CERVICAL SPINE ANGLES, CRANIOCERVICAL POSTURE, NECK LENGTH AND OROPHARYNGEAL AIRWAY ANALYSES OF OBSTRUCTIVE SLEEP APNEA PATIENTS IN BOTH SUPINE AND UPRIGHT POSITIONS: A RETROSPECTIVE THREE-DIMENSIONAL IMAGING STUDY

摘要

introduction: Obstructive sleep apnea (OSA) is one of the most common sleep-related breathing disorders. Previous airway studies of OSA subjects have relied largely on two-dimensional (2D) radiographs. The purpose of this study was to use three-dimensional (3D) imaging to the analyze the relationships among cervical spine angles, craniocervical posture, cervical spine length and the oropha-ryngeal airway volume in OSA patients in both the supine and upright positions. methods: Twenty-eight OSA subjects with 3D imaging were included. Airway dimensions, craniocervical posture, spine angles and spine length were assessed using Dolphin? 11.8. Correlation analyses were performed to detect associations amongthe recorded and measured variables. Mean differences were determined between the supine and upright subjects, results and conclusions: Significant associations were found: positive associations between Apnea-Hypopnea Index (AHI) and age, craniocervical posture and airway volumes, craniocervical posture and cervical vertebrae C1-C2 spinal angle, and spine length and airway volumes. Negative associations were found between craniocervical posture and body mass index (BMI), C2-C3 and C1-C4 angle and age. McGregor and McRae angles were found to be correlated. Subjects in the supine position had significantly smaller oropharyngeal airway dimensions than subjects in the upright position. Craniocervical extension was correlated positively with increased BMI and negatively correlated with airway volumes; however, spinal angles were not. Subjects in the supine position demonstrated smaller airway volumes than upright subjects. Subject positioning and posture are important consideration during the evaluation of OSA.