Evaluation of Upper Airway in Children with Obstructive Sleep Apnea Using Cone-Beam Computed Tomography

Laryngoscope. 2021 Mar;131(3):680-685. doi: 10.1002/lary.28863. Epub 2020 Jul 13.

Abstract

Objective: Cone-beam computed tomography (CBCT) offers three-dimensional structures in assessing upper airway of patients. This study aims to compare the cone-beam computerized tomography scan measurements between children with obstructive sleep apnea (OSA) and primary snoring.

Study design: Case-control study.

Methods: This prospective study was conducted in a tertiary referral center. Thirty-six children with moderate-to-severe OSA (with apnea-hypopnea index [AHI] > 5 events/hour) and 36 age-, gender-, and obesity-matched children with primary snoring (AHI <1) were enrolled. The measurements in CBCT parameters were compared between children with moderate-to-severe OSA and primary snorers by conditional logistic regression model.

Results: A total of 72 children (mean age, 7.9 ± 2.8 years; 64% male) were included. Children with moderate-to-severe OSA had a significantly smaller nasopharyngeal (2900 ± 1400 vs. 3800 ± 1800 mm3 , P = .017) and oropharyngeal airway volume (5600 ± 2700 vs. 7400 ± 4000 mm3 , P = .026) than those with primary snoring. Children with moderate-to-severe OSA, as compared to primary snorers, also had a significantly smaller minimal airway area in nasopharynx (77.4 ± 37.7 vs. 107.7 ± 52.0 mm2 , P = .006) and oropharynx (66.6 ± 61.9 vs. 101.6 ± 65.8 mm2 , P = .023). Moreover, the airway length was not significantly different between children with moderate-to-severe OSA and primary snoring.

Conclusions: The three-dimensional CBCT airway analysis could be used as a useful tool to evaluate upper airway in children with OSA.

Level of evidence: 3 Laryngoscope, 131:680-685, 2021.

Keywords: Child, cone-beam computerized tomography, polysomnography, sleep apnea syndromes, upper airway, volume.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Cone-Beam Computed Tomography / methods*
  • Female
  • Humans
  • Imaging, Three-Dimensional / methods*
  • Logistic Models
  • Male
  • Nasopharynx / diagnostic imaging
  • Observer Variation
  • Oropharynx / diagnostic imaging
  • Polysomnography
  • Prospective Studies
  • Reproducibility of Results
  • Respiratory System / diagnostic imaging
  • Sleep Apnea, Obstructive / diagnostic imaging*
  • Snoring / diagnostic imaging*