A cephalometric comparison of subjects with snoring and obstructive sleep apnoea

This prospective study analysed the upright lateral cephalometric radiograp hs of 115 dentate, Caucasian males. Forty-five subjects exhibited proven ob structive sleep apnoea (OSA), 46 were simple snorers, and the remaining 24 subjects, who had no history of respiratory disease and did not snore, acte d as controls. Radiographs were traced and digitized, and comparisons were made of the dento-skeletal, soft tissue, and oropharyngeal features of the three groups. Differences were also sought between the snoring and OSA subj ects. Of the hard tissue measurements, only the cranial base angle and mandibular body length showed significant inter-group differences (P < 0.001 and P < 0.05, respectively). When the airway and associated structures were examine d, both snorers a nd OSA subjects exhibited narrower airways, reduced oroph aryngeal areas, shorter and thicker soft palates, and larger tongues than t heir control counterparts. Comparison of the two sleep disordered breathing groups showed no differences in any of the skeletal or dental variables ex amined. However in OSA subjects, the soft palate was larger and thicker (P < 0.05), both lingual and oropharyngeal areas were increased (P < 0.01 and P < 0.05, respectively) and the hyoid was further from the mandibular plane (P < 0.05). Thus, whilst the dento-skeletal patterns of snorers resembled those of subj ects with OSA, some differences in soft tissue and hyoid orientation were a pparent. There was not, however, a recognizable gradation in size of the ai rway and its associated structures from control through snoring to OSA subj ects. This suggests that there may be a cephalometrically recognizable pred isposition towards the development of sleep disordered breathing, but that this is only one facet of the condition.