Correlation between cephalometric variables and obstructive sleep apnoea severity in children

Authors

  • A Galeotti Bambino Gesù Children's Research Hospital, Rome, DDS, Dentistry Unit, Department of Paediatric Surgery
  • P Festa Bambino Gesù Children's Research Hospital, Rome, DDS, Dentistry Unit, Department of Paediatric Surgery
  • V Viarani Bambino Gesù Children's Research Hospital, Rome, DDS, Dentistry Unit, Department of Paediatric Surgery
  • M Pavone Bambino Gesù Children's Research Hospital, Rome, MD, Paediatric Pulmonology and Respiratory Intermediate Care Unit, Sleep and Long Term Ventilation Unit, Department of Pediatrics
  • E Sitzia Bambino Gesù Children's Research Hospital, Rome, MD, Otorhinolaringology Unit, Department of Pediatric Surgery
  • S Piga Bambino Gesù Children's Research Hospital, Rome, DDS, Dentistry Unit, Department of Paediatric Surgery, MSc, Unit of Clinical Epidemiology, Medical Direction
  • R Cutrera Bambino Gesù Children's Research Hospital, Rome, DDS, Dentistry Unit, Department of Paediatric Surgery, MD, Pediatric Pulmonology and Respiratory Intermediate Care Unit, Department of Pediatric Surgery
  • GC De Vincentiis Bambino Gesù Children's Research Hospital, Rome, DDS, Dentistry Unit, Department of Paediatric Surgery, MD, Otorhinolaringology Unit, Department of Pediatric Surgery
  • V D’Antò DDS, PhD, Section of Orthodontics, Department of Neurosciences, Reproductive Sciences and Oral Sciences, University of Naples "Federico II", Naples

DOI:

https://doi.org/10.23804/ejpd.2019.20.01.09

Keywords:

Cephalometric analysis, Children, Obstructive sleep apnea, polysomnography, Upper airways space

Abstract

AIM: Alterations in craniofacial growth have been associated with obstructive sleep apnoea in children. The main objectives of this study were to analyse the correlation between cephalometric variables and Obstructive Apnea/Hypopnea Index (OAHI) in order to investigate if craniofacial features may influence the severity of obstructive sleep apnoea and to study the correlation between upper nasopharyngeal width and maxillomandibular skeletal discrepancy in sagittal and vertical plane. MATERIALS: Study Design: Correlations between cephalometric variables and obstructive sleep apnoea/hypopnea index and between upper airways space and maxillomandibular skeletal discrepancy were investigated. Forty-seven children with obstructive sleep apnoea diagnosed by overnight sleep study (polysomnography) underwent a lateral radiograph, orthodontic and ear-nose-throat examinations. Cephalometric analysis according to Kirjavainen has been performed to define skeletal and upper airways variables. Statistics: Spearman's correlation analysis was performed between OAHI and all cephalometric variables. Pearson's correlation analysis was performed between cephalometric variables of upper airway space and cephalometric variables related to maxillomandibular discrepancy. Chi-square test was used to compare occlusal features with adenoidal and tonsillar hypertrophy. Kruskal-Wallis rank test was used to compare OAHI with occlusal variables and adenotonsillar hypertrophy. CONCLUSION: The present study shows a significant correlation between maxillomandibular discrepancy and the severity of OSA. Moreover, the reduction of nasopharyngeal width was correlated to maxillomandibular hyperdivergent growth pattern. These results support the presence of a correlation between sleep-disordered breathing and craniofacial features even if the cause-effect relation is still unclear. Based on these evidences, we suggest the importance of orthodontic evaluation in the management of paediatric OSA.