Cone-beam computed tomography assessment of upper airway dimensions in patients at risk of obstructive sleep apnea identified using STOP-Bang scores

Imaging Sci Dent. 2021 Dec;51(4):439-446. doi: 10.5624/isd.20210193. Epub 2021 Oct 15.

Abstract

Purpose: The aim of this study was to identify correlations between the STOP-Bang score and upper airway dimensions using cone-beam computed tomography (CBCT) scans.

Materials and methods: This study included 101 subjects (46 men, 55 women) from dental patients who received CBCT scans from 2014 to 2020. The patients were divided into those with a low obstructive sleep apnoea (OSA) risk (STOP-Bang score<3) and those with an intermediate to high OSA risk (STOP-Bang score≥3), and their upper airway dimensions were then analysed on CBCT scans. Comparisons between the low-risk and intermediate/high-risk groups were conducted using the t-test and the Mann-Whitney test. Correlations between the total STOP-Bang score and upper airway dimension parameters were established using Spearman correlation coefficients. P values≤0.05 were considered to indicate statistical significance.

Results: Intermediate/high-risk subjects were predominantly male and over 50 years of age, with a higher body mass index. They had significantly longer upper airways, smaller average airway volumes, and smaller widths and antero-posterior dimensions of the narrowest upper airway segment. The total upper airway length was positively correlated with the STOP-Bang score (r s= 0.278). The average volume (r s= -0.203) and width of the narrowest upper airway segment (r s= -0.305) were both negatively correlated with STOP-Bang scores.

Conclusion: Subjects with higher STOP-Bang scores had upper airways that were longer, narrower, and smaller in terms of average volume. CBCT scans taken for dental patients as part of investigative procedures could be correlated with STOP-Bang scores to screen for patients at risk of OSA.

Keywords: Body Mass Index; Cone-Beam Computed Tomography; Sleep Apnea, Obstructive.