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

Abstract

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 cm³ vs. 24.8 ± 2.9 cm³) and the mandibular bone volume (44.0 ± 6.4 cm³ vs. 46.9 ± 5.2 cm³) 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.