Evaluation of the Role of Palatal Tonsil Hypertrophy in Sleep Apnea Patients: Cephalometric Analysis

The purpose of this research was to elucidate the relationship between tonsillar hypertrophy and Obstructive Sleep Apnea Syndrome (OSAS) in terms of cephalometric analysis, as well as to determine factors that affect OSAS severity. 25 patients were enrolled in this study. Lateral cephalograms of the subjects were taken. Disease severity was evaluated by the Apnea Hypopnea Index (AHI). Cephalometric measurements (angle between line S-N and line N-A (SNA), angle between line S-N and line N-B (SNB), distance between the Mandibular Plane and the Hyoid (MPH), posterior airway space, the width of the airway behind the base of tongue along the B-Go line (PAS), upper airway space, the distance parallel to long axis of the airway, between a horizontal plane tangent to the superior aspect of the hyoid and a horizontal plane tangent to the posterior palate (UAL), multiplication of PAS and UAL (PAS × UAL)) were analyzed and compared between the groups with and without tonsillar hypertrophy. PAS and PAS × UAL were lower in the no hypertrophy group. SNB was significantly lower in the severe apnea group than mild to moderate group in no hypertrophy group (p = 0.035). In conclusion, patients with tonsillar hypertrophy had severe obstruction, but they had a relatively larger pharyngeal space on cephalometric analysis. After exclusion of the tonsillar hypertrophy group, cephalometric analysis could be more effective for analyzing OSAS severity.