Cephalometric Evaluation of Craniofacial Morphology in Pediatric Patients With Fully Diagnosed OSA With Distinct Sagittal Skeletal Malocclusions

Study Objectives: To establish whether craniofacial and nasopharyngeal morphology, assessed through lateral cephalometry, in children properly diagnosed with obstructive sleep apnea (OSA) differed from that of non-likely OSA control children stratified based on sagittal malocclusion and to evaluate if there is any association with apneahypopnea index (AHI) severity. Materials and Methods: Various cephalometric measurements were compared between 22 children (mean age 8.8) with nocturnal polysomnography (nPSG) diagnosed OSA that had already adeno-tonsillectomy and a control group of 20 nonlikely OSA children (mean age 9.2) based on a negative pediatric sleep questionnaire (PSQ) results matched for age, sex and sagittal malocclusion. Results: Statistically significant increases in Go-Me and Ba^SN dimensions were observed among OSA children when higher AHI values (4.5 and 4 mm), whereas ANSPNS dimension was significantly increased in the Class II sample according to OSA severity (3.5 mm). No significant differences were identified for any variables among Class III based on OSA severity. In comparison to controls, in Class II both the angle between palatal plane and anterior cranial base and the angle of the flexure of cranial base were significantly reduced in OSA children (0.36 and 2.3 mm). In addition, an increased thickness of the upper adenoid profile and a reduced dimension of upper pharynx were observed (3.2 and 2.1 mm). In Class III a shorter bony nasopharynx was statistically significant (3.2 mm). Conclusions: The OSA sample showed some distinct craniofacial features compared to a non-likely OSA group. These differences were not consistently located when sagittal malocclusion was considered.