Correlation of morphological variants of the soft palate and Need's ratio in normal individuals: A digital cephalometric study

Application of Berlin questionnaire in obstructive sleep apnea syndrome through soft palate morphology types

BACKGROUND

Obstructive sleep apnea (OSA) is a sleep disorder characterized by intermittent complete and partial airway collapse, resulting in frequent episodes of apnea and hypopnea. The Berlin questionnaire (BQ) is a simple, inexpensive instrument used to screen for OSA, which is about risk factors for sleep apnea, namely, snoring behavior, daytime sleepiness or fatigue, and the presence of obesity or hypertension. This 10-question test has since then become well known for its accuracy in predicting the presence of sleep apnea in patients. Cephalometry is a relatively inexpensive method and it permits a good assessment of the soft tissue elements that define the soft palate and its surrounding structures. Therefore, the present study aims to study the morphology of the soft palate using lateral cephalometry and classify it into various types. And to identify the individuals with OSA syndrome through a particular type of soft palate and correlate it with the BQ.

MATERIAL AND METHODS

This prospective study was conducted in the Department of Oral Medicine and Radiology of D.Y.Patil Dental College, Pune. About 150 subjects for the study were selected by random sampling from the outpatient department of Oral Medicine and Radiology and the patients were referred from the orthodontics department. Lateral cephalograms were assessed for soft palate morphology types, and all participants filled the BQ. A Chi-square test was applied. The level of significance was set at P < 0.05.

RESULTS

Among six types of the soft palate, the maximum number of participants had type 2 (rat-tail type) of the soft palate (26.0%). A highly significant association was found between the BQ (positive and negative response) and soft palate morphology types (i.e., P < 0.01). A maximum number of participants who responded to the BQ had type 5 (S type) of the soft palate (76.47%).

CONCLUSION

The type 2 (rat-tail) soft palate was the most frequent type, while the type 4 (straight-line) shape was the least common among all the six types. The persons with type 5 (S-shape) soft palate responded more positively to the BQ as compared to other types of soft palate. This shows that a particular type of soft palate could be responsible for causing OSA syndrome.

CLINICAL SIGNIFICANCE

Lateral cephalogram and BQ, which are relatively inexpensive and widely available, can be used in resource-limited and thickly populated countries like India to correctly identify patients with OSA syndrome.

A Digital Cephalometric Study on The Morphometric Evaluation of Soft Palate in Oral Submucous Fibrosis

OBJECTIVE

Oral submucous fibrosis (OSMF) is a chronic precancerous condition affecting the oral cavity, which is progressive and characterised by burning sensation and fibrotic change leading to restriction of mouth opening. This study evaluated the morphology of soft palate in different stages of OSMF patients using digital lateral cephalogram and compare it with healthy individuals.

METHODS

The study included 60 subjects, who were grouped as 30 OSMF and 30 healthy subjects from the same geographic population. Digital lateral cephalograms were taken with Planmeca Proline XC (Oy, Helsinki, Finland). Soft palate morphology was evaluated using Lateral Cephalogram, and the results were analysed statistically.

RESULTS

Leaf-shaped (Type 1) soft palate was commonly seen in the control group and stage I and II OSMF. Stage III OSMF patients presented with a butt-shaped (Type 3) soft palate. As the disease progressed, there was a conversion of Type 1 variety of soft palate to Type 3 variety. There was a gradual reduction in the length of the soft palate in the anteroposterior direction in OSMF patients compared to the control group.

CONCLUSION

Early cephalometric diagnosis of soft palate changes may play a pivotal role in the overall management of OSMF.<br />.

Morphometric Evaluation of Soft Palate in OSMF Patients Using Cephalometrics

Oral submucous fibrosis (OSF) is a chronic disease and a well-recognized potentially malignant condition of the oral cavity characterized by inflammation and a progressive fibrosis of the lamina propria and deeper connective tissues. To study the morphology of soft palate in different stages of OSF on digital lateral cephalogram. To compare the changes in morphology of soft palate in OSF patients with control. The study was conducted from 2017 to 2018 on 217 patients with their age ranging from 17 to 60 years. All patients detailed clinical examination and history was taken and cephalometric evaluation was done. Type I (51.14%) was found to be the most common in OSF group followed by type II (21.86%) and type VI (13.64%). The present study highlighted the variable radiographic appearances of the soft palate on lateral cephalograms with type I as most common morphology. Cephalometric analysis is one of the most commonly accepted techniques for evaluating the soft palate in both normal individuals and in those with cleft lip and palate.

Morphological variation of the velum in children and adults using magnetic resonance imaging

PURPOSE

The purpose of this study was to investigate variations in velar shape according to age, sex, and race using magnetic resonance imaging (MRI).

MATERIALS AND METHODS

The study sample consisted of 170 participants (85 children, 85 adults) between 4 and 34 years of age. Velar morphology was visually classified using midsagittal MRI scans for each participant by 2 independent raters. Inter- and intra-rater reliability was assessed. Statistical analyses were performed to identify correlations of velar shape with sex, age, and race.

RESULTS

The most frequent velar shape was "butt" for both adults (41%) and children (58%) in this study. The least common shapes for adults were "leaf" and "S." The children did not exhibit any "leaf" or "straight" velar shapes. A statistically significant difference was noted for age with respect to velar shape (P=0.014). Sex and race were found to have no significant impact on velar shape in this study.

CONCLUSION

When using MRI to evaluate velar morphology, the "butt" shape was most common in both children and adults. Velar shape varied significantly with age, while race and sex did not have a significant impact.

Cephalometrics of Pharyngeal Airway Space in Lebanese Adults

Purpose. The upper airway space is significant in orthodontic diagnosis and treatment planning. The objectives of this study are to assess the dimensions of soft tissue elements of the upper pharyngeal space and evaluate potential correlations with modifying variables such as gender, skeletal class, and anthropometric parameters. Materials and Methods. Lateral cephalograms were obtained from 117 healthy young adult Lebanese subjects. Nineteen cephalometric linear/angular measurements of the nasopharynx, oropharynx, and hypopharynx were recorded. Anthropometric parameters including body mass index and neck circumference were measured. Results. Significant differences were demonstrated for 12 out of the 19 parameters considered between genders. Uvula and tongue dimensions and the distances between epiglottis-posterior pharyngeal wall and epiglottis-posterior nasal spine were significantly larger in males. The anteroposterior inclination of the uvula and the distances between the uvula and posterior pharyngeal wall were significantly greater in females. No significant differences were found between skeletal classes relative to most of the variables. Body mass index and neck circumference were positively correlated with the dimensions of tongue and uvula. Conclusions. Sexual dimorphism relative to some cephalometric variables and anthropometric parameters may account partly for larger oronasopharyngeal spaces in females. Anthropometric data need to be accounted for in population-related comparisons.

An Innovative Approach to Evaluate the Morphological Patterns of Soft Palate in Oral Submucous Fibrosis Patients: A Digital Cephalometric Study

Oral submucous fibrosis (OSMF) is a chronic insidious disease affecting mucosa and submucosa of oral cavity and soft palate. The present study aimed to evaluate the morphology of soft palate in normal individuals and OSMF patients using lateral cephalometry and to compare and correlate these variants of soft palate with different stages of OSMF. 100 subjects were included in the study, who were divided into two groups. Group I included 50 subjects with clinical diagnosis of OSMF and Group II included 50 normal subjects (control group). Using digital lateral cephalometry, velar length and width were measured and soft palatal patterns were categorized based on You et al.'s classification. Leaf and rat-tail patterns of soft palate were predominant in control group, whereas butt and crook shaped variants were more in study group. Anteroposterior (A-P) length of soft palate was significantly greater in stage I OSMF, while superoinferior (S-I) width was greater in stage III OSMF. Interestingly, a negative correlation was observed in staging of OSMF and A-P dimensions. As the staging of OSMF advances, the A-P length of soft palate decreases, but S-I width increases.

A Focus on Variation in Morphology of Soft Palate Using Cone-Beam Computed Tomography with Assessment of Need's Ratio in Central Madhya Pradesh Population

INTRODUCTION

Soft palate is an anatomical structure that helps in modifying the quality of voice and to breathe while swallowing. Through the variants and shapes of the soft palate, we can assess the age and gender of an individual.

AIM

The aim of the present study was to investigate the variation in morphology of soft palate and to find its association with the Need's ratio, Velar Length (VL), Velar Width (VW) and Pharyngeal Depth (PD), in age groups and gender using CBCT in Central Madhya Pradesh population.

MATERIALS AND METHODS

The study sample consisted of 121 CBCT scans of individuals aged between 15 to 45 years. These scans were retrieved from the Department of Oral Radiology. The velar morphology on CBCT was examined and grouped into six types. The results obtained were subjected to a statistical analysis to find the association between variants of the soft palate with gender and different age groups. ANOVA and Z-test were used for statistical analysis. The p≤0.05 was considered as significant while p≤0.001 was considered as highly significant.

RESULTS

The most frequent type of soft palate was rat tail shaped. The mean VL and VW values were significantly higher in males while PD and Need's ratio were higher among females, insignificantly associated with the types of soft palate. A significant association was observed between the mean VL and VW with various age groups, showing an increase in values with an increase in age.

CONCLUSION

A variation in morphology of soft palate plays an important role in the assessment of velopharyngeal closure and in diagnosing obstructive sleep apnoea individuals.

Morphological Study of Soft Palate by Using Computed Tomography-A Prospective Study

BACKGROUND

Soft palate is an important part of oro-naso-pharyngeal apparatus. The morphometric assessment of soft palate is well-performed on computed tomography (CT).

AIM

To evaluate the morphology of soft palate in healthy individuals by using Computed tomography.

MATERIALS AND METHODS

The study was conducted on 300 healthy voluntary participants who were subjected to CT scan (sagittal view) of head and neck region. The measurements of antero-posterior and supero-inferior length of soft palate were performed by using Syngo CT 2009E software.

STATISTICAL ANALYSIS

The statistical analysis was performed by using SPSS software version 16 and test applied were one-way ANOVA, independent t-test, chi-square and Karl Pearson's co-relation coefficient.

RESULTS

The participant's age ranged from 18-80 years with mean of 39.51±14.64. The study had equal number of males (n=150) and females (n=150). Out of six shapes of soft palate, Butt type (38.7%) was the commonest. The morphology of soft palate in different age groups was statistically not significant (p>0.05). The total mean of antero-posterior length (30.31±3.39 mm) of soft palate was more than supero-inferior length (10.72±1.71 mm). The mean of antero-posterior length in males (30.69±3.42 mm) was more than females (29.92±3.32 mm); which was statistically significant (p<0.05). The mean of supero-inferior length in males (10.67±1.78 mm) was less than females (10.78+1.64 mm), which was statistically not significant (p>0.05).

CONCLUSION

CT scan is an important diagnostic aid for studying the accurate morphology of soft palate.