Obstructive sleep apnoea: multiple comparisons of cephalometric variables of obese and non-obese patients

Background: Pathogenesis of obstructive sleep apnoea (OSA) is complex and n ot yet fully understood. Several factors contribute to OSA severity. Obesit y is believed to play an important role, Nevertheless, not all OSA patients are obese. Therefore, the different features that cause nocturnal upper ai rway obstruction in obese and non-obese OSA patients could be expected, Pur pose: To investigate the different components of cervico-craniofacial skele tal and upper airway soft tissue morphology among obese OSA, non-obese OSA patients and the controls, Patients: One hundred male OSA patients were cla ssified into two groups on the basis of body mass index (BMI) as obese (BMI greater than or equal to 30 kg/m(2)) and non-obese (BMI < 30 kg/m(2)), Con sequently; 57 obese and 43 non-obese OSA patients were examined and compare d with a control group of 36 healthy males, Study design: A comprehensive c ephalometric analysis of cervico-craniofacial skeletal and upper airway sof t tissue morphology was performed. Sixty-eight cephalometric variables were compared among the three groups by one way analysis of variance with Bonfe rroni's test, Results: Both OSA groups had aberrations of cervico-craniofac ial skeletal as well as upper airway soft tissue morphology when compared w ith the controls. These anatomic deviations were confined to cervico-cranio facial skeletal structures in the non-obese OSA patients, whereas the obese OSA patients had more abnormalities in the upper aim as soft tissue morpho logy, head posture and position of the hyoid bone. Conclusion: The findings imply that there should be different treatment regimens for the two subgro ups of OSA patients. Cephalometric analysis together with various considera tions of BMI is highly recommended as one of the most important tools in di agnosis and treatment planning for OSA patients. (C) 2000 European Associat ion for Cranio-Maxillofacial Surgery.