2023 Volume 66 Issue 1 Pages 17-23
The guidelines from the American Academy of Sleep Medicine and the Japanese clinical practice guidelines for sleep apnea syndrome (SAS) both have algorithms for diagnosing and treating SAS. These guidelines both describe the need to evaluate patients with sleep apnea requiring treatment for upper respiratory obstructive disease and maxillofacial malformation and to consider surgery after evaluation. However, there have been few reports indicating how many patients complain of sleep-related disorders exhibit both upper airway obstruction and maxillofacial malformation. The subjects were 744 patients, aged 18 years or older, who visited the Ota Memorial Sleep Center from January 1 to December 31, 2017. Each subject underwent overnight polysomnography (PSG), temporal head x-ray (cephalogram), upper airway examination by an otorhinolaryngologist, computed tomography (CT), and rhinomanometry. We analyzed the frequency of upper respiratory obstructive disease and maxillofacial malformation. The maxillofacial morphological frequency of −1SD or less was 3.5% for the maxillary index, 7.5% for the mandibular index, and 30.0% for the submandibular growth index. The frequency of cases considered for treatment by otolaryngologists, tonsillar hypertrophy was 16.1%, deviated nasal septum was 13.0%, and chronic sinusitis was 18.0%. In this study, it was clarified that there is a certain proportion of upper respiratory tract-related risks among patients who consult with complaints of sleep-related disorders.
