SEARCH · PubMed Health

Results for “pharyngitis”

Explore indexed PubMed citations for clinical trials, systematic reviews and public health research. Read source abstracts and follow each citation to its original PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 253 records · Page 14Linked to original sources

PubMed1992

Occlusion and narrowing of the pharyngeal airway in obstructive sleep apnea: evaluation by ultrafast spoiled GRASS MR imaging.

Morphologic abnormalities of the pharyngeal airway are frequently found in patients with obstructive sleep apnea. These structural alterations in the pharyngeal airway can be detected in awake patients by using rapid imaging techniques. Ten patients with clinically proved obstructive sleep apnea had ultrafast spoiled gradient-recalled acquisition in the steady state (GRASS) MR imaging of the pharyngeal airway to determine the presence of occlusions and/or narrowings. Twelve sequential images were obtained at one midsagittal plane and at eight transverse planes through the pharyngeal airway. The scans were obtained at the rate of one image per 1.04 sec while the patient was breathing quietly. Occlusions or narrowings of the pharyngeal airways were detected on MR images in all patients. The site(s) of the occlusions and the site(s) and extent of the narrowings varied. Six patients had occlusions and four had narrowings of one or more sites. This study shows that ultrafast spoiled GRASS MR imaging can be used to evaluate patients with obstructive sleep apnea during tidal breathing and is useful for determining the presence of occlusions and narrowings of the pharyngeal airway.

Adult↗

PubMed1999

[Knowledge and practice of primary care physicians relating to the treatment of streptococcal pharyngitis].

Knowledge and practice of primary care physicians as to diagnosis and treatment of group A, b-hemolytic streptococcal pharyngitis, and the degree to which they agreed with the medical literature and current clinical guidelines were examined. The study was conducted in a group of 195 general physicians, pediatricians, and family medicine specialists and residents. The data were collected using questionnaires which included personal information and questions relating to b-hemolytic streptococcal pharyngitis and were analyzed by chi-square and t-tests, and logistic regression, as appropriate. A new dependent variable, good clinical practice (GCP), was defined as the total number of correct answers to the questions in the questionnaire. 147 of the 195 eligible physicians returned completed questionnaires, a compliance rate of 76%. 96.6% cited penicillin V as the drug of choice at a daily dosage of 1 g (43.7%) or 2 g (25.4%), for 10 days (90%). 133 physicians (90%) stated that the goal of penicillin therapy for b-hemolytic streptococcal pharyngitis is to prevent late complications. 116 physicians (82%) cited rheumatic fever as a complication of group A b-hemolytic streptococcal pharyngitis, preventable by appropriate antibiotic therapy. However, only 84 (59%) cited glomerulonephritis as a preventable complication. When the knowledge and attitudes of the respondents was analyzed in terms of the new variable, GCP, a significant association (p < 0.001) was found between physicians' attitudes and variables such as where they had studied medicine, and work seniority. Those with less seniority and or medical graduates of the Americas demonstrated greater knowledge and better clinical judgment than their more senior colleagues and graduates of European and Asian medical schools. Most primary care physicians in northern Israel treat group A b-hemolytic streptococcal pharyngitis as recommended in the medical literature. The level of medical studies in Israel and the Americas and the quality of training of residents in family medicine and pediatrics, have a positive influence on the degree of knowledge of as common a subject as b-hemolytic streptococcal pharyngitis. Emphasis should be placed on continuing medical education among primary care physicians, particularly veteran general physicians and those who studied in European or Asian medical schools.

Adult↗

PubMed2004

Antibiotics for acute group A streptococcal pharyngitis.

(1) Since the 1940s, a large number of comparative randomised placebo-controlled trials have evaluated antibiotic therapy for pharyngitis, initially parenteral benzathine benzylpenicillin, then oral phenoxymethylpenicillin (penicillin V). Our literature search identified a Cochrane meta-analysis of all these trials, with the exception of one published in 2003. (2) When group A betahemolytic streptococci (group A streptococci) are present in the throat, antibiotic therapy accelerates symptom relief (particularly fever and pain) by a day or two. This has been shown with 7-day treatments but not with 3-day treatments. There is no convincing evidence that antibiotics relieve symptoms in children. (3) According to the Cochrane meta-analysis, signs of progression to locoregional suppuration were noted in 1% of patients receiving placebo, compared to 0.09% of patients receiving antibiotics in the most recent trials (statistically significant difference). (4) Comparative trials done in the 1950s showed that benzathine benzylpenicillin helped prevent acute rheumatic fever, reducing the risk by about 75%. Since 1985 nearly 1000 patients with pharyngitis have been given a placebo in clinical trials, and none have developed acute rheumatic fever. (5) There is no firm evidence that antibiotics reduce the risk of acute glomerulonephritis. (6) The adverse effects associated with most antibiotics are mild. This is especially true for penicillin. However, there is a risk of rare but serious adverse effects: anaphylaxis is estimated to occur in 5 per 10 000 patients treated with injectable penicillin, while the risk associated with oral penicillin used to treat pharyngitis has not been quantified. Moreover, antibiotics affect the bacterial ecology, encouraging resistance among some bacterial species other than group A streptococci. (7) A strategy based on the use of a clinical diagnostic score, followed by a rapid test if the score is intermediate, seems to be the best way of restricting antibiotics to patients with pharyngitis due to group A streptococci. (8) In patients with group A streptococcal pharyngitis, a strategy of starting antibiotics only after 48 hours of symptoms delays symptom control but seems to reduce the risk of relapse. According to a clinical trial in patients with pharyngitis from all causes, advising patients to postpone antibiotic therapy reduces antibiotic use by about 85%, without increasing the risk of serious clinical complications. (9) In practice, immediate antibiotic therapy is justified for patients with severe symptoms or signs of progression to locoregional suppuration, and when the local incidence of acute rheumatic fever is high. In other situations, whether or not group A streptococci are involved, antibiotic therapy should be started only if symptoms do not begin to improve after 48 hours of symptomatic treatments.

Adult↗

PubMed1991

Community-wide outbreak of group G streptococcal pharyngitis.

Although several outbreaks of group G beta-hemolytic streptococcal (GGBHS) pharyngitis have been described, doubt still remains regarding the etiologic role of GGBHS in acute pharyngitis beyond a limited number of situations. In the winter/spring of 1986/87, throat cultures were obtained from 222 consecutive children seen at a private pediatric office with acute pharyngitis and group A beta-hemolytic streptococci (GABHS) were recovered from 91 children (41%) and GGBHS from 56 children (25%). One patient had both GABHS and GGBHS isolated. This isolation rate of GGBHS was dramatically greater than in previous and subsequent years, and 67% of the GGBHS isolates occurred during an 8-week period. Results of DNA fingerprinting of the 57 isolates of GGBHS demonstrated that 43 (75%) appeared to be the same strain. The patients with GGBHS were comparable to those with GABHS with respect to clinical findings, antistreptolysin-O titer response, and clinical response to antibiotic therapy. However, patients with GGBHS were significantly older (P less than .05). This is the first well-documented, community-wide outbreak of GGBHS pharyngitis and the first respiratory outbreak of GGBHS pharyngitis in a pediatric population. GGBHS may be a more important cause of acute, treatable pharyngitis than had been previously recognized.

Adolescent↗

PubMedDate not supplied

The effects of the rapid strep test on physician management of streptococcal pharyngitis.

Management of pharyngitis remains an important and controversial subject. A retrospective chart review at the University of South Alabama Family Practice Center was undertaken to assess changes in physician prescribing and testing patterns since the advent of rapid testing of streptococcal pharyngitis (rapid strep tests [RST]). Charts for study were identified by encounter form coding of a diagnosis of streptococcal pharyngitis or pharyngitis not otherwise specified. Control and test groups were formed based on the availability of the RST, and a stratified sample was drawn from each group. In the group of patients studied after the RST became available, data analysis showed a significantly increased likelihood that patients received antibiotics with a positive RST (odds ratio [OR] = 6.42), whereas those patients with a negative or no RST were significantly less likely to receive antibiotics (OR = 2.50 and 2.48, respectively). Group assignment was a significant predictor of test-ordering behavior (P less than 0.05). A higher than expected rate of streptococcal pharyngitis was noted in the group of patients who had the RST available to them. The RST plays an important though not fully defined role in the current management of pharyngitis.

Adolescent↗

PubMedDate not supplied

[Pharyngeal cysts of branchial origin, a review of the literature and a clinical case report].

Nasal pharyngeal swellings are very often treated without a previous complete clinical examination of the patient and of the disease site. For this reason the recurrence rate of this pathology is quite high. The causes for this phenomenon are likely due to the benign aspect of the tumor and the easy approach to the pharynx. Leaving aside the therapeutical aspect, there are also multiple theories concerning the etiology of pharyngeal cyst based on epidemiological and histopathological observations. Branchiogenic origin very likely seems to be the cause of cystic swelling arising at the lateral side of the pharynx, between the Eustachian tube and the posterior tonsillar pillar. Examination of the case review collected from literature, revealed that diagnostic and therapeutical procedures performed by various authors seem to be very haphazard, ranging from simple physical examination and puncture draining to CT and/or MRI scanning and external trans-mandibular approach to the cyst. The authors describe one case of a subject with a pharyngeal branchial cyst, who had been previously undergone puncture drainage. The correct diagnosis was achieved through MRI and cytologic examination of the fluid aspirated from the cyst. With MRI it was possible to make a correct topo-diagnosis, which localized the position of the cyst in the left pharyngo-tonsillar recesses, medial to the pharyngeal constrictor muscles. MRI also confirmed the absence of fistulous ducts connected to the cyst. These clinical and laboratory data induced us to use an intra-oral approach to the cyst, which was removed by blunt dissection. Physical examination and MRI were repeated six months later and showed the complete removal of the cyst and the presence of a synechia between the upper part of the left posterior pillar and the pharyngeal wall. No further treatment was given because of the absence of symptoms. The authors stress the importance of less invasive surgery in the case of pharyngeal cyst possible after detailed monitoring of the disease site with modern computed tomography CT, MRI.

Adult↗

PubMed1998

Correlation of laryngeal and pharyngeal carcinomas and 24-hour pH monitoring of the esophagus and pharynx.

The cause of laryngeal and pharyngeal carcinomas is likely multifactorial. Smoking is an important factor, but mucosal damage from gastroesophageal reflux may also contribute. The purpose of this study was to determine whether gastroesophageal reflux is more common in patients with laryngeal or pharyngeal carcinomas than in those without these malignancies. Over an 8-year period, we correlated the results of clinical and radiographic examinations of the pharynx and esophagus to pH monitoring results in 798 patients with a variety of upper aerodigestive tract symptoms and who underwent both pH monitoring and barium esophagography. In this group, 63 patients (52 men, 11 women) had laryngeal or pharyngeal carcinomas, and 735 patients (319 men, 416 women) had neither malignancy. Abnormal pH findings were defined as a total percentage of esophageal acid exposure time of 6% or more as determined with the esophageal probe, or any reflux event detected with the pharyngeal probe. Thirty-four of 63 patients with carcinomas (54%) had abnormal pH-monitoring results: Esophageal acid exposure was abnormal in 10 patients, pharyngeal acid exposure was abnormal in 7 patients, and acid exposure was abnormal in both areas in 17 patients. Of the 735 patients without malignancies, 365 (50%) had abnormal pH-monitoring results (p > 0.05). In this population of patients, abnormal results of pH monitoring were common, occurring in 399 (50%) of 798 patients, but no significant difference was found between results in those with and without laryngeal or pharyngeal carcinomas. Therefore, our study found that gastroesophageal reflux as shown by pH monitoring was not more common in patients with these malignancies.

Adult↗

PubMed1998

A new concept and technique for reconstruction of the lower pharyngeal space using the free jejunal graft.

OBJECTIVE: To report on a new concept and simple operative procedure to conform the diameter of the oral end of free jejunal grafts to that of pharyngeal defects for reconstruction of the lower pharyngeal space. DESIGN AND METHODS: A preliminary study showed that the jejunum is supplied by a highly vascular network and that longitudinal paramesenteric incisions can be made without disturbing the blood supply of the jejunum. We then developed the following operative procedure. The position of the highest point of the pharyngeal defect and the site of the recipient vessels are determined. The free jejunal graft is positioned with its mesentery in correspondence with the location of the recipient vessels. The position of a longitudinal incision 180 degrees to the highest point of the defect is then determined. After the oral border of the jejunum is opened with scissors, a pharyngojejunal end-to-end anastomosis is performed. PATIENTS: Eighteen patients with defects of the lower pharyngeal space after cancer treatment. RESULTS: We transferred jejunal grafts in 18 patients using this operative procedure. In 7 of these patients, paramesenteric incisions were made. The lengths of the incisions ranged from 2 to 8 cm. Transfer was successful in all 18 patients. Postoperative leakage occurred in 1 patient in whom an antimesenteric incision had been made; however, a fistula did not develop. CONCLUSIONS: Our method allows defects of the lower pharyngeal space to be reconstructed with end-to-end anastomosis of free jejunal grafts regardless of the location of the defect or of recipient vessels. This method is simple and appropriate for correcting large pharyngeal defects.

Adult↗

PubMed1989

Pharyngeal function after carotid endarterectomy.

Neurologic deficiencies, with special reference to pharyngeal function, were studied prospectively in 12 patients before and after they underwent carotid endarterectomy. Pharyngeal function was monitored with cineradiography. Five patients developed pharyngeal dysfunction: defective closure of the laryngeal vestibule, epiglottic dysmotility, and pharyngeal constrictor paresis 1 week postoperatively. In 2 patients this dysfunction remained, while in 3 it had resolved 4 weeks after the operation. Pharyngeal dysfunction was more common in patients with preoperative minor stroke and a temporary perioperative carotid shunt and in patients with a long operation time. The registered transient pharyngeal dysfunction may be due to manipulation of the cervical structures including the vagus nerve and the pharynx or due to cerebrovascular damage during the operation. Our findings support careful monitoring of postoperative oral finding in patients at risk.

Adult↗

PubMed2001

Videomanometric analysis of supraglottic swallow, effortful swallow, and chin tuck in patients with pharyngeal dysfunction.

Simultaneous videoradiography and solid-state manometry (videomanometry) was performed in 8 patients (4 women, 4 men; age range = 46-81 years, mean age = 70 years) with pharyngeal dysfunction. Five patients had severe pharyngeal dysfunction with frequent misdirected swallows. Three patients had moderate pharyngeal dysfunction with delayed initiation of pharyngeal swallow. Three different swallowing techniques were used: supraglottic swallow, effortful swallow, and chin tuck. Ten video radiographic variables and six manometric variables were analyzed. Contrast media penetration to the airways was analyzed regarding number of events and level of penetration. Supraglottic swallow, effortful swallow, and chin tuck did not reduce the number of misdirected swallows, but effortful swallow and chin tuck significantly (p = 0.008) reduced the depth of contrast penetration into the larynx and trachea. There was no significant improvement of pharyngeal retention. Chin tuck reduced the distance between the thyroid and the hyoid and the distance between the mandible and the hyoid. No other measured variable was significantly altered. This study shows that none of the different swallowing techniques reduced the number of misdirected swallows. However, there was a significantly reduced depth of the misdirected swallows. The swallowing techniques did not seem to prevent the occurrence of retention or improve weak pharyngeal constrictor muscles in this group of patients with severe to moderate dysfunction.

Aged↗

PubMed2005

Timing of pharyngeal and upper esophageal sphincter pressures as a function of normal and effortful swallowing in young healthy adults.

The effect of effortful swallow on pharyngeal pressure and UES relaxation onsets and durations was examined. Eighteen adults, nine males and nine females (mean age=27.9 yr), participated. Timing of pharyngeal pressure and onset and duration of UES relaxation were measured across ten trials of normal and ten trials of effortful swallows. Results revealed that manometric timing measurements are consistent across trials. The first and second statistical analyses investigated the pharyngeal pressure and UES relaxation onsets and durations, respectively. Both analyses identified a significant interaction of swallow type (i.e., effortful vs. normal) by manometric sensor location (p<0.05). Across normal and effortful swallows, UES relaxation preceded pharyngeal pressure onsets, yet the rate of change (or degree of delay) varied across the sensors. Furthermore, the effortful swallow elicited longer pharyngeal pressure and UES relaxation durations, yet the pressure duration measured in the upper pharynx was significantly longer than that measured lower in the pharynx. These findings offer insight as to the potential positive and negative influence of the effortful swallow on pharyngeal timing.

Adult↗

PubMed2003

Clinical efficacy of clarithromycin against uterine cervical and pharyngeal Chlamydia trachomatis and the sensitivity of polymerase chain reaction to detect C. trachomatis at various time points after treatment.

The detection and eradication of pharyngeal Chlamydia trachomatis in patients with chlamydial uterine cervicitis (commercial sex workers and others) were investigated. Pharyngeal C. trachomatis was detected in 75.0% of the commercial sex workers and in 21.9% of the other subjects. All the pharyngeal C. trachomatis-positive patients had a past history of orogenital contact. Chlamydial infection was treated with clarithromycin for 7 or 14 days. The presence of C. trachomatis was determined by polymerase chain reaction (PCR) on days 8, 15, and 22 after completion of the treatment. In the 7-day treatment group, the eradication rate of pharyngeal C. trachomatis was 53.3%, 56.7%, and 60.0% on days 8, 15, and 22, respectively, after completion of the treatment, while the eradication rate of cervical C. trachomatis was 83.3%, 96.7%, and 100% on days 8, 15, and 22, respectively. The eradication rate of pharyngeal C. trachomatis in the 7-day treatment was significantly lower than that of cervical C. trachomatis, while there was no significant difference in the 14-day treatment. The eradication rate of pharyngeal C. trachomatis in the 14-day treatment was significantly higher than that in the 7-day treatment. Since the DNA of dead organisms may be detected because of high PCR sensitivity, appropriate therapeutic judgment by PCR could be done around day 22 after completion of the treatment.

Adult↗

PubMed2002

The effect of posture and a mandibular protruding device on pharyngeal dimensions: a cephalometric study.

The objectives were to evaluate the impact of body posture on cephalometric measures and the level and the extent to which treatment with a mandibular protruding device (MPD) affects pharyngeal width. The study was composed of 77 patients: 50 were diagnosed with obstructive sleep apnea (OSA) and 27 snored. After each patient underwent a baseline medical (including a somnographic registration), dental and stomatognathic examination, an MPD that would protrude the mandible 75% of the maximal protrusion range was fabricated. In a radiographic examination, four cephalograms were taken: two in the upright position with and without the MPD and two in the supine position with and without the MPD. The cephalometric measures focused on the pharyngeal structures. MPD treatment significantly increased the relative pharyngeal area (at the level of the oropharynx and the hypopharynx) by a mean of +89.6 mm2 (P < 0.01) in the upright posture. The relative pharyngeal area, however, was reduced by more than 50% in the supine position compared with the upright position, independent of MPD treatment. In the supine position, compared with upright, most pharyngeal measures decreased significantly; the hyoid was significantly lower and displaced posteriorly, and the area of the velum increased by a mean of +201.2 mm2 (P < 0.001). We conclude that the MPD significantly increased most pharyngeal measures except the linear distance between the hyoid bone and the third vertebra and decreased the area of the velum.

Adult↗

PubMed1989

Neuronal analysis of pharyngeal peristalsis in the gastropod Navanax in terms of identified motoneurons innervating identified muscle bands. II. Radial and circumferential motor fields.

The neuronal basis of pharyngeal ingestion and peristalsis was studied in the gastropod Navanax inermis. Radially and circumferentially oriented muscles produce expansion and constriction of the pharynx. Motor fields of 11 identified radial motoneurons and 13 identified circumferential motoneurons were determined with respect to circumferential and longitudinal muscle band coordinates by muscle movements, electromyography, antidromic stimulation and axonal anatomy. Activation of these identified motoneurons can account for all the elemental pharyngeal movements observed during feeding. Four motoneurons, each innervating most of radial muscle, can mediate ingestion. Three radial motoneurons with anterior motor fields can mediate anterior expansion during sealing of the pharyngeal lips around prey and during regurgitation. Ten circumferential motoneurons have small arciform motor fields, the distributions of which correspond to the regional specializations in circumferential band organization. Arciform constriction can center eccentric ingested prey within the pharyngeal lumen during peristalsis. Arciform constrictions could combine to form an annular constriction in peristalsis. Small, non-overlapping, circumferential motor fields maximize the number of independent annular units available to produce a fine peristaltic wave. Sphincters have more circumferential motoneurons with smaller motor fields; this innervation permits finer motor control. Radial motoneurons with posterior motor fields can produce expansion caudal to a circumferential constriction during peristalsis. Motor fields of regional radial motoneurons show greater interanimal variability than circumferential motor fields, which is correlated with a less essential role of radial motoneurons in peristalsis. Two circumferential motoneurons with giant posterior pharyngeal motor fields can mediate pharyngeal emptying either in swallowing or in regurgitation.

Action Potentials↗

PubMed1991

Alterations of hyoid bone position and pharyngeal depth and their relationship after surgical correction of mandibular prognathism.

The present investigation studied changes of hyoid bone position and pharyngeal depth at the levels of the second and fourth cervical vertebrae and their relationships in mandibular prognathism patients who received combined orthodontic-surgical treatment. The material consisted of presurgical and 1-year postsurgical profile cephalograms of 52 adult orthognathic surgery patients (40 females and 12 males) who initially had mandibular prognathism and had undergone bilateral vertical ramus osteotomy through an extraoral incision in the retroangular area. Hyoid bone position and pharyngeal depth were assessed on the profile radiographs with 10 cephalometric variables. Paired t tests were used to evaluate the operative changes in all cephalometric parameters. The relationships between pairs of variables describing hyoid bone position and pharyngeal depth were assessed by means of Pearson's product-moment correlation analysis. Significant differences (p less than 0.01) were observed for the distances of the hyoid bone to the maxilla and the mandible. The distances of the hyoid bone with the anterior cranial base, the vertebral column, and the anterior pharyngeal wall, and the measurements representing pharyngeal depth exhibited no significant changes (p greater than 0.05). Moderate correlations were seen between (1) the depth of the pharynx at the fourth cervical vertebra and the hyosymphyseal distance (r = 0.34) and the distance between the point of the projection of the hyoid bone to the mandibular line with its posterior border (r = -0.34), and (2) the depth of the pharynx at the second cervical vertebra and the distance of the hyoid bone with the anterior pharyngeal wall at the level of the fourth cervical vertebra (r = -0.33).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

PubMed2004

Long-term changes in pharyngeal airway morphology after mandibular setback surgery.

Long-term changes in pharyngeal airway morphology were evaluated after mandibular setback surgery in 10 women who were diagnosed as having skeletal mandibular prognathism and underwent mandibular setback surgery by bilateral sagittal split ramus osteotomy (SSRO) and orthodontic multi-bracket treatment. The subjects were assessed before treatment (T1), 3-6 months after SSRO (T2), and 2 or more years after SSRO (T3). From T1 to T2, the pharyngeal airway constricted significantly. On the other hand, from T2 to T3, the lower facial morphology showed no significant changes. The pharyngeal airway morphology showed significant changes in soft-palate length and posterior reference line to point of posterior tongue, indicating a tendency for relapse. These results suggest that, although the lower facial morphology and the pharyngeal airway morphology showed marked changes after SSRO, the pharyngeal airway morphology exhibited gradual physiologic readaptation. However, because the lower facial morphology after surgery was retained and stable for a long period, it was considered normal for the pharyngeal airway morphology to adapt after surgery to the improved hard tissue relationship.

Adult↗

PubMed2005

The interaction between respiratory and autonomic function during sleep-related changes in pharyngeal airway patency.

Sleep-related changes in pharyngeal function result in an increased resistance to airflow and in some people complete pharyngeal occlusion. Clinically, pharyngeal occlusion causes obstructive sleep apnoea syndrome (OSA). This is a prevalent disorder, which is an independent risk factor for the development of systemic hypertension. Several mechanisms contribute to the sleep-related changes in pharyngeal function in both health and disease, including a reduction in respiratory-related muscle activation, and an increase in latency of the pharyngeal reflex to negative intralumenal pressure. Arousal from sleep causes increases in ventilation and autonomic cardiovascular function that far exceed physiological requirements--the so-called 'waking reflex'. In patients with OSA the waking reflex is augmented either by hypoxemia, hypercapnia, or large swings in intrathoracic pressure. How these factors interact to cause the acute surges in heart rate and systemic blood pressure that occur at the termination of an apnoea will be reviewed, together with the longer term consequences of pharyngeal occlusion during sleep.

Airway Obstruction↗

PubMed1997

A role of pharyngeal length in obstructive sleep apnea patients.

A narrow pharyngeal pathway may be one of the most significant predisposing factors for obstructive sleep apnea (OSA). Accordingly, the objectives of many treatment modalities are focused on widening the constricted part of the pharynx. Despite the obvious limitations as a two-dimensional imaging technique, cephalometrics has been used more recently as a clinical screening tool for OSA. This study was designed to investigate whether pharyngeal variables more reliable than a single measurement of the most constricted area exist in cephalograms. A total of 80 pairs of upright and supine cephalograms were obtained and subclassified into four groups, in accordance with OSA severity. A medial axis program conveniently provided the variables for the study by transforming digitized outlines of the pharyngeal structure. The results indicate that the pharyngeal length and the pharyngeal width below the most constricted area may be the most important variables. We observed that the pharynx becomes considerably longer in the apneic group after a body position change from upright to supine. Pharyngeal length in the supine position may be more important than a one-dimensional measurement of the most constricted area in the diagnosis and treatment of OSA.

Analysis of Variance↗