Evaluating the relationship between oropharyngeal airway volume and risk of sleep apnea: A cone‑beam computed tomography study

Abstract

Background: The aim of this study was to compare oropharyngeal airway measurements among
high‑ and low‑risk individuals for obstructive sleep apnea syndrome.
Materials and Methods: In this cross‑sectional study on patients referred for cone‑beam
computed tomography (CBCT) imaging before dental implant surgery, inclusion criteria were
individuals aged >30 years, Class I occlusion, without anomalies of the head and neck, dentulous
individuals, systemically healthy, and without defects in the airways. The exclusion criteria were
individuals whose responses to the study questionnaires did not match that of their companions
and images with artifacts. These patients and their relatives/housemates were requested to fill in
the Epworth Sleepiness Scale and Berlin questionnaires. Based on the answers, the patients were
classified as high‑risk groups, and patients formed low‑risk groups. CBCT images were obtained
with 85 kVp and 35 mAs and analyzed using ITK‑Snap and Mimics. Oropharyngeal airway volume,
minimum cross‑sectional area, both mesiodistal and anterior–posterior distances in the same
axial cut, and linear length between the posterior pharyngeal wall and nasal spine/soft palate/
tongue on the midsagittal slice were measured. The level of significance was considered 0.05 for
the independent samples t‑test and Chi‑square test. Pearson’s correlation coefficient was chosen
to discover correlations between CBCT measurements and patients’ age, body mass index (BMI),
and neck circumference.
Results: In total, 32 individuals participated with a mean age of 50.2 and 53.2 years in the high‑risk
and low‑risk groups, respectively. Ten females and six males comprised the high‑risk group, and
eight females and eight males formed the low‑risk group. Higher BMI and neck circumference
existed in the high‑risk group, and they both showed a direct relationship with the Epworth score.
Oropharyngeal measurements presented significant differences between the two groups, except
for the distance between the base of the tongue and the posterior pharyngeal wall (P = 0.86).
Conclusion: Oropharyngeal airway volume and minimal cross‑sectional area can be used as a
predictor for obstructive sleep apnea, and CBCT imaging is beneficial for this purpose.
Key Words: Cone‑beam computed tomography, oropharyngeal airway, sleep apnea

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 Mahsayeh Lashkarizadeh: Pubmed,Google Scholar