nach oben

Somnologie

Erschienen in:

01.09.2009 | Schwerpunkt

Der Stellenwert bildgebender Verfahren bei der obstruktiven Schlafapnoe

verfasst von: Prof. Dr. B.A. Stuck, J.T. Maurer

Erschienen in: Somnologie | Ausgabe 3/2009

Einloggen, um Zugang zu erhalten

Zusammenfassung

Von den schlafbezogenen Atmungsstörungen ist die obstruktive Schlafapnoe (OSA) besonders häufig. Zur Untersuchung des oberen Atemwegs gibt es verschiedenste Techniken. Als bildgebende Verfahren sind hier v. a. die Radiokephalometrie, die Computertomographie (CT) und die Magnetresonanztomographie (MRT) zu nennen. Ihnen ist die vorliegende Übersichtsarbeit gewidmet. Diese Untersuchungsverfahren haben Einblicke in die Pathophysiologie der OSA bei Erwachsenen und Kindern ermöglicht und das Verständnis der Ursachen und Mechanismen der Atemwegsobstruktion erweitert. Mit Hilfe der Kephalometrie wurden charakteristische Auffälligkeiten in der skelettalen Anatomie des oberen Atemwegs dargestellt und als Risikofaktoren für eine OSA identifiziert. Zum Teil zeigen diese Parameter Zusammenhänge mit der Schwere der Erkrankung und mit einem erfolgreichen Einsatz progenierender Schienen. Mit CT und MRT wurden Unterschiede in der Weichteilanatomie zwischen Gesunden und Patienten mit OSA dargestell. Durch die dynamischen Untersuchungstechniken wurden die Mechanismen der Atemwegsobstruktion teilweise entschlüsselt. Diese Techniken haben sich jedoch in der klinischen Versorgung der Patienten nicht durchgesetzt. Eine Indikation zur routinemäßigen Durchführung besteht derzeit nicht.

Abbott MB, Donnelly LF, Dardzinski BJ et al (2004) Obstructive sleep apnea: MR imaging volume segmentation analysis. Radiology 232:889–895PubMedCrossRef

Almeida FR, Lowe AA, Sung JO et al (2006) Long-term sequellae of oral appliance therapy in obstructive sleep apnea patients: Part 1. Cephalometric analysis. Am J Orthod Dentofacial Orthop 129:195–204PubMedCrossRef

Arens R, McDonough JM, Corbin AM et al (2003) Upper airway size analysis by magnetic resonance imaging of children with obstructive sleep apnea syndrome. Am J Respir Crit Care Med 167:65–70PubMedCrossRef

Arens R, McDonough JM, Costarino AT et al (2001) Magnetic resonance imaging of the upper airway structure of children with obstructive sleep apnea syndrome. Am J Respir Crit Care Med 164:698–703PubMed

Arens R, Sin S, McDonough JM et al (2005) Changes in upper airway size during tidal breathing in children with obstructive sleep apnea syndrome. Am J Respir Crit Care Med 171:1298–1304PubMedCrossRef

Avrahami E, Englender M (1995) Relation between CT axial cross-sectional area of the oropharynx and obstructive sleep apnea syndrome in adults. AJNR Am J Neuroradiol 16:135–140PubMed

Avrahami E, Solomonovich A, Englender M (1996) Axial CT measurements of the cross-sectional area of the oropharynx in adults with obstructive sleep apnea syndrome. AJNR Am J Neuroradiol 17:1107–1111PubMed

Back LJ, Tervahartiala PO, Piilonen AK et al (2002) Bipolar radiofrequency thermal ablation of the soft palate in habitual snorers without significant desaturations assessed by magnetic resonance imaging. Am J Respir Crit Care Med 166:865–871PubMedCrossRef

Bates CJ, McDonald JP (2005) The relationship between severity of obstructive sleep apnoea/hypopnoea syndrome (OSAHS) and lateral cephalometric radiograph values: a clinical diagnostic tool. Surgeon 3:338–346PubMed

10.

Battagel JM, Johal A, Kotecha B (2000) A cephalometric comparison of subjects with snoring and obstructive sleep apnoea. Eur J Orthod 22:353–365PubMedCrossRef

11.

Battagel JM, L’Estrange PR (1996) The cephalometric morphology of patients with obstructive sleep apnoea (OSA). Eur J Orthod 18:557–569PubMedCrossRef

12.

Bohlman ME, Haponik EF, Smith PL et al (1983) CT demonstration of pharyngeal narrowing in adult obstructive sleep apnea. AJR Am J Roentgenol 140:543–548PubMed

13.

Boot H, Poublon RM, Van Wegen R et al (1997) Uvulopalatopharyngoplasty for the obstructive sleep apnoea syndrome: value of polysomnography, Mueller manoeuvre and cephalometry in predicting surgical outcome. Clin Otolaryngol Allied Sci 22:504–510PubMedCrossRef

14.

Caballero P, Alvarez-Sala R, Garcia-Rio F et al (1998) CT in the evaluation of the upper airway in healthy subjects and in patients with obstructive sleep apnea syndrome. Chest 113:111–116PubMedCrossRef

15.

Chen NH, Li KK, Li SY et al (2002) Airway assessment by volumetric computed tomography in snorers and subjects with obstructive sleep apnea in a Far-East Asian population (Chinese). Laryngoscope 112:721–716PubMedCrossRef

16.

Ciscar MA, Juan G, Martinez V et al (2001) Magnetic resonance imaging of the pharynx in OSA patients and healthy subjects. Eur Respir J 17:79–86PubMedCrossRef

17.

Cozza P, Ballanti F, Castellano M, Fanucci E (2008) Role of computed tomography in the evaluation of orthodontic treatment in adult patients with obstructive sleep apnea syndrome (OSA). Prog Orthod 9:6–16PubMed

18.

Crumley RL, Stein M, Gamsu G et al (1987) Determination of obstructive site in obstructive sleep apnea. Laryngoscope 97:301–308PubMedCrossRef

19.

Dempsey JA, Skatrud JB, Jacques AJ et al (2002) Anatomic determinants of sleep-disordered breathing across the spectrum of clinical and nonclinical male subjects. Chest 122:840–851PubMedCrossRef

20.

Do KL, Ferreyra H, Healy JF, Davidson TM (2000) Does tongue size differ between patients with and without sleep-disordered breathing? Laryngoscope 110:1552–1555PubMedCrossRef

21.

Doghramji K, Jabourian ZH, Pilla M et al (1995) Predictors of outcome for uvulopalatopharyngoplasty. Laryngoscope 105:311–314PubMedCrossRef

22.

Donnelly LF (2005) Obstructive sleep apnea in pediatric patients: evaluation with cine MR sleep studies. Radiology 236:768–778PubMedCrossRef

23.

Donnelly LF, Casper KA, Chen B, Koch BL (2002) Defining normal upper airway motion in asymptomatic children during sleep by means of cine MR techniques. Radiology 223:176–180PubMedCrossRef

24.

Donnelly LF, Shott SR, LaRose CR et al (2004) Causes of persistent obstructive sleep apnea despite previous tonsillectomy and adenoidectomy in children with down syndrome as depicted on static and dynamic cine MRI. AJR Am J Roentgenol 183:175–181PubMed

25.

Donnelly LF, Surdulescu V, Chini BA et al (2003) Upper airway motion depicted at cine MR imaging performed during sleep: comparison between young Patients with and those without obstructive sleep apnea. Radiology 227:239–245PubMedCrossRef

26.

Endo S, Mataki S, Kurosaki N (2003) Cephalometric evaluation of craniofacial and upper airway structures in Japanese patients with obstructive sleep apnea. J Med Dent Sci 50:109–120PubMed

27.

Fairburn SC, Waite PD, Vilos G et al (2007) Three-dimensional changes in upper airways of patients with obstructive sleep apnea following maxillomandibular advancement. J Oral Maxillofac Surg 65:6–12PubMedCrossRef

28.

Ferguson KA, Ono T, Lowe AA et al (1995) The relationship between obesity and craniofacial structure in obstructive sleep apnea. Chest 108:375–381PubMedCrossRef

29.

Fransson AM, Tegelberg A, Svenson BA et al (2002) Influence of mandibular protruding device on airway passages and dentofacial characteristics in obstructive sleep apnea and snoring. Am J Orthod Dentofacial Orthop 122:371–379PubMedCrossRef

30.

Fregosi RF, Quan SF, Kaemingk KL et al (2003) Sleep-disordered breathing, pharyngeal size and soft tissue anatomy in children. J Appl Physiol 95:2030–2038PubMed

31.

Fricke BL, Donnelly LF, Shott SR et al (2006) Comparison of lingual tonsil size as depicted on MR imaging between children with obstructive sleep apnea despite previous tonsillectomy and adenoidectomy and normal controls. Pediatr Radiol 36:518–523PubMedCrossRef

32.

Gale DJ, Sawyer RH, Woodcock A et al (2000) Do oral appliances enlarge the airway in patients with obstructive sleep apnoea? A prospective computerized tomographic study. Eur J Orthod 22:159–168PubMedCrossRef

33.

Galvin JR, Rooholamini SA, Stanford W (1989) Obstructive sleep apnea: diagnosis with ultrafast CT. Radiology 171:775–778PubMed

34.

Gao XM, Zeng XL, Fu MK, Huang XZ (1999) Magnetic resonance imaging of the upper airway in obstructive sleep apnea before and after oral appliance therapy. Chin J Dent Res 2:27–35PubMed

35.

Guimaraes CV, Donnelly LF, Shott SR et al (2008) Relative rather than absolute macroglossia in patients with Down syndrome: implications for treatment of obstructive sleep apnea. Pediatr Radiol 38:1062–1067PubMedCrossRef

36.

Haponik EF, Smith PL, Bohlman ME et al (1983) Computerized tomography in obstructive sleep apnea. Correlation of airway size with physiology during sleep and wakefulness. Am Rev Respir Dis 127:221–226PubMed

37.

Hochban W, Brandenburg U, Peter JH (1994) Surgical treatment of obstructive sleep apnea by maxillomandibular advancement. Sleep 17:624–629PubMed

38.

Hoekema A, Doff MH, de Bont LG et al (2007) Predictors of obstructive sleep apnea-hypopnea treatment outcome. J Dent Res 86:1181–1186PubMedCrossRef

39.

Hoekema A, Hovinga B, Stegenga B, De Bont LG (2003) Craniofacial morphology and obstructive sleep apnoea: a cephalometric analysis. J Oral Rehabil 30:690–696PubMedCrossRef

40.

Horiuchi A, Suzuki M, Ookubo M et al (2005) Measurement techniques predicting the effectiveness of an oral appliance for obstructive sleep apnea hypopnea syndrome. Angle Orthod 75:1003–1011PubMed

41.

Horner RL, Mohiaddin RH, Lowell DG et al (1989) Sites and sizes of fat deposits around the pharynx in obese patients with obstructive sleep apnoea and weight matched controls. Eur Respir J 2:613–622PubMed

42.

Hou HM, Hagg U, Sam K et al (2006) Dentofacial characteristics of Chinese obstructive sleep apnea patients in relation to obesity and severity. Angle Orthod 76:962–969PubMedCrossRef

43.

Hou HM, Sam K, Hagg U et al (2006) Long-term dentofacial changes in Chinese obstructive sleep apnea patients after treatment with a mandibular advancement device. Angle Orthod 76:432–440PubMedCrossRef

44.

Hsu PP, Tan AK, Chan YH et al (2005) Clinical predictors in obstructive sleep apnoea patients with calibrated cephalometric analysis–a new approach. Clin Otolaryngol 30:234–241PubMedCrossRef

45.

Hsu PP, Tan BY, Chan YH et al (2004) Clinical predictors in obstructive sleep apnea patients with computer-assisted quantitative videoendoscopy upper airway analysis. Laryngoscope 114:791–799PubMedCrossRef

46.

Hui DS, Ko FW, Chu AS et al (2003) Cephalometric assessment of craniofacial morphology in Chinese patients with obstructive sleep apnoea. Respir Med 97:640–646PubMedCrossRef

47.

Iida-Kondo C, Yoshino N, Kurabayashi T et al (2006) Comparison of tongue volume/oral cavity volume ratio between obstructive sleep apnea syndrome patients and normal adults using magnetic resonance imaging. J Med Dent Sci 53:119–126PubMed

48.

Ikeda K, Ogura M, Oshima T et al (2001) Quantitative assessment of the pharyngeal airway by dynamic magnetic resonance imaging in obstructive sleep apnea syndrome. Ann Otol Rhinol Laryngol 110:183–189PubMed

49.

Ingman T, Nieminen T, Hurmerinta K (2004) Cephalometric comparison of pharyngeal changes in subjects with upper airway resistance syndrome or obstructive sleep apnoea in upright and supine positions. Eur J Orthod 26:321–326PubMedCrossRef

50.

Ito D, Akashiba T, Yamamoto H et al (2001) Craniofacial abnormalities in Japanese patients with severe obstructive sleep apnoea syndrome. Respirology 6:157–161PubMedCrossRef

51.

Jäger L, Günther E, Gauger J, Reiser M (1998) Fluoroscopic MR of the pharynx in patients with obstructive sleep apnea. AJNR Am J Neuroradiol 19:1205–1214PubMed

52.

Johal A, Conaghan C (2004) Maxillary morphology in obstructive sleep apnea: a cephalometric and model study. Angle Orthod 74:648–656PubMed

53.

Johal A, Patel SI, Battagel JM (2007) The relationship between craniofacial anatomy and obstructive sleep apnoea: a case-controlled study. J Sleep Res 16:319–326PubMedCrossRef

54.

Koren A, Groselj LD, Fajdiga I (2009) CT comparison of primary snoring and obstructive sleep apnea syndrome: role of pharyngeal narrowing ratio and soft palate-tongue contact in awake patient. Eur Arch Otorhinolaryngol 266:727–734PubMedCrossRef

55.

Kubota Y, Nakayama H, Takada T et al (2005) Facial axis angle as a risk factor for obstructive sleep apnea. Intern Med 44:805–810PubMedCrossRef

56.

Kyung SH, Park YC, Pae EK (2005) Obstructive sleep apnea patients with the oral appliance experience pharyngeal size and shape changes in three dimensions. Angle Orthod 75:15–22PubMed

57.

Langin T, Pepin JL, Pendlebury S et al (1998) Upper airway changes in snorers and mild sleep apnea sufferers after uvulopalatopharyngoplasty (UPPP). Chest 113:1595–1603PubMedCrossRef

58.

Larsson SG, Gislason T, Lindholm CE (1988) Computed tomography of the oropharynx in obstructive sleep apnea. Acta Radiol 29:401–405PubMedCrossRef

59.

Li HY, Chen NH, Wang CR et al (2003) Use of 3-dimensional computed tomography scan to evaluate upper airway patency for patients undergoing sleep-disordered breathing surgery. Otolaryngol Head Neck Surg 129:336–342PubMedCrossRef

60.

Li HY, Li KK, Chen NH et al (2005) Three-dimensional computed tomography and polysomnography findings after extended uvulopalatal flap surgery for obstructive sleep apnea. Am J Otolaryngol 26:7–11PubMedCrossRef

61.

Li KK, Powell NB, Kushida C et al (1999) A comparison of Asian and white patients with obstructive sleep apnea syndrome. Laryngoscope 109:1937–1940PubMedCrossRef

62.

Liao YF, Chuang ML, Huang CS, Tsai YY (2004) Upper airway and its surrounding structures in obese and nonobese patients with sleep-disordered breathing. Laryngoscope 114:1052–1059PubMedCrossRef

63.

Liu SA, Li HY, Tsai WC, Chang KM (2005) Associated factors to predict outcomes of uvulopharyngopalatoplasty plus genioglossal advancement for obstructive sleep apnea. Laryngoscope 115:2046–2050PubMedCrossRef

64.

Liu Y, Lowe AA, Fleetham JA, Park YC (2001) Cephalometric and physiologic predictors of the efficacy of an adjustable oral appliance for treating obstructive sleep apnea. Am J Orthod Dentofacial Orthop 120:639–647PubMedCrossRef

65.

Lowe AA, Fleetham JA, Adachi S, Ryan CF (1995) Cephalometric and computed tomographic predictors of obstructive sleep apnea severity. Am J Orthod Dentofacial Orthop 107:589–595PubMedCrossRef

66.

Malhotra A, Huang Y, Fogel RB et al (2002) The male predisposition to pharyngeal collapse: importance of airway length. Am J Respir Crit Care Med 166:1388–1395PubMedCrossRef

67.

Marklund M (2006) Predictors of long-term orthodontic side effects from mandibular advancement devices in patients with snoring and obstructive sleep apnea. Am J Orthod Dentofacial Orthop 129:214–221PubMedCrossRef

68.

Mayer G, Meier-Ewert K (1995) Cephalometric predictors for orthopaedic mandibular advancement in obstructive sleep apnoea. Eur J Orthod 17:35–43PubMed

69.

Millman RP, Carlisle CC, Rosenberg C et al (2000) Simple predictors of uvulopalatopharyngoplasty outcome in the treatment of obstructive sleep apnea. Chest 118:1025–1030PubMedCrossRef

70.

Mortimore IL, Marshall I, Wraith PK et al (1998) Neck and total body fat deposition in nonobese and obese patients with sleep apnea compared with that in control subjects. Am J Respir Crit Care Med 157:280–283PubMed

71.

Naganuma H, Okamoto M, Woodson BT, Hirose H (2002) Cephalometric and fiberoptic evaluation as a case-selection technique for obstructive sleep apnea syndrome (OSAS). Acta Otolaryngol 122:57–63CrossRef

72.

Okubo M, Suzuki M, Horiuchi A et al (2006) Morphologic analyses of mandible and upper airway soft tissue by MRI of patients with obstructive sleep apnea hypopnea syndrome. Sleep 29:909–915PubMed

73.

Otsuka R, Almeida FR, Lowe AA (2007) The effects of oral appliance therapy on occlusal function in patients with obstructive sleep apnea: a short-term prospective study. Am J Orthod Dentofacial Orthop 131:176–183PubMedCrossRef

74.

Otsuka R, Almeida FR, Lowe AA, Ryan F (2006) A comparison of responders and nonresponders to oral appliance therapy for the treatment of obstructive sleep apnea. Am J Orthod Dentofacial Orthop 129:222–229PubMedCrossRef

75.

Rachmiel A, Aizenbud D, Pillar G et al (2005) Bilateral mandibular distraction for patients with compromised airway analyzed by three-dimensional CT. Int J Oral Maxillofac Surg 34:9–18PubMedCrossRef

76.

Riha RL, Brander P, Vennelle M, Douglas NJ (2005) A cephalometric comparison of patients with the sleep apnea/hypopnea syndrome and their siblings. Sleep 28:315–320PubMed

77.

Ringqvist M, Walker-Engstrom ML, Tegelberg A, Ringqvist I (2003) Dental and skeletal changes after 4 years of obstructive sleep apnea treatment with a mandibular advancement device: a prospective, randomized study. Am J Orthod Dentofacial Orthop 124:53–60PubMedCrossRef

78.

Robertson C, Herbison P, Harkness M (2003) Dental and occlusal changes during mandibular advancement splint therapy in sleep disordered patients. Eur J Orthod 25:371–376PubMedCrossRef

79.

Robertson CJ (2001) Dental and skeletal changes associated with long-term mandibular advancement. Sleep 24:531–537PubMed

80.

Rodenstein DO, Dooms G, Thomas Y et al (1990) Pharyngeal shape and dimensions in healthy subjects, snorers, and patients with obstructive sleep apnoea. Thorax 45:722–727PubMedCrossRef

81.

Rose E, Lehner M, Staats R, Jonas IE (2002) Cephalometric analysis in patients with obstructive sleep apnea. Part II: Prognostic value in treatment with a mandibular advancement device. J Orofac Orthop 63:315–324PubMedCrossRef

82.

Rose EC, Schnegelsberg C, Staats R, Jonas IE (2001) Occlusal side effects caused by a mandibular advancement appliance in patients with obstructive sleep apnea. Angle Orthod 7:452–460

83.

Rose EC, Staats R, Virchow C, Jonas IE (2002) Occlusal and skeletal effects of an oral appliance in the treatment of obstructive sleep apnea. Chest 122:871–877PubMedCrossRef

84.

Ryan CF, Lowe AA, Li D, Fleetham JA (1991) Three-dimensional upper airway computed tomography in obstructive sleep apnea. A prospective study in patients treated by uvulopalatopharyngoplasty. Am Rev Respir Dis 144:428–432PubMed

85.

Saigusa H, Suzuki M, Higurashi N, Kodera K (2009) Three-dimensional morphological analyses of positional dependence in patients with obstructive sleep apnea syndrome. Anesthesiology 110:885–890PubMedCrossRef

86.

Sakakibara H, Tong M, Matsushita K et al (1999) Cephalometric abnormalities in non-obese and obese patients with obstructive sleep apnoea. Eur Respir J 13:403–410PubMedCrossRef

87.

Sam K, Lam B, Ooi CG et al (2006) Effect of a non-adjustable oral appliance on upper airway morphology in obstructive sleep apnoea. Respir Med 100:897–902PubMedCrossRef

88.

Sanner BM, Heise M, Knoben B et al (2002) MRI of the pharynx and treatment efficacy of a mandibular advancement device in obstructive sleep apnoea syndrome. Eur Respir J 20:143–150PubMedCrossRef

89.

Schiffman PH, Rubin NK, Dominguez T et al (2004) Mandibular dimensions in children with obstructive sleep apnea syndrome. Sleep 27:959–965PubMed

90.

Schoenberg SO, Floemer F, Kroeger H et al (2000) Combined assessment of obstructive sleep apnea syndrome with dynamic MRI and parallel EEG registration: initial results. Invest Radiol 35:267–276PubMedCrossRef

91.

Schotland HM, Insko EK, Schwab RJ (1992) Quantitative magnetic resonance imaging demonstrates alterations of the lingual musculature in obstructive sleep apnea. Sleep 22:605–613

92.

Schwab RJ, Gefter WB, Hoffman EA et al (1993) Dynamic upper airway imaging during awake respiration in normal subjects and patients with sleep disordered breathing. Am Rev Respir Dis 148:1385–1400PubMed

93.

Schwab RJ, Pasirstein M, Pierson R et al (2003) Identification of upper airway anatomic risk factors for obstructive sleep apnea with volumetric magnetic resonance imaging. Am J Respir Crit Care Med 168:522–530PubMedCrossRef

94.

Sforza E, Bacon W, Weiss T et al (2000) Upper airway collapsibility and cephalometric variables in patients with obstructive sleep apnea. Am J Respir Crit Care Med 161:347–352PubMed

95.

Shepard JW Jr, Stanson AW, Sheedy PF, Westbrook PR (1990) Fast-CT evaluation of the upper airway during wakefulness in patients with obstructive sleep apnea. Prog Clin Biol Res 345:273–279PubMed

96.

Shepard JW Jr, Thawley SE (1989) Evaluation of the upper airway by computerized tomography in patients undergoing uvulopalatopharyngoplasty for obstructive sleep apnea. Am Rev Respir Dis 140:711–716PubMed

97.

Shott SR, Donnelly LF (2004) Cine magnetic resonance imaging: evaluation of persistent airway obstruction after tonsil and adenoidectomy in children with Down syndrome. Laryngoscope 114:1724–1729PubMedCrossRef

98.

Skinner MA, Robertson CJ, Kingshott RN et al (2002) The efficacy of a mandibular advancement splint in relation to cephalometric variables. Sleep Breath 6:115–124PubMedCrossRef

99.

Stein MG, Gamsu G, de Geer G et al (1987) Cine CT in obstructive sleep apnea. AJR Am J Roentgenol 148:1069–1074PubMed

100.

Stuck BA, Kopke J, Hormann K et al (2005) Volumetric tissue reduction in radiofrequency surgery of the tongue base. Otolaryngol Head Neck Surg 132:132–135PubMedCrossRef

101.

Stuck BA, Kopke J, Maurer JT et al (2002) Evaluating the upper airway with standardized magnetic resonance imaging. Laryngoscope 112:552–558PubMedCrossRef

102.

Stuck BA, Kopke J, Maurer JT et al (2003) Lesion formation in radiofrequency surgery of the tongue base. Laryngoscope 113:1572–1576PubMedCrossRef

103.

Stuck BA, Neff W, Hormann K et al (2005) Anatomic changes after hyoid suspension for obstructive sleep apnea: an MRI study. Otolaryngol Head Neck Surg 133:397–402PubMedCrossRef

104.

Suratt PM, Dee P, Atkinson RL et al (1983) Fluoroscopic and computed tomographic features of the pharyngeal airway in obstructive sleep apnea. Am Rev Respir Dis 127:487–492PubMed

105.

Suto Y, Matsuo T, Kato T et al (1993) Evaluation of the pharyngeal airway in patients with sleep apnea: value of ultrafast MR imaging. AJR Am J Roentgenol 160:311–314PubMed

106.

Tangugsorn V, Krogstad O, Espeland L, Lyberg T (2000) Obstructive sleep apnoea: multiple comparisons of cephalometric variables of obese and non-obese patients. J Craniomaxillofac Surg 28:204–212PubMed

107.

Tsai HH, Ho CY, Lee PL, Tan CT (2007) Cephalometric analysis of nonobese snorers either with or without obstructive sleep apnea syndrome. Angle Orthod 77:1054–1061PubMedCrossRef

108.

Tsai HH, Ho CY, Lee PL, Tan CT (2009) Sex differences in anthropometric and cephalometric characteristics in the severity of obstructive sleep apnea syndrome. Am J Orthod Dentofacial Orthop 135:155–164PubMedCrossRef

109.

Verin E, Tardif C, Buffet X et al (2002) Comparison between anatomy and resistance of upper airway in normal subjects, snorers and OSAS patients. Respir Physiol 129:335–343PubMedCrossRef

110.

Vos W, De Backer J, Devolder A et al (2007) Correlation between severity of sleep apnea and upper airway morphology based on advanced anatomical and functional imaging. J Biomech 40:2207–2213PubMedCrossRef

111.

Welch KC, Foster GD, Ritter CT et al (2002) A novel volumetric magnetic resonance imaging paradigm to study upper airway anatomy. Sleep 25:532–542PubMed

112.

Woodson BT, Conley SF (1997) Prediction of uvulopalatopharyngoplasty response using cephalometric radiographs. Am J Otolaryngol 18:179–184PubMedCrossRef

113.

Yao M, Tachibana N, Okura M et al (2004) Relationships of craniofacial morphology and body mass index with sleep-disordered breathing in Japanese men. Laryngoscope 114:1838–1842PubMedCrossRef

114.

Yokoyama M, Yamanaka N, Ishii H et al (1996) Evaluation of the pharyngeal airway in obstructive sleep apnea: study by ultrafast MR imaging. Acta Otolaryngol Suppl 523:242–244PubMed

115.

Yoshida K, Fukatsu H, Ando Y et al (1999) Evaluation of sleep apnea syndrome with low-field magnetic resonance fluoroscopy. Eur Radiol 9:1197–1202PubMedCrossRef

116.

Young JW, McDonald JP (2004) An investigation into the relationship between the severity of obstructive sleep apnoea/hypopnoea syndrome and the vertical position of the hyoid bone. Surgeon 2:145–151PubMed

117.

Yu X, Fujimoto K, Urushibata K et al (2003) Cephalometric analysis in obese and nonobese patients with obstructive sleep apnea syndrome. Chest 124:212–218PubMedCrossRef

118.

Yucel A, Unlu M, Haktanir A et al (2005) Evaluation of the upper airway cross-sectional area changes in different degrees of severity of obstructive sleep apnea syndrome: cephalometric and dynamic CT study. AJNR Am J Neuroradiol 26:2624–2629PubMed

119.

Zhao X, Liu Y, Gao Y (2008) Three-dimensional upper-airway changes associated with various amounts of mandibular advancement in awake apnea patients. Am J Orthod Dentofacial Orthop 133:661–668PubMedCrossRef

Titel: Der Stellenwert bildgebender Verfahren bei der obstruktiven Schlafapnoe
verfasst von: Prof. Dr. B.A. Stuck
J.T. Maurer
Publikationsdatum: 01.09.2009
Verlag: D. Steinkopff-Verlag
Erschienen in: Somnologie / Ausgabe 3/2009
Print ISSN: 1432-9123
Elektronische ISSN: 1439-054X
DOI: https://doi.org/10.1007/s11818-009-0415-7

Leitlinien kompakt für die Neurologie

Mit medbee Pocketcards sicher entscheiden.

^{Seit 2022 gehört die medbee GmbH zum Springer Medizin Verlag}

Kostenlos registrieren

Neu im Fachgebiet Neurologie

Akuter Schwindel: Wann lohnt sich eine MRT?

28.04.2024 Schwindel Nachrichten

Akuter Schwindel stellt oft eine diagnostische Herausforderung dar. Wie nützlich dabei eine MRT ist, hat eine Studie aus Finnland untersucht. Immerhin einer von sechs Patienten wurde mit akutem ischämischem Schlaganfall diagnostiziert.

Niedriger diastolischer Blutdruck erhöht Risiko für schwere kardiovaskuläre Komplikationen

25.04.2024 Hypotonie Nachrichten

Wenn unter einer medikamentösen Hochdrucktherapie der diastolische Blutdruck in den Keller geht, steigt das Risiko für schwere kardiovaskuläre Ereignisse: Darauf deutet eine Sekundäranalyse der SPRINT-Studie hin.

Frühe Alzheimertherapie lohnt sich

25.04.2024 AAN-Jahrestagung 2024 Nachrichten

Ist die Tau-Last noch gering, scheint der Vorteil von Lecanemab besonders groß zu sein. Und beginnen Erkrankte verzögert mit der Behandlung, erreichen sie nicht mehr die kognitive Leistung wie bei einem früheren Start. Darauf deuten neue Analysen der Phase-3-Studie Clarity AD.

Viel Bewegung in der Parkinsonforschung

25.04.2024 Parkinson-Krankheit Nachrichten

Neue arznei- und zellbasierte Ansätze, Frühdiagnose mit Bewegungssensoren, Rückenmarkstimulation gegen Gehblockaden – in der Parkinsonforschung tut sich einiges. Auf dem Deutschen Parkinsonkongress ging es auch viel um technische Innovationen.

Update Neurologie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.

Newsletter bestellen

Springer Medizin

Zusammenfassung

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2009

Heimüberwachung („home monitoring“) von Kindern und Jugendlichen: Vorschläge für die praktische Anwendung

Mitteilungen Somnologie

Der Stellenwert operativer Verfahren in der Therapie der obstruktiven Schlafapnoe des Erwachsenen

Funktionelle Topodiagnostik der oberen Atemwege bei schlafbezogenen Atmungsstörungen

Coherency of attention deficit/hyperactivity and sleep-related problems