Do patients with different craniofacial patterns have differences in upper airway volume? A systematic review with...

Area of Science:

• Orthodontics and Dental Anatomy
• Medical Imaging and Radiology
• Respiratory Physiology

Background:

• Craniofacial skeletal discrepancies are linked to variations in upper airway dimensions.
• Understanding these relationships is crucial for diagnosing and treating conditions affected by airway size.

Approach:

• A systematic review and network meta-analysis of human studies published until May 2023.
• Inclusion of cross-sectional studies using 3D imaging to measure upper airway volumes in individuals with diverse sagittal and vertical skeletal patterns.
• Rigorous data extraction, bias assessment, and meta-analysis, including subgroup analyses and confidence assessment using CINeMA.

Key Points:

• Class II skeletal patterns are associated with a significant decrease in total pharyngeal airway volume, primarily in the oropharynx.
• Class III skeletal patterns show a significant increase in total pharyngeal airway volume, notably in the oropharynx and hypopharynx.
• Hyperdivergent vertical skeletal patterns correlate with reduced oropharyngeal volume compared to normodivergent patterns.

Conclusions:

• Significant differences in upper airway volume exist across various sagittal and vertical craniofacial skeletal configurations.
• Observed airway volume differences are more pronounced in adults than in children.
• Findings should be interpreted cautiously due to high risk of bias from study design and reporting inconsistencies.