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
Midfacial degloving surgical approach is an excellent alternative to the lateral rhinotomy in exposure to the nasal cavity, paranasal sinuses and the nasopharynx. By lifting the soft tissue from the midportion of the face, many extensive benign tumors such as inverted papilloma, nasopharyngeal angiofibroma and some limited malignant lesions could be safely removed. This procedure could be combined with other approaches such as transtemporal, intracranial approach to resect more extensive tumors around the orbit, central skull base, as well. This technique was applied in 40 cases, ranging from 12-72 years of age and in a variety of diseases in Siriraj Hospital from 1991 to 2000. Fifty five per cent were diagnosed as inverted papilloma and 20 per cent were nasopharyngeal angiofibroma. The surgical technique in this operation was emphasized and it has proved to be an extensively valuable procedure for wide exposure of the operative field without any external scar. Functional outcome was obtained in most of the cases with minimal complications.