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Correspondence |

Measurement of Mandibular Volume for Anatomical Imbalance in OSA FREE TO VIEW

Richard W.W. Lee, MBBS, PhD
Author and Funding Information

FINANCIAL/NONFINANCIAL DISCLOSURES: None declared.

CORRESPONDENCE TO: Richard W. W. Lee, MBBS, PhD, Department of Respiratory Medicine, Gosford Hospital, Holden Street, Gosford, NSW 2250, Australia


Copyright 2016, . All Rights Reserved.


Chest. 2016;149(6):1588. doi:10.1016/j.chest.2016.03.061
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Anatomical imbalance in OSA can be assessed with upper airway imaging taking into account the amount of soft tissues within a bony enclosure; such imbalance has been shown to increase the collapsibility of the passive pharyngeal airway. The study by Schorr et al examined the relationship between tongue/mandibular volume ratio and passive critical closing pressure in white and Japanese-Brazilian subjects. It showed that this anatomical imbalance only influenced passive critical closing pressure in the white subjects. An important methodological consideration in this study is that the bony compartment was a measurement of the mandibular bone, rather than the mandibular bony “enclosure” volume. The shorter mandible length in the Japanese/Brazilian subjects is also inconsistent with the larger mandibular bony volume reported, suggesting that the bony measurement used was not demonstrative of the degree of craniofacial bony restriction. Imaging studies examining upper airway anatomical imbalance should apply methods to measure the bony enclosure.,

References

Watanabe T. .Isono S. .Tanaka A. .et al Contribution of body habitus and craniofacial characteristics to segmental closing pressures of the passive pharynx in patients with sleep-disordered breathing. Am J Respir Crit Care Med. 2002;165:260-265 [PubMed]journal. [CrossRef] [PubMed]
 
Schorr F. .Kayamori F. .Hirata R.P. .et al Different craniofacial characteristics predict upper airway collapsibility in Japanese-Brazilian and white men. Chest. 2016;149:737-746 [PubMed]journal. [CrossRef] [PubMed]
 
Sutherland K. .Phillips C.L. .Yee B.J. .et al Maxillomandibular volume influences the relationship between weight loss and improvement in obstructive sleep apnea. Sleep. 2016;39:43-49 [PubMed]journal. [CrossRef] [PubMed]
 
Shelton K.E. .Gay S.B. .Hollowell D.E. .et al Mandible enclosure of upper airway and weight in obstructive sleep apnea. Am Rev Respir Dis. 1993;148:195-200 [PubMed]journal. [CrossRef] [PubMed]
 

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References

Watanabe T. .Isono S. .Tanaka A. .et al Contribution of body habitus and craniofacial characteristics to segmental closing pressures of the passive pharynx in patients with sleep-disordered breathing. Am J Respir Crit Care Med. 2002;165:260-265 [PubMed]journal. [CrossRef] [PubMed]
 
Schorr F. .Kayamori F. .Hirata R.P. .et al Different craniofacial characteristics predict upper airway collapsibility in Japanese-Brazilian and white men. Chest. 2016;149:737-746 [PubMed]journal. [CrossRef] [PubMed]
 
Sutherland K. .Phillips C.L. .Yee B.J. .et al Maxillomandibular volume influences the relationship between weight loss and improvement in obstructive sleep apnea. Sleep. 2016;39:43-49 [PubMed]journal. [CrossRef] [PubMed]
 
Shelton K.E. .Gay S.B. .Hollowell D.E. .et al Mandible enclosure of upper airway and weight in obstructive sleep apnea. Am Rev Respir Dis. 1993;148:195-200 [PubMed]journal. [CrossRef] [PubMed]
 
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