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Anatomical predispositions of masticatory apparatus and upper respiratory tract for development of obstructive sleep apnea and snoring

C. Madjova, S. Chokanov, Z. Ruseva, M. Milkov


Snoring occurs in the area of the uvula, soft palate, tonsillar pillars and/or pharyngeal walls. While obstructive sleep apnea (OSA) is a secondary collapse of these anatomic levels, but also due to obstruction by the lingual ton­sils or epiglottis. Тhe anatomical and structural factors associated with craniofacial bony anatomy predisposing to the OSA are: retrognathia and micrognathia; maxillo-mandibular hypoplasia, large degree of overjet; high-arched hard palate; enlarged `kissing` tonsils - adenotonsillar hypertrophy. These craniofacial skeletal abnor­malities can lead to OSA among children and non-obese adults.

The prevalence of sleep disordered breathing (SDB) in the middle-aged general population was reported to be around 9% for women and 27% for men in studies performed in the 1980s and 1990s. Considering the recent im­provements in the recording techniques and the various criteria used to define respiratory events, our aim was to re-evaluate the prevalence of SDB using three different apnea-hypopnea definitions. The palatine uvula, usually referred to as simply the uvula, is a conic projection from the posterior edge of the middle of the soft palate, com­posed of connective tissue containing a number of racemose glands, and some muscular fibers (musculus uvulae).

Snoring is more closely associated with fat deposition in the pharynx, enlarged tonsils of Waldeyer`s ring, or devi­ated septum problems. The soft palate is distinguished from the hard palate at the front of the mouth in the fact that it does not contain bone. The structural muscles are the five muscles of the soft palate that play important roles in swallowing and breathing. The muscles are: tensor veli palatini, which is involved in swallowing; palato­glossus, involved in swallowing; palatopharyngeus, involved in breathing; levator veli palatini, involved in swal­lowing; and musculus uvulae, which moves the uvula. These muscles are innervated by the pharyngeal plexus via the vagus nerve, with the exception of the tensor veli palatini.

The tongue is a muscular organ in the mouth of most vertebrates that manipulates food for mastication and is used in the act of swallowing. It plays an important role in the digestive system and is the primary organ of taste in the gustatory system. Adults who habitually breathe through the mouth, attributable to nasal obstruction, are more likely to have sleep disorders and attention-deficit/hyperactivity disorder.

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About The Authors

C. Madjova
Medical University of Varna

S. Chokanov
Medical University of Varna

Z. Ruseva
Medical University of Varna

M. Milkov
Medical University of Varna

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