Can a single cephalometric measurement predict obstructive sleep apnea severity?

STUDY OBJECTIVES: To look for an association between the vertical position of the hyoid, as measured by the sella-hyoid (S-H) distance and the severity of obstructive sleep apnea (OSA). A previously published study on this subject showed a significant correlation between S-H distances more than 120 mm and severe OSA. DESIGN AND SETTING: A retrospective study of patients who were treated with a mandibular advancement splint (MAS) for sleep disordered breathing during June 2000 to May 2005 at the orthodontic department of Colchester University Hospital. PATIENTS AND PARTICIPANTS: One hundred and six consecutive patients who were treated with MAS during the period. MEASUREMENTS AND RESULTS: Lateral cephalograms were taken and traced prior to the provision of MAS therapy, and the distance S-H was measured. The mean S-H distance was 125.5 mm (103-148 mm) with a median of 126 mm. Four out of 8 patients (50%) with severe OSA had a S-H distance more than 120 mm, as did 38 out of 50 (76%) with mild to moderate OSA (AHI 5-30), and 17 out of 22 patients (77.27%) with an AHI of 0 to 4. No significant correlations between the S-H distance and the severity of OSA were found (Pearson correlation coefficient -0.034 and 95% confidence interval: -0.25, 0.18). CONCLUSION: There was no correlation between patients' OSA severity and their cephalometric S-H distance. The utility of the latter as a screening test cannot therefore be recommended as a substitute for existing diagnostic tests.