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Mandibular dimensions in children with obstructive sleep apnea syndrome
Patricia H Schiffman1, Nathania K Rubin, Troy Dominguez
1Division of Plastic and Reconstructive Surgery, The Children's Hospital of Philadelphia, Pennsylvania 19104-4399, USA.
Objective:
We hypothesized that mandibular size may play a role in the etiology of obstructive sleep apnea syndrome (OSAS) in children, since a smaller mandible may reduce airway size. We used magnetic resonance imaging to determine the mandible dimensions of children with OSAS.
Design:
Case control study.
Setting:
Tertiary-care pediatric hospital.
Participants:
Twenty-four subjects (mean age 4.9 +/- 1.7 years) with mild to moderate OSAS (Apnea Index 3.5 +/- 5.1), and 24 matched controls (mean age 4.9 +/- 1.8 years).
Intervention:
Magnetic resonance imaging of the upper airway under sedation.
Measurements:
Eight measurements were obtained from a 3-dimensional segmentation of the mandible using 3DVIEWNIX software. Measurements included length, height, width, midsymphysis menti angle, angle of mandible, enclosure area, surface area, and volume. Descriptive comparisons using Student t test and multivariate analyses of variance were performed.
Results:
Individual measurement comparisons revealed no significant differences between groups. Multivariate analysis showed a lower bound of a 95% confidence interval for an effect size measure for "general mandibular size," including all 6 linear, the area, and the volume measurements, to be -0.25.
Conclusion:
Our study shows that a smaller mandible is not a feature in children with OSAS who do not have apparent craniofacial abnormalities.