Association between pterygoid hamulus length and apnea hypopnea index in patients with obstructive sleep apnea: a combined three-dimensional cone beam computed tomography and polysomnographic study

Oral Surg Oral Med Oral Pathol Oral Radiol. 2016 Mar;121(3):330-9. doi: 10.1016/j.oooo.2015.10.032. Epub 2015 Nov 14.

Abstract

Objective: The purpose of this study was to investigate the relationships among the pterygoid hamulus (PH), the maxillo-mandibular complex to the pharynx, the upper airway, and the soft palate and a possible connection to sleep apnea severity as assessed by polysomnography.

Study design: A total of 100 left and right sides of the PH were retrospectively measured by two observers from 50 cone beam computed tomography images by using three-dimensional rendering program in patients with obstructive sleep apnea (33 males and 17 females, with a mean age of 56.8 years; range 32-82 years).

Results: The mean apnea hypopnea index was 30.2 (range 0-95). A linear regression analysis on the apnea hypopnea index with the total length of the PH adjusted for gender, body mass index, neck circumference, and age showed a statistically significant association: (-0.234(∗); P = .005). None of the other variables reached formal significance.

Conclusion: The pterygoid hamulus length is inversely associated with sleep apnea severity. Our study provides further insight into the pathophysiology of sleep apnea, with the result that PH length could be a future supplementary measurement to help clinicians to stratify and determine the best treatment options for patients with obstructive sleep apnea.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Cone-Beam Computed Tomography / methods*
  • Female
  • Humans
  • Imaging, Three-Dimensional
  • Male
  • Middle Aged
  • Oropharynx / diagnostic imaging*
  • Palate, Soft / diagnostic imaging*
  • Polysomnography*
  • Retrospective Studies
  • Severity of Illness Index
  • Sleep Apnea, Obstructive / diagnostic imaging*
  • Sleep Apnea, Obstructive / physiopathology*
  • Sphenoid Bone / diagnostic imaging*