A Comparative Analysis of Cephalometric data and Drug induced sleep endoscopy in OSA patients – a Sri Lankan perspective

Obstructive sleep apnoea (OSA) is a growing problem, where the diagnosis and management are rapidly evolving. The investigative tools and limited resources in developing countries pose an extra challenge in optimally treating patients with OSA.Polysomnography and drug induced sleep endoscopy are important diagnostic parameters. Cephalometric parameters are an emerging tool in the diagnostic workup, where no data is available in Sri Lankan population where surgery features as a popular treatment option.

Objectives: To identify a correlation between DISE, AHI and cephalometric parameters in a Sri Lankan population and identify common levels of obstruction in the upper airway , which influence treatment outcomes.

Results: CircumferentialVelopharyngeal and oropharyngeal obstruction aremore prevalent levels of obstruction. Statistically significant correlation between oropharyngeal collapse with SNB angle and epiglottic collapse with SNB angle and MP-H distance were seen. No correlation between DISE findings and SNA angles.

No significant correlation between cephalometry and AHI. Post op symptomatic relief based on ESS and VAS score is statistically significant.

Conclusion: Cephalometric findings are complimentary to DISE and AHI findings, but not superior in our population. Extremes from the standard deviations of cephalometric data should be treated with caution when selecting treatment options.