Lateral Cephalometric Analysis in Thai Patients without Clinical Features of Obstructive Sleep Apnea Syndrome

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Natthawut Somboonsap
Wish Banhiran
Choakchai Metheetrairut
Pipat Chiewvit


Objective: To obtain referent normative values of lateral cephalometric parameters of the upper airway in Thai people without
clinical features of obstructive sleep apnea syndrome (OSAS).
Methods: A total of 105 healthy subjects (80 males and 25 females) were recruited. Inclusion criteria were healthy people
age ≥ 18 years with body mass index (BMI) of < 30 kg/m2, normal visual harmony of facial profile, no history of snoring
or witnessed apnea, and no excessive daytime sleepiness (Epworth Sleepiness Scale ≤ 8). All subjects must have a regular
sleep pattern with total sleep duration of 7-9 hours and must have no complaint of difficulty sleeping. Exclusion criteria were
pregnant women, patients with previous orthodontic treatment, corrective jaw surgery, upper airway surgery, neoplasm, irradiation
in head and neck, and patients who had underlying illnesses using medication or substance which affected the sleep-wake
cycle. All subjects had lateral cephalometric radiographs taken with a standardized technique. Every data was measured twice
on separate occasions.
Results: The reliability of repeated measurements was excellent shown by intraclass correlation coefficients ranging from 0.95
to 0.99. The baseline data were presented in mean ± SD. SNA, SNB, PAS, MPH and PNS-P in males were 84.3 ± 4.0, 81.5
± 4.1, 14.2 ± 3.4, 16.1 ± 5.3, and 34.8 ± 6.1, respectively. SNA, SNB, PAS, MPH and PNS-P in females were 84.4 ± 3.1,
80.7 ± 3.2, 11.1 ± 3.3, 10.8 ± 4.9, and 32.3 ± 3.1, respectively. The parameters that were different between both genders
included N-ANS, GN-GO, H-PP, MPH, PAS, and TL. (p < 0.05)
Conclusion: To date, this study has possibly represented the largest local database of lateral cephalometric measurements focusing
on Thai people without clinical features of OSAS. It may be another useful reference for future research and clinical practice.


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Somboonsap, N. ., Banhiran, W. ., Metheetrairut, C. ., & Chiewvit, P. . (2020). Lateral Cephalometric Analysis in Thai Patients without Clinical Features of Obstructive Sleep Apnea Syndrome. Siriraj Medical Journal, 63(5), 157–162. Retrieved from
Original Article


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