Association of apnea-hypopnea index and lateral cephalometry pre- and post-surgery in obstructive sleep apnea patients


  • Aswini A. Department of ENT, Soham ENT Hospital, Madurai, Tamil Nadu, India
  • Swati Mishra Department of ENT, GMERS Vadnagar, Gujarat, India
  • Devanshi Modi Department of ENT, GMERS Vadnagar, Gujarat, India
  • Sanjay Udupi Department of ENT, KKR ENT Hospital, Kilpauk, Chennai, Tamil Nadu, India



OSHAS, ESS, AHI, Cephalometry


Background: Snoring and obstructive sleep apnea are new emerging medical entity and require early diagnosis and treatment because of their increasing implication on physical, mental, social and emotional health. Aim of this study is to assess severity of OSHAS and co-relate efficacy of various post-surgical parameter on objective and subjective improvement in patients.

Methods: 43 patients having the symptoms were included in the study and followed over a period of three months and during their post operative visit their lateral cephalometric findings, ESS were recorded and compared to pre operative values to see if any association exists between them.

Results: it was seen that various surgical interventions did bring about subjective and objective improvement in patients and these were statistically significant.

Conclusions: OSHAS is a spectrum of disorders and has great impact on persons physical, mental and emotional well-being. Early diagnose and treatment eliminated the future risks. Surgical intervention helps improve symptoms of OSHAS and should be undertaken without delay wherever indicated.


Remmers JE, De Groot WJ, Sauerland EK, Anch AM. Pathogenesis of upper airway occlusion during sleep. J Appl Physiol. 1978;44(6):931-8.

Young T, Finn L, Peppard PE. Sleep disordered breathing and mortality: eighteen-year follow-up of the Wisconsin sleep cohort. Sleep. 2008;31(8):1071-8.

Paulo TMB, Edson SFF, Telma M. Correlation of cephalometric and anthropometric measures with obstrucitve sleep apnea severity. Int Arch Otorhinolaryngol. 2013;17(3):23-6.

Schlosshan D, Elliot M. Clinical presentation and diagnosis of the obstructive sleep apnea hypopnea syndrome. Thorax. 2004;59(4):347-52.

Dobrowolska M. Craniofacial structure in patients with obstructive sleep apnoea. Folia Morphol. 2009;75(3):311-5.

Szymanska J, Dobrowolska-Zarzycka M. The influence of upper airways diameter on the intensity of obstructive sleep apnea. Agric Environ Med. 2014;21(1):217-20.

Krieger J. Clinical presentations of sleep apnoea. Eur Respir Mon. 1998;3:75-105.

Davies RJO, Stardling JR. The relationship between neck circumference, radiographic pharyngeal anatomy, and the obstructive sleep apnea syndrome. Eur Respir J. 1990;3:509-14.

Hsueh-Yu L. Suspension Palatoplasty for Obstructive sleep Apnea- A preliminary study. Sci Rep. 2018;8:4224.

Ottavio PM. Modified hyoid suspension technique in the treatment of multilevel related obstructive sleep apnea. Otolaryngol Head Neck Surg. 2014;150(2):321-4.

Mike Y. Cephalometric Parameters after multilevel pharyngeal surgery for patients with Obstructive sleep apnea. Laryngoscope. 1998;108:789-95.

Stuck BA, Neff W, Hörmann K, Verse T, Bran G, Baisch A. Anatomic changes after Hyoid suspension for obstructive sleep apnea; An MRI study. Am Acad Otolaryngol Head Neck Surg. 2005;133(3):397-402.

Bowden MT. Outcomes of Hyoid suspension for the treatment of Obstructive Sleep Apnea. Arch Otolaryngol Head Neck Surg. 2005;131:440-5.






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