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Obstructive sleep apnea (OSA) is a common disorder characterized by recurrent pharyngeal obstruction during sleep. Upper airway anatomy plays a major role in pathogenesis of OSA. Neck obesity as measured by neck circumference and position of hyoid are independently associated with OSA severity, but their relation with anatomical variables and pharyngeal collapsibility is less well known. Objective: To determine the association of upper airway collapsibility with hyoid position and neck circumference among OSA patients. Methods: Records of polysomnography diagnosed 40 OSA patients satisfying the inclusion criteria were selected. Lateral cephalograms were recorded at natural head position. Upper airway variables measured are superior pharyngeal airway space (SPAS), middle pharyngeal airway space (MPAS), inferior pharyngeal airway space (IPAS) and length of soft palate. Hyoid position was assessed by the distance from hyoid to mandibular plane and hyoid to C3 vertebrae. Neck circumference (cm) was measured for all subjects at the level of cricothyroid membrane. Results: Inferiorly positioned hyoid bone, increased length of soft palate and larger neck circumference showed statistically significant correlation with increased upper airway collapsibility among OSA patients (P<0.05). Conclusion: As the study shows the association of upper airway collapsibility with neck obesity and hyoid position, during routine clinical and radiographic examination larger neck circumference, inferiorly displaced hyoid and increased length of soft palate helps in identifying high risk candidates for OSA.

Upper Airway and its Association with Neck Circumference and Hyoid Position in OSA Subjects – A Cephalometric Study