Evaluation of Upper Airway in Children with Obstructive Sleep Apnea Using Cone-Beam Computed Tomography

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 mm3, P =.017) and oropharyngeal airway volume (5600 ± 2700 vs. 7400 ± 4000 mm3, 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 mm2, P =.006) and oropharynx (66.6 ± 61.9 vs. 101.6 ± 65.8 mm2, 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.