Mandibular plane to hyoid in lateral cephalometry as a predictive parameter for severity of obstructive sleep apnea
Keywords:
Lateral cephalometric, mandibular plane to hyoid, OSA, predictive parameterAbstract
Background: Obstructive sleep apnea (OSA) is a common disorder affecting at least 2.0% to 4.0% of the adult population. Early diagnosis and treatment can reduce patient burden. A lateral cephalometric radiograph (LCR) is one method to evaluate upper airway obstruction in patients with OSA.
Objective: This crosssectional study aimed to investigate the predictive performance of mandibular plane to hyoid (MPH) in LCR for determining the OSA severity.
Methods: One hundred and three adult subjects were analyzed. LCR was performed under standardized processes and measured twice on separate occasions. Receiver operating characteristic (ROC) curve analysis was performed to obtain the optimal threshold values. Sensitivity, specificity and predictive values were calculated.
Results: The predictive performances of MPH for detecting OSA severity are as follows; for mild OSA, the area under the ROC curve (AUC) was 0.747. A cutoff MPH of 12.875 mm provided sensitivity of 54.6%, specificity of 100.0%, positive predictive values (PPV) of 100.0% and negative predictive values (NPV) of 12.0%. For moderate OSA, AUC was 0.773. A cutoff MPH of 13.665 mm. provided sensitivity of 59.8%, specificity of 90.5%, PPV of 96.1% and NPV of 36.5%. As for severe OSA, AUC was 0.787. A cutoff MPH of 16.035 mm provided sensitivity of 62.5%, specificity of 83.6%, PPV of 76.9% and NPV of 71.9%.
Conclusions: MPH in LCR is a good predictive parameter for OSA, it provides high accuracy, high specificity and high PPV. However, as sensitivity values were low, this parameter may not be an appropriate screening tool
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