Cephalometric Comparisons of Craniofacial and Upper Airway Structures in Young Children with Obstructive Sleep Apnea Syndrome

Abstract

We studied 15 children ofpreschool age who had obst ructive sleep apnea syndrom e to evaluate thei r dentof acial morph ology in relation to the pharyngeal airway spac e. We fo und that (1) sleep apnea was often associated with mandibular retrognathia , (2) the lower incisors tended to exhibit a retroclin e, (3) there were no signific ant differences in angular and linear measurements in the cranial base between pat ients with sleep apnea and a control group of30 nonapn eic children, and (4) the apn eic children had a narrower epipharynge al airwa y space than did the controls. These findin gs suggest that obstructive sleep apn ea is probably caused by both adenoidal hypertrophy and abnormal developm ent ofthe f acial skeleton. We highly recomm end cephalometric analysis as a valuable tool fo r conducting the presurgical evaluation of sleep apnea in children ofpreschool age.

Diagnostic Issues in Pediatric Obstructive Sleep Apnea

“…To evaluate the upper airway in children with OSAS, several radiologic techniques are available, including lateral neck radiographs, cephalometrics, fluoroscopy, computerized tomography, and magnetic resonance imaging (MRI) (29)(30)(31). The above modalities have all demonstrated that the upper airway of children with OSAS is smaller on average than compared with that of normal children.…”

Craniofacial morphology in preschool children with sleep-related breathing disorder and hypertrophy of tonsils

“…Measurements of the pharyngeal airway space (18,(20)(21)(22) and the hyoid bone position (23,24): na-s-ba: the angle between na-s and s-ba .…”

Cephalometric norms for the upper airway of 12-year-old Chinese children

“…The soft-tissue morphology of the upper airway that may related to pediatric SDB includes narrowed pharyngeal airways, and larger adenoids, tonsils and soft palates [8-10]; the related hard-tissue morphology includes an increased intermaxillary angle, a retrognathic mandible [11,12], an increased mandibular angle, a longer lower anterior facial height [13,14], narrow dental arches and deep palatal height [15,16], and an inferiorly positioned hyoid bone [17,18]. …”