Evaluation of Upper Airway in Children with Obstructive Sleep Apnea Using <scp>Cone‐Beam</scp> Computed Tomography
Wei‐Chung Hsu, Kun‐Tai Kang, Chung‐Chen Jane Yao, Chen‐Han Chou, Wen‐Chin Weng, Pei‐Lin Lee, Yunn‐Jy Chen
Abstract
Objective Cone‐beam computed tomography (CBCT) offers three‐dimensional structures in assessing upper airway of patients. This study aims to compare the cone‐beam computerized tomography scan measurements between children with obstructive sleep apnea (OSA) and primary snoring. Study Design Case–control study. Methods This prospective study was conducted in a tertiary referral center. Thirty‐six children with moderate‐to‐severe OSA (with apnea‐hypopnea index [AHI] > 5 events/hour) and 36 age‐, gender‐, and obesity‐matched children with primary snoring (AHI <1) were enrolled. The measurements in CBCT parameters were compared between children with moderate‐to‐severe OSA and primary snorers by conditional logistic regression model. Results A total of 72 children (mean age, 7.9 ± 2.8 years; 64% male) were included. Children with moderate‐to‐severe OSA had a significantly smaller nasopharyngeal (2900 ± 1400 vs. 3800 ± 1800 mm 3 , P = .017) and oropharyngeal airway volume (5600 ± 2700 vs. 7400 ± 4000 mm 3 , P = .026) than those with primary snoring. Children with moderate‐to‐severe OSA, as compared to primary snorers, also had a significantly smaller minimal airway area in nasopharynx (77.4 ± 37.7 vs. 107.7 ± 52.0 mm 2 , P = .006) and oropharynx (66.6 ± 61.9 vs. 101.6 ± 65.8 mm 2 , P = .023). Moreover, the airway length was not significantly different between children with moderate‐to‐severe OSA and primary snoring. Conclusions The three‐dimensional CBCT airway analysis could be used as a useful tool to evaluate upper airway in children with OSA. Level of Evidence 3 Laryngoscope , 131:680–685, 2021