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Objective-To compare the Cone-Beam Computerized Tomography (CBCT) scan measurements between patients with Obstructive Sleep Apnea (OSA) and snorers to develop a prediction model for OSA based on CBCT imaging and the Berlin Questionnaire.Materials and methods-80 subjects (46 OSA patients with Apnea-Hypoapnea Index [AHI]≥ 10 and 34 snorers AHI<10 based on ambulatory somnographic assessment) were recruited through flyers and mail at USC School of Dentistry and at a private practice. Each patient answered the Berlin Questionnaire, and was imaged with CBCT in supine position. Linear and volumetric measurements of the upper airway were performed by one blinded operator and multivariate logistic regression analysis was used to identify risk factors for OSA.Results-OSA patients were predominantly male, older, had a larger neck size and larger Body Mass index than the snorers. The minimum cross-sectional area of the upper airway and its lateral dimension were significantly smaller in the cases. Airway uniformity defined as the minimum crosssectional area divided by the average area was significantly smaller in the OSA patients.Conclusions-Age>57 years, male gender, a "high risk" Berlin Questionnaire and narrow upper airway lateral dimension (<17mm) were identified as significant risk factors for OSA. The results of this study indicate that 3-dimensional CBCT airway analysis could be used as a tool to assess the presence and severity of OSA. The presence and severity (as measured by the RDI) of OSA is

Objective-To examine the influence of aging and body-mass-index (BMI) on the oropharynx configuration in male and female Japanese patients.Study design-This study examined the computed tomography (CT) images of 19 male and 19 females, group matched for age and BMI. The airway and the soft tissue volumes between the posterior nasal spine and top of the epiglottis were compared.Results-The patient's height, total oropharynx length (TOL), and lower oropharynx lengths and volume measurements (soft tissue and airway) demonstrated statistically significant gender differences. Men consistently had larger TOL and volumes than women. In men, TOL changed with age, and age was a significant predictor of lower oropharynx length. In males, the upper oropharynx soft tissue volume decreased significantly with age and lower oropharynx soft tissue volume increased significantly with age. In females no significant relationship was identified.Conclusion-The airway lengthens with aging in males and we speculate that it becomes more collapsible, which in turn could contribute to obstructive sleep apnea.

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Objective To compare the incidental radiographic findings in the maxillofacial structures and the pharyngeal airway between moderate/severe Obstructive Sleep Apnea (OSA) subjects and mild OSA/normal subjects using Cone-Beam Computed Tomography (CBCT) scans. Study Design 53 moderate/severe OSA subjects (with a Respiratory Disturbance Index [RDI]≥15 events/hr) and 33 mild OSA/normal subjects, (RDI<15) based on ambulatory somnographic assessment were recruited. Supine CBCT’s were taken and sent for radiological report. The incidental findings were compared between the two groups. Results Moderate/severe subjects had larger prevalence of conchae bullosa, hypertrophic turbinates, hypertrophic tonsils, elongated or posteriorly placed soft palate, narrower airway, enlarged tongue, and focal calcifications, though no significant differences were found. Conclusions CBCT is useful in identifying maxillofacial and airway anomalies that could interfere with normal breathing. However, no significant difference was found in prevalence of incidental findings between moderate/severe OSA and mild/normal subjects. Further studies are necessary to generalize our results.