La radiologia medica

, Volume 118, Issue 4, pp 648–659

Morfologia craniofacciale e sindrome delle apnee-ipopnee ostruttive nel sonno: un’analisi craniometrica comparativa

  • L. Perillo
  • S. Cappabianca
  • M. Montemarano
  • L. Cristallo
  • A. Negro
  • A. Basile
  • F. Iaselli
  • A. Rotondo
Paediatric Radiology / Radiologia Pediatrica

Riassunto

Obiettivo

Scopo del nostro studio è stato definire la possibile correlazione tra la sindrome delle apnee-ipopnee ostruttive del sonno (OSAHS) pediatrica con determinate caratteristiche morfovolumetriche dello scheletro craniofacciale attraverso un’analisi craniometrica comparativa basata sulla cefalometria convenzionale tra bambini affetti e controlli.

Materiali e metodi

Sono stati valutati retrospettivamente gli esami cefalometrici di quaranta bambini affetti da OSAHS. Sono stati identificati sedici punti craniometrici e misurati ventisette indici lineari ed angolari riferiti alle caratteristiche morfovolumetriche dello scheletro craniofacciale. Successivamente, lo stesso procedimento di identificazione dei punti e misurazione degli indici è stato effettuato sugli esami cefalometrici di quaranta controlli. Per ciascuno degli indici ottenuti, poi, abbiamo calcolato nei due gruppi media, deviazione standard, errore standard e valore del test t di Student. Dal confronto dei valori ottenuti nelle due serie abbiamo infine calcolato attraverso il test t di Student il grado di significatività della differenza tra i bambini affetti da OSAHS ed i controlli.

Risultati

Le differenze di solo cinque dei ventisette indici lineari ed angolari valutati non sono risultate statisticamente significative tra i due gruppi, confermando la predisposizione al disturbo determinata da un particolare assetto dello splancnocranio. Le differenze più significative hanno riguardato l’inclinazione del piano mandibolare e la distanza tra la sella e l’osso ioide, indice affidabile della posizione verticale di quest’ultimo.

Conclusioni

Nonostante i limiti legati alla natura bidimensionale dell’indagine cefalometrica convenzionale, principalmente correlati agli errori di proiezione e di identificazione, e nonostante l’esecuzione dell’esame in posizione eretta, consideriamo elevato il valore diagnostico dell’indagine ed il suo contenuto informativo, riaffermando cosÌ il suo ruolo di indagine di imaging prima istanza nei bambini con disturbi del respiro legati al sonno.

Parole chiave

OSAHS Scheletro craniofacciale Cefalometria 

Craniofacial morphology and obstructive sleep apnoea-hypopnoea syndrome: a craniometric comparative analysis

Abstract

Purpose

The aim of this study was to define the relationship between paediatric obstructive sleep apnoea-hypopnea syndrome (OSAHS) and craniofacial morphovolumetric features through comparative craniometric analyses between affected children and controls based on conventional cephalometry.

Materials and methods

Cephalometric examinations of 40 children affected by OSAHS were retrospectively evaluated. Sixteen craniometric landmarks were identified, and 27 linear and angular indices related to craniofacial morphovolumetric features were measured. Subsequently, the same process of identifying landmarks and measuring indices was performed on the cephalometric examinations of 40 controls. For each index, we then calculated in both groups the mean, standard deviation, standard error and p value. By comparing the values obtained in the two series, we calculated the degree of significance of each difference between children with OSAHS and controls using the Student t test.

Results

Differences of only 5/27 linear and angular indices considered were not statistically significant between groups, thus confirming susceptibility to the disorder in relation to certain splanchnocranic morphovolumetric features. The most significant differences involved mandibular plane inclination and distance between landmark sella and hyoid bone, a reliable index being the vertical position of the latter.

Conclusions

Despite the limitations associated with the 2D nature of conventional cephalometry, mainly related to projection and identification errors, and despite the upright position during examination, we consider the diagnostic value and information content of this technique high, thus reaffirming its role as a first-line imaging investigation in children with sleep-related breathing disorders.

Keywords

OSAHS Craniofacial skull Cephalometry 

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Copyright information

© Springer-Verlag Italia 2012

Authors and Affiliations

  • L. Perillo
    • 1
  • S. Cappabianca
    • 2
  • M. Montemarano
    • 2
  • L. Cristallo
    • 1
  • A. Negro
    • 2
  • A. Basile
    • 2
  • F. Iaselli
    • 2
    • 3
  • A. Rotondo
    • 2
  1. 1.Dipartimento di Odontoiatria, Facoltà di Medicina e ChirurgiaSeconda Università di NapoliNapoliItaly
  2. 2.Sezione Scientifica di Radiologia, Unità di Radiologia, Radioterapia, Dipartimento di Internistica Clinica e Sperimentale “F. Magrassi, A. Lanzara”, e Medicina NucleareSeconda Università di Napoli, Primo Policlinico di NapoliNapoliItaly
  3. 3.CasertaItaly

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