- •Upper airways in children with obstructive sleep apnea (OSA) are different from normal children.
- •There is need to identify potential craniofacial anatomy that may predispose to pediatric OSA.
- •There are cutoff values for cone-beam computed tomography measurements that may be predictive of the presence and severity of pediatric OSA.
Morphometric evaluation of upper airways helps in identifying potential craniofacial anatomy that may predispose to pediatric obstructive sleep apnea (OSA). This study evaluated upper airway parameters three-dimensionally in children with OSA, with Class II malocclusion and a retrognathic mandible, to identify cutoff values for cone-beam computed tomography measurements that may predict the presence and severity of pediatric OSA.
The study comprised 47 growing children with OSA with Class II malocclusion and 47 low-risk OSA-matched controls. Upper airway was segmented into nasopharynx, oropharynx, and hypopharynx using cone-beam computed tomography and MIMICS16.0 software. Parameters included volume, minimum cross-sectional area (CSAmin), anterioposterior and lateral distances of CSAmin, and upper airway length.
The volume, cross-sectional area (CSAmin), and anteroposterior and lateral distances of CSAmin were significantly decreased at the level of the oropharynx in patients with OSA. At the level of the hypopharynx, CSAmin was significantly narrower and upper airway length was significantly increased in patients with OSA. OSA predictive cutoff values were proposed as 41.36 mm2 CSAmin at the level of oropharynx, 52.45 mm2 CSAmin at the level of hypopharynx, and 55.47 mm upper airway length. Only CSAmin at the level of the oropharynx had an independent association with OSA severity (P = 0.021).
Significant differences were found in the upper airway parameters of children with OSA compared with corresponding controls. CSAmin may represent part of the issues that play a role in the pathogenesis of OSA and may serve as a predictive of disease severity.
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Published online: September 23, 2022
Accepted: August 9, 2022
Received in revised form: August 7, 2022
Received: June 6, 2022
Funding: This work was supported by Health Campus in Universiti Sains Malaysia under the RUI grant scheme 1001/PPSG/812158.
Competing interests: Authors have completed and submitted the ICMJE Form for Disclosure of potential conflicts of interest. None declared.
Provenance and peer review: Non-commissioned; externally peer reviewed.
© 2022 World Federation of Orthodontists. Published by Elsevier Inc. All rights reserved.