Assessment of Cephalometric Parameters and Correlation With the Severity of the Obstructive Sleep Apnea Syndrome

Abstract

Background In individuals diagnosed with obstructive sleep apnea syndrome (OSAS), variations in craniofacial structure have been inconsistently documented, showing differing degrees of alteration between obese and nonobese patients. In addition, sleep disturbance has also been shown to induce disequilibrium in this population of patients. This pilot observational study aimed to assess craniofacial values in obese and nonobese subpopulations of patients with OSAS and their correlation and association with the severity of OSAS. We also assessed whether OSAS patients are characterized by an impaired equilibrium in relation to and associated with the severity of OSAS. Methods Forty consecutive adult patients with OSAS (45% female) with a mean age of 56 ± 8.18 years were included. Through cephalometry, we assessed the upper (UPa-UPp) and lower (LPa-LPp) pharynx diameters, superior anterior facial height (Sor-ANS), anterior facial height (ANS-Me), anterior vertical dimension (Sor-Me), posterior facial height (S-Go) and craniovertebral angle (CVA). Furthermore, we analyzed postural equilibrium through a stabilometric examination. Results Nonobese patients with OSAS had a reduced UPa-UPp (p = 0.02). Cephalometric measurements were correlated with the severity of OSAS in nonobese patients, whereas only Sor-ANS was correlated with the severity of OSAS in the obese subpopulation. In the overall population, altered craniofacial values are associated with severe OSAS. Although there are differences in equilibrium between obese and nonobese OSAS patients, the stabilometric measurements were not correlated or associated with OSAS severity. Conclusion Altered craniofacial values in OSAS patients are linked to OSAS severity, which is influenced by obesity but not exclusively; these patients also experience compromised equilibrium unrelated to obesity and disease severity. From a translational medicine perspective, these findings underscore the importance of a multidisciplinary approach in the management of OSAS, suggesting that interventions tailored not only to weight management but also to craniofacial and postural rehabilitation could enhance patient outcomes. Furthermore, the identification of specific craniofacial alterations associated with OSAS severity opens new avenues for the development of personalized diagnostic tools and therapeutic devices, exemplifying the potential of translational research in bridging the gap between clinical observations and innovative treatments.