Three-dimensional cone beam computed tomography analysis of craniofacial phenotype in nonobese apneic young adults.

OBJECTIVE

The obstructive sleep apnea (OSA) syndrome with its various phenotypes, as assessed by the apnea-hypopnea index (AHI), has become a major public health issue. While physicians are regularly faced with a variety of patients with OSA complaints, they may not be aware that OSA in nonobese young adults remains a largely underinvestigated topic. It is hypothesized that, in these subjects, facial bone volumes are smaller than in healthy adults.

METHODS

This cross-sectional, nonrandomized, controlled study was designed to compare the 3D cephalometric analysis of bone and craniofacial soft tissues in a group of 23 nonobese apneic (AHI ≥ 15), young (18-35 years) adults and in a control group of 23 nonapneic (AHI < 15) healthy subjects by using cone beam computed tomography (CBCT). All subjects were Caucasian and underwent a sleep examination in the Sleep Clinic of the University Hospital of Liege.

RESULTS

The two groups were comparable except for age and medications. The maxillary bone volume (23.2 ± 4.6 cm vs. 24.8 ± 2.9 cm) and the mandibular bone volume (44.0 ± 6.4 cm vs. 46.9 ± 5.2 cm) adjusted for demographic and biometric characteristics were significantly smaller in OSA subjects than in controls. OSA subjects had also a smaller angle of the maxillary diagonals (95.3 ± 13.9° vs. 106 ± 15.9°) and, at the mandible, a narrower width (90.8 ± 8.0 mm vs. 95.1 ± 5.3 mm), a wider gonial angle (119.9 ± 5.5° vs. 116.5 ± 4.4°), a longer ramus (51.2 ± 6.6 mm vs. 47.3 ± 5.0 mm), and a shorter corpus (74.1 ± 10.3 mm vs. 78.9 ± 5.8 mm) than controls.

CONCLUSION

Craniofacial structures that most discerned apneic subjects from controls were the maxillary and mandible bone volumes. An overly narrow maxilla and a postero-rotating mandible were also associated with OSA.

LEVEL OF EVIDENCE

III.

REGISTRATION

NCT06022679.