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Vol. 31. Issue 2.
Pages 62-67 (February 1995)
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Vol. 31. Issue 2.
Pages 62-67 (February 1995)
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Índices cefalométricos en pacientes con síndrome de apnea del sueño
Cephalometric indexes in patients with sleep apnea syndrome
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A. de Vega Gómez1, M. Corrales Zarauza, F. Payo Losa
Servicio de Fisiología Respiratoria. Hospital Central de Asturias (Instituto Nacional de Silicosis). Oviedo
J. Cobo Plana*
* Cátedra de Ortodoncia. Escuela de Estomatología. Universidad de Oviedo. Oviedo
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Se estudian los índices cefalométricos determinados en 16 pacientes diagnosticados de síndrome de apnea del sueño (SAOS), y se comparan con los medidos en 12 sujetos controles, para determinar si existen en ellos alteraciones estructurales de base que los diferencien, investigando la existencia de algún patrón facial característico de dichos pacientes con SAOS.

Nuestros resultados revelan la existencia de un micrognatismo del maxilar superior en pacientes con SAOS (derivado de la disminución significativa de los índices convexidad, Mx 1, y ángulos SNA y ANB), una mayor longitud del paladar blando y una disminución de la profundidad faríngea funcional. Todo ello va a producir una disminución de la permeabilidad del espacio aéreo faríngeo posterior. Además, se observa un patrón facial alargado, dolicocefálico, en pacientes con SAOS, con producción de mordida abierta anterior.

Se analizan las limitaciones de la cefalometría convencional, reconociendo su utilidad en el establecimiento de una línea base previa al tratamiento y en la evaluación posquirúrgica, aunque se hace constar no obstante que para la valoración del tratamiento quirúrgico de los pacientes con SAOS, no debería de utilizarse un único test de estudio.

Palabras clave:
Cefalometría
Apnea
Sueño

The cephalometric indexes of 16 patients with obstructive sleep apnea syndrome (OSAS) were compared with those of 12 Controls in order to determine if fundamental anatomical changes were present in the patients and to identify a pattern of facial features that might be characteristic of individuals with OSAS.

Our results point to micrognathia of the upper maxilla in OSAS patients (indicated by significantly lower indexes for convexity, Mx 1, and the angles SNA and ANB). We also found a longer soft palate and a functionally shallower pharynx. Together theses features reduce the permeability of the posterior pharyngeal air space. Additionally, we observed a dolichocephalic facial pattern in OSAS patients, along with a tendency to morbid anterior opening.

We analyze the limitations of conventional cephalometry. While recognizing its usefulness in establishing baseline indexes before treatment and in postsurgical assessmént, we nevertheless point out that it cannot be relied upon as the only test for evaluating surgical correction in OSAS patients.

Key words:
Cephalometry
Apnea
Sleep
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Copyright © 1995. Sociedad Española de Neumología y Cirugía Torácica
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