Comparative evaluation of the upper pharyngeal airway among children with/without UCLP and with/without OSA

To evaluate the volume and the most constricted cross-sectional area (lumen) sizes of the upper pharyngeal airway among children with/without unilateral cleft lip and palate (UCLP) and with/without obstructive sleep apnea (OSA).

This prospective study was conducted on 66 Thai children aged 5 to 12 years, encompassing demographic information, polysomnographic data, and sex distribution: 34 with non-syndromic UCLP (16 with OSA; 18 without OSA) and 32 non-cleft children (16 with OSA; 16 without OSA). Subjects were divided into two age groups: preadolescent group (ages 10-12) and younger group (ages 5-9). Cone-beam computed tomography images were acquired with subjects in a supine position. Subsequent measurements were conducted using the Dolphin imaging program (version 11.7 premium) to investigate and compare the volumes and lumens of the nasopharyngeal, oropharyngeal, and hypopharyngeal airways.

In the younger group, the UCLP with OSA group exhibited significantly smaller volumes and lumens in the oropharyngeal airway compared to the non-cleft group without OSA (volume: p = 0.044; lumen: p = 0.031, 95% CI). All upper pharyngeal airway parts had comparable volumes and lumens between age groups. However, preadolescence reported no significant differences.

Statistically significant differences were observed only in the oropharyngeal airway measurements in the younger sample compared to the adolescent sample. This underscores the importance of considering oropharyngeal airway structure in diagnosing and preventing OSA in children. However, it is essential to note that while airway size is a fundamental factor, it may not be the sole determinant of OSA occurrence. Other factors likely contribute to the condition as well.