ABSTRACT
Objective: To obtain referent normative values of lateral cephalometric parameters of the upper airway in Thai people without clinical features of obstructive sleep apnea syndrome (OSAS). Methods: A total of 105 healthy subjects (80 males and 25 females) were recruited. Inclusion criteria were healthy people age > 18 years with body mass index (BMI) of < 30 kg/m2, normal visual harmony of facial profile, no history of snoring or witnessed apnea, and no excessive daytime sleepiness (Epworth Sleepiness Scale ≤ 8). All subjects must have a regular sleep pattern with total sleep duration of 7-9 hours and must have no complaint of difficulty sleeping. Exclusion criteria were pregnant women, patients with previous orthodontic treatment, corrective jaw surgery, upper airway surgery, neoplasm, irradiation in head and neck, and patients who had underlying illnesses using medication or substance which affected the sleep-wake cycle. All subjects had lateral cephalometric radiographs taken with a standardized technique. Every data was measured twice on separate occasions. Results: The reliability of repeated measurements was excellent shown by intraclass correlation coefficients ranging from 0.95 to 0.99. The baseline data were presented in mean ± SD. SNA, SNB, PAS, MPH and PNS-P in males were 84.3 ± 4.0, 81.5 ± 4.1, 14.2 ± 3.4, 16.1 ± 5.3, and 34.8 ± 6.1, respectively. SNA, SNB, PAS, MPH and PNS-P in females were 84.4 ± 3.1, 80.7 ± 3.2, 11.1 ± 3.3, 10.8 ± 4.9, and 32.3 ± 3.1, respectively. The parameters that were different between both genders included N-ANS, GN-GO, H-PP, MPH, PAS, and TL. (p < 0.05) Conclusion: To date, this study has possibly represented the largest local database of lateral cephalometric measurements focusing on Thai people without clinical features of OSAS. It may be another useful reference for future research and clinical practice.
ABSTRACT
Objective: To report the first case experience of maxillomandibular advancement for treatment of severe obstructive sleep apnea syndrome (OSAS) in Thailand. Methods: We present a 65-year-old man patient with severe obstructive sleep apnea syndrome who underwent maxillomandibular advancement in Siriraj Hospital with 4 months follow up. Results: Significant improvement in both subjective symptoms and objective polysomnographic parameters have been demonstrated. There were no serious adverse effects after the operation. Conclusion: Maxillomandibular Advancement procedure may be an excellent alternative treatment for severe OSAS patients who failed CPAP or other interventions and do not need a tracheostomy.