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Hyoid Bone Position and Upper Airway Morphology of Children With Obstructive Sleep Apnea: A Systematic Review and

Yaqi Li1,2, Tingting Zhao1,2,3,4, Peter Ngan5

  • 1State Key Laboratory of Oral and Maxillofacial Reconstruction and Regeneration, Key Laboratory of Oral Biomedicine Ministry of Education, Hubei Key Laboratory of Stomatology, School and Hospital of Stomatology, Wuhan University, Wuhan, China.

Orthodontics & Craniofacial Research
|November 12, 2024
PubMed

Insights

Children with obstructive sleep apnea (OSA) often have a lower and more forward hyoid bone position. This may contribute to a narrower airway space behind the soft palate in pediatric OSA patients.

Area of Science:

  • Orthodontics and Pediatric Dentistry
  • Sleep Medicine
  • Radiology

Background:

  • Obstructive sleep apnea (OSA) is a common condition in children, affecting their health and development.
  • Upper airway morphology and hyoid bone position are implicated in the pathophysiology of pediatric OSA.

Purpose of the Study:

  • To systematically review and synthesize evidence on hyoid bone position and upper airway dimensions in children with OSA.
  • To compare cephalometric measurements between children with and without OSA.

Main Methods:

  • Systematic literature search of major databases (PubMed, Embase, Web of Science, CINAHL, WorldCat) from inception to March 2024.
  • Inclusion of studies comparing hyoid bone position and upper airway morphology using lateral cephalograms in children with and without OSA.
  • Methodological quality assessment using the Newcastle-Ottawa Scale and meta-analysis with a random-effects model.

Main Results:

  • Meta-analysis of 13 studies revealed children with OSA have increased hyoid bone distance to the mandibular plane (Hy-MP) and cervical vertebrae (Hy-C3).
  • A narrower airway space posterior to the soft palate (U-MPW) was observed in children with OSA compared to controls.
  • No significant difference in the inferior posterior airway space (IPAS) was found between groups.

Conclusions:

  • Children with OSA tend to exhibit a more anterior and inferior hyoid bone position.
  • The posterior airway space behind the soft palate is narrower in children with OSA, potentially contributing to airway obstruction.
  • Further research may explore the causal relationship and therapeutic implications.

Keywords:
hyoid bone positionpaediatric obstructive sleep apneaupper airway morphology

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