Original article
Can facial type be used to predict changes in hyoid bone position with age? A perspective based on longitudinal data

https://doi.org/10.1016/j.ajodo.2006.10.039Get rights and content

Introduction

Low positioning of the hyoid bone is associated with the unique human ability of speech, but it might also predispose the airway to collapse. The low position of the hyoid bone has been studied in adults with sleep apnea. However, information on age-related changes in hyoid bone position in the general adult population is sparse.

Methods

We used pairs of lateral cephalometric radiographs taken 15 years apart to assess vertical changes over time in hyoid position in 163 normal white men (ages, 30-72 years).

Results and Conclusions

Significant changes in hyoid bone position were independent of age or obesity but were related to facial type, as classified by the steepness of the lower margin of the mandible. Changes in hyoid position over time were significant in dolichofacial subjects but not in brachyfacial subjects. This finding might be particularly important because a low hyoid bone with a brachial face appears to be a morphologic characteristic of nonobese patients with severe obstructive sleep apnea.

Section snippets

Material and methods

All participants were white men of European descent. Our sample consisted of cephalometric radiographs from 163 healthy participants in the original study (T1) (according to a health questionnaire and clinical and laboratory examinations) with complete dentition or with sufficient posterior teeth to provide for stable vertical stops, and a minimum of 10 years later (T2).

Changes in hyoid bone position were measured from the lateral cephalometric radiographs from the men participating in the

Results

The participants' ages at T1 ranged from 30.6 to 67.0 years with a mean age of 45.9 years (Table I). BMI scores concurrent with the radiograph were 20 to 36 (mean, 25.9). The time interval range was 11.3 to 18.6 years with a mean of 15.2 years.

The means and standard deviations of the T1 hyoid bone measurements and lower anterior facial height (LAFH) for all subjects were for HYS (mean, 125.7 mm; SD, 8.13 mm), HYMP (mean, 20.2 mm, SD, 5.56 mm), HYRGN (mean, 41.29 mm, SD, 6.25 mm), GOHYME (mean,

Discussion

Collapsibility and compliance of the pharynx can be critical issues, especially when the usual supine sleeping position is considered.18, 19 A large tongue, along with a narrow and elongated vertical supralaryngeal vocal tract combined with the loss of epiglottic-soft palate overlap, is believed to underlie language skills.3 These features appear to be advantageous for better phonation, because acoustic variability requires the pharyngeal airway to be a long and compliant conduit. However, the

Conclusions

Hyoid bone positional changes with aging (or elapsed time) depend on the facial forms in men. Our morphometric data suggest that the continued descent of the hyoid bone in men might be associated with breathing functions influenced by facial form. The following are our findings from this study.

  • 1

    Hyoid position changes appear to continue lifelong and are associated with aging.

  • 2

    Hyoid position and changes are independent of obesity.

  • 3

    Hyoid position and changes differ by facial types; thus, facial forms

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    Supported by a grant from the Dean's Seed Grant program of the UCLA School of Dentistry, Los Angeles, Calif, to the first author. This investigation was conducted, in part, in a facility constructed with support from Research Facilities Improvement Program Grant Number CO6 RR-14529-01 from the National Center for Research Resources, National Institutes of Health.

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