Cephalometric evaluation of the nasopharyngeal airway space in paediatric patients suffering from respiratory disorders

Abstract

Obstructive Sleep Apnea Syndrome (OSAS) in children is a disorder of breathing during sleep charac-terized by prolonged partial upper airway obstruction and/or intermittent complete obstruction (ob-structive apnea) that disrupts normal ventilation during sleep and normal sleep patterns. It is associated with symptoms including habitual (nightly) snoring, sleep difficulties, and/or daytime neurobehavioral problems. Nocturnal polysomnography has generally been accepted as the gold standard for the diag-nosis of OSA syndrome but cephalometrics could be an adjunctive procedure for screening anatomical abnormalities in patients with OSAS.A sample of 66 children aged between 4 and 11 years (average age 7±2.6 years) from the “Centre for the Study and Care of Sleep Respiratory Disorders”, were ana-lyzed at the Department of Pediatric Dentistry of the University of Rome ”La Sapienza”, in collabora-tion with the Second Pediatric Clinic.The subjects were divided into 3 groups: Group I: 22 OSAS-noMB subjects; Group II : 22 OSAS-MB subjects; Group III: 22 subjects with no breathing disorders (control group). Descriptive statistics for all the cephalometric variables was calculated in the 3 groups. The results of the present study showed that in OSAS groups, with or without mouth breathing, there was a significantly greater obstruction of the nasopharyngeal airway space compared with the control sample.When comparing the OSAS-MB group with the OSAS-noMB group, the sagittal dimensions were significantly smaller in the OSAS-MB subjects only for the lower portion of the nasopharynx (P3 and P4 measurements) while in the upper level (P1 and P2) there were no statistically significant differences between the 2 groups. This obstruction was mainly caused by an increase in the thickness of the adenoid tissue.