Marcela Lima Gurgel1, Cauby Chaves Junior2, Lucia Helena Soares Cevidanes3, Paulo Goberlânio de Barros Silva1, Francisco Samuel Rodrigues Carvalho4, Lúcio Mitsuo Kurita1, Thays Crosara Abrahão Cunha5, Cibele Dal Fabbro6, Fabio Wildson Gurgel Costa1. 1. Department of Dental Clinic, School of Dentistry, Federal University of Ceará, 1273 Monsenhor Furtado St, Fortaleza, CE, Brazil. 2. Department of Dental Clinic, School of Dentistry, Federal University of Ceará, 1273 Monsenhor Furtado St, Fortaleza, CE, Brazil. cmcjr@uol.com.br. 3. Department of Orthodontics and Pediatric Dentistry, School of Dentistry, University of Michigan, Ann Arbor, MI, USA. 4. Department of Dental Clinic, School of Dentistry, Federal University of Ceará Campus Sobral, Sobral, Brazil. 5. Biotechnology Institute, Federal University of Uberlândia, Uberlândia, Minas Gerais, Brazil. 6. Faculty of Dental Medicine, Center for Advance Research in Sleep Medicine & Stomatology, Universite de Montreal & CIUSSS Nord Ile de Montreal, CHUM, Montreal, QC, Canada.
Abstract
BACKGROUND: A reliable method for analyzing the upper airway (UA) remains a challenge. This study aimed to report the methods for UA assessment using cone-beam computed tomography (CBCT) in adults with obstructive sleep apnea (OSA). METHODS: We performed a systematic review (PROSPERO #CRD42021237490 and PRISMA checklist) that applied a search strategy to seven databases and grey literature. RESULTS: In 29 studies with moderate-to-high risk of bias, investigators mostly reported the body position during CBCT (upright or supine) and hard tissue references, diverging in UA delimitation and terminologies. The meta-analysis showed two subgroups (upright and supine), and no statistical differences were identified (p = 0.18) considering the UA area. The volume in the OSA group was smaller than that in the control group (p < 0.003 and Cohen's d = - 0.81) in the upright position. Patients with OSA showed smaller anteroposterior dimensions than the control group and were not affected by the position during image acquisition (p = 0.02; Cohen's d = - 0.52). The lateral measurements were also lower in the OSA group (supine) (p = 0.002; Cohen's d = - 0.6). CONCLUSIONS: Patients with OSA showed smaller UA measurements in the upright (volume) and supine (lateral dimension) positions. The anteroposterior dimension was also reduced in patients with OSA compared to the control group, regardless of the position during CBCT acquisition.
BACKGROUND: A reliable method for analyzing the upper airway (UA) remains a challenge. This study aimed to report the methods for UA assessment using cone-beam computed tomography (CBCT) in adults with obstructive sleep apnea (OSA). METHODS: We performed a systematic review (PROSPERO #CRD42021237490 and PRISMA checklist) that applied a search strategy to seven databases and grey literature. RESULTS: In 29 studies with moderate-to-high risk of bias, investigators mostly reported the body position during CBCT (upright or supine) and hard tissue references, diverging in UA delimitation and terminologies. The meta-analysis showed two subgroups (upright and supine), and no statistical differences were identified (p = 0.18) considering the UA area. The volume in the OSA group was smaller than that in the control group (p < 0.003 and Cohen's d = - 0.81) in the upright position. Patients with OSA showed smaller anteroposterior dimensions than the control group and were not affected by the position during image acquisition (p = 0.02; Cohen's d = - 0.52). The lateral measurements were also lower in the OSA group (supine) (p = 0.002; Cohen's d = - 0.6). CONCLUSIONS: Patients with OSA showed smaller UA measurements in the upright (volume) and supine (lateral dimension) positions. The anteroposterior dimension was also reduced in patients with OSA compared to the control group, regardless of the position during CBCT acquisition.
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