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Three-Dimensional Assessment of Upper Airway Morphology and Sleep-Disordered Breathing Risk in Unilateral
Akila Aiyar1, Peter Stoustrup1, Thomas Klit Pedersen1,2
1Section of Orthodontics, Aarhus University, Aarhus, Denmark.
Objective:
Unilateral craniofacial microsomia (UCM) presents varying unilateral deficiencies of the temporomandibular joint, mandibular ramus, masticatory muscles, and adjacent soft tissues and ear. Reduced mandibular and maxillary dimensions may decrease upper airway volume and may increase the risk of sleep-disordered breathing (SDB). This retrospective pilot study aimed to evaluate a novel three-dimensional (3D) method for assessing nasal cavity (NC) and pharyngeal airway (PA) dimensions in growing patients with UCM compared with healthy controls, and to explore the potential associations between airway dimensions and SDB risk using the pediatric Sleep Questionnaire (PSQ).
Material And Methods:
This retrospective case-control pilot study analysed Cone-beam computed tomography (CBCT) scans from 11 patients with UCM (mean age 12.7 ± 4.4 years) and 11 age-matched controls (mean age 12.1 ± 1.1 years). Two calibrated investigators performed airway measurements, including total and partial NC and PA volumes, minimal cross-sectional area (MCS), and hydraulic diameter. SDB risk in the UCM group was assessed using PSQ scores. Reliability was evaluated with intra-class correlation coefficients and Dahlberg's formula. Group differences were tested using unpaired t-tests.
Results:
Patients with UCM showed significantly smaller NC volume (9714.9 ± 3032 mm3) than controls (12773.9 ± 1963 mm3; p < 0.0001). PA volume and MCS did not differ significantly. Four of the eleven patients with UCM showed a high PSQ-based risk of SDB and tended to have smaller airway dimensions. Measurement reliability was acceptable.
Conclusions:
CBCT-based 3D assessment of upper airway morphology was feasible in patients with UCM. Patients with UCM demonstrated significantly reduced nasal cavity volume compared with controls. Exploratory analysis suggested that some patients may be at increased risk of SDB; however, these findings require confirmation in larger studies.
