Obstructive sleep apnea syndrome: Hooked appearance of the soft palate in awake patients - Cephalometric and CT findings

PURPOSE: To determine whether a hooked appearance of the soft palate can be seen in awake patients with snoring with or without obstructive sleep apne a syndrome (OSAS) on cephalometric radiographs and computed tomographic (CT ) scans. MATERIALS AND METHODS: One hundred thirty-one patients with snoring underwe nt cephalometric radiography, with which the posterior airway space, soft p alate length and width, and distance between the hyoid bone and mandibular plane were measured, and/or pharyngeal CT, with which the ruminal areas of the airway at the naso-, oro-, and hypopharyngeal levels were measured. RESULTS: Of the 131 patients, 96 had OSAS, and 35 had snoring. Nine of 96 p atients with OSAS had soft palate hooking on awake pharyngeal CT or cephalo metric images. No patient with snoring alone had hooking. Patients with hoo king had a larger posterior airway space than did patients with OSAS withou t hooking (P = .05), and an enlarged (greater than or equal to 15-mm) poste rior airway space was more frequent in patients with hooking (eight of nine patients)than in those without hooking (34 of 87) (P < .01). Oropharyngeal and hypopharyngeal areas were significantly larger in patients with hookin g than in patients without hooking or in patients with snoring (P less than or equal to .04). CONCLUSION: Cephalometric radiography and CT can demonstrate hooking of the soft palate in awake patients. This finding indicates a high risk for OSAS .