Interpreting xray of airways

[dammit_daniel]

Hi,

Can anyone with experience with airways measurements help me with interpreting my xray

I have a side profile view. Is there anything abnormal?

https://imgur.com/a/yecWsvJ

[april]

I'm no expert, but your airway looks extremely narrow.

[CCW]

Your airway is 3.1mm at the narrowest. Less than 10mm is considered a risk for sleep apnea. You're breathing through a straw.

[kavan]

Can you tell me who wrote the airway measurements in there. I'm asking because on my SCREEN, I get pretty much the same mm measures as written beside the short green lines to the airway. But the SCALE of 5cm is measuring about 5.8-5.9 cm on my screen.

[dammit_daniel]

Thanks for the info. I thought it LOOKED narrow aswell, the max fac I saw was useless and didn't say anything.

Hey Kavan, I put the measurements on using the 3D viewer program they gave me with the measurement tool. Not sure why the scale is messed up 

[kavan]

Thanks for the info. I thought it LOOKED narrow aswell, the max fac I saw was useless and didn't say anything.

Hey Kavan, I put the measurements on using the 3D viewer program they gave me with the measurement tool. Not sure why the scale is messed up 

OK, well I knew to ask WHO put the measurements on there as they don't mesh with the scale. So, those aren't your 'real life' measures. IF the maxfax got those for you, go back and DEMAND he tell you the measure of the airway. If he doesn't, give his NAME here.

[dammit_daniel]

When I use the measuring tool on the scale it gives me the same measurements, so I'm assuming when I uploaded it the image may of been distorted? But I thought the measurements I labeled there would be correct?

[kavan]

When I use the measuring tool on the scale it gives me the same measurements, so I'm assuming when I uploaded it the image may of been distorted? But I thought the measurements I labeled there would be correct?

My ruler got the same measurements as you for the airway but NOT on the 5cm scale.

[dammit_daniel]

I'm not certain but when i uploaded it, its possible the image was stretched/shrunk vertically, where the scale is, and not horizontally(like the horizontal throat measurements).

[kavan]

IDK. Disregard my measures because holding a ruler to the screen can only be an approximation and not exact even though I get same 4mm measure. I'm just NOT familiar enough to draw much info from a Cone Beam Computed Tomography scan. I'm just uncertain whether or not that's the actual measure of your air way.

Also perplexed that you went to a doctor specifically to ascertain a measure and that measure was not interpreted FOR YOU.

The only thing I can suggest at this point would be to go to a maxfax WITHOUT specific objective for him to read the airway but WITH complaint of retrusive jaw as to get a CEPH. A lot of them will jut tell you if the airway is small. Even if they don't, I think people on here are more familar with CEPHS.

Here is a CEPH diagram where if one knows where to find the airway, it can be traced and then measured relative to the scale they give.


http://www.jpbsonline.org/viewimage.asp?img=JPharmBioallSci_2015_7_6_539_163532_f5.jpg

Here's a link about sleep apnea.

https://www.aafp.org/afp/1999/1115/p2279.html

[dammit_daniel]

Thanks Kavan. Yep pretty useless Max Fac, I don't think he was confident working with airways issues. I have another appointment with a doctor who I think will be more helpful this Sat.
I'll ask about a CEPH. Thanks so much for the links.

[haven]

You took a sleep test and came up negative? From posts here I've seen people post saying they've come up positive for some degree of sleep apnea and appear to have larger airways than yours. Perhaps there's more to be taken into consideration? Either way your airway does narrow. How old are you?

[dammit_daniel]

Yes negative for apnea, but showed 13 arousals per hour and low levels of deep sleep. I think I have upper airways resistance syndrome, which doesn't show up on the AHI measurements but should show up on the RDI(respiratory disturbance index). For some reason my clinic doesn't measure that, but I've read that it's very common around the world to measure RDI's, and it is known that people with low AHI and high RDI will still suffer for daytime sleepiness.

I'm 25.

I read another persons problem where he had extreme daytime sleepiness but showed negative for sleep apnea. He said his airways was completely  collapsed while he was awake. Image below.

https://imgur.com/a/l90ZL

His sleep study showed very low amounts of deep sleepy. His doctors theory was that his body never went into deep sleep because it was constantly in a state of alert trying to keep his airways open.

I have also read that some say upper airways resistance syndrome precedes sleep apnea, as the body after a while stops responding to the narrowing of the airways and results in the airways collapsing and apneas/hyponeas occuring.

[haven]

From the image you provided of the other person it appears they have a large overjet, so they could probably advance his lower jaw to help out. There's another guy on here who based on his xray has what appears to be a large airway than yourself but says they showed signs of mild apnea

http://jawsurgeryforums.com/index.php?topic=6920.0

I've seen a few surgeons in my area and they never brought up my airway as a concern even though I'm Class II. At least from my research I don't really show any symptons. I'm around your age too. You should def keep researching and seeking more professionals for opinions. You might not have issues right now, but you could develop symptoms as you age.

[dammit_daniel]

Hey just an update.

I just saw a fantastic surgeon, Dr Lance West. He took a ceph and said my airways were more narrow than people who he had seen that had sleep apnea! He said my occlusional plane was steep and both my jaws were recessed so he has recommended double jaw surgery and ccw rotation. He is going to liaise with the sleep clinic and possibly recommend a sleep endoscopy. He also said he had close ties with Bill Arnett and would discuss my airways with him!

Thanks for the guidance guys!