in Asian and Caucasian patients seen at a sleep disorders center" 92 : 843-848, 1998

22 "Cephalometric predictors of obstructive sleep apnea" 29 : 338-345, 2000

23 "Cephalometric comparisons between Chinenese and Caucasian patients with obstructive sleep apnea" 117 : 479-485, 2000

24 "Cephalometric analyses and flow-volume loops in obstructive sleep apnea patients" 6 : 303-311, 1983

25 "A comparison of Asian and white patients with obstructive sleep apnea syndrome" 109 : 1937-1940, 1999