Orthodontic and Facial Characteristics of Craniofacial Syndromic Children with Obstructive Sleep Apnea

<b>Introduction:</b> Obstructive sleep apnea (OSA) is a disorder in which ventilation becomes disrupted due to a complete or partial upper airway obstruction Altered craniofacial morphology is one of the most important anatomical factors associated with obstructive sleep apnea (OSA). Stu...

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Main Authors: Suliman Alsaeed, Nelly Huynh, David Wensley, Kevin Lee, Mona M. Hamoda, Evan Ayers, Kate Sutherland, Fernanda R. Almeida
Format: Article
Language:English
Published: MDPI AG 2023-06-01
Series:Diagnostics
Subjects:
Online Access:https://www.mdpi.com/2075-4418/13/13/2213
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author Suliman Alsaeed
Nelly Huynh
David Wensley
Kevin Lee
Mona M. Hamoda
Evan Ayers
Kate Sutherland
Fernanda R. Almeida
author_facet Suliman Alsaeed
Nelly Huynh
David Wensley
Kevin Lee
Mona M. Hamoda
Evan Ayers
Kate Sutherland
Fernanda R. Almeida
author_sort Suliman Alsaeed
collection DOAJ
description <b>Introduction:</b> Obstructive sleep apnea (OSA) is a disorder in which ventilation becomes disrupted due to a complete or partial upper airway obstruction Altered craniofacial morphology is one of the most important anatomical factors associated with obstructive sleep apnea (OSA). Studies have assessed craniofacial features in the non-syndromic pediatric population. The aim of this study was to analyze the orthodontic and facial characteristic of craniofacial syndromic children referred for polysomnography (PSG) and to assess the correlation with the apnea–hypopnea index (AHI). <b>Methods:</b> In the current cross-sectional study, consecutive syndromic patients referred for PSG were invited to participate. A systematic clinical examination including extra- and intra-oral orthodontic examination was performed by calibrated orthodontists. Standardized frontal and profile photographs with reference points were taken and analyzed using ImageJ<sup>®</sup> software to study the craniofacial morphology. PSG data were analyzed for correlation with craniofacial features. STROBE guidelines were strictly adopted during the research presentation. <b>Results:</b> The sample included 52 syndromic patients (50% females, mean age 9.38 ± 3.36 years) diagnosed with 17 different syndromes, of which 24 patients had craniofacial photography analysis carried out. Most of the sample (40%) had severe OSA, while only 5.8% had no OSA. Down’s syndrome (DS) was the most common syndrome (40%) followed by Goldenhar syndrome (5%), Pierre Robin Sequence (5%), and other syndromes. The severity of AHI was significantly correlated with decreased midfacial height. increased thyromental angle and cervicomental angle, decreased mandibular angle, and decreased upper facial height. All patients with DS were diagnosed with OSA (57% severe OSA), and their ODI was significantly correlated with increased intercanthal distance. Obesity was not correlated to the severity of AHI for syndromic patients. <b>Conclusions:</b> Decreased midfacial height and obtuse thyromental angle were correlated with increased AHI for syndromic patients. Increased intercanthal distance of DS patients could be a major predictor of OSA severity. Obesity does not seem to play a major role in the severity of OSA for syndromic patients. Further studies with larger samples are necessary to confirm these findings.
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spelling doaj.art-220c2784d8704b21a3b50102976c112d2023-11-18T16:21:35ZengMDPI AGDiagnostics2075-44182023-06-011313221310.3390/diagnostics13132213Orthodontic and Facial Characteristics of Craniofacial Syndromic Children with Obstructive Sleep ApneaSuliman Alsaeed0Nelly Huynh1David Wensley2Kevin Lee3Mona M. Hamoda4Evan Ayers5Kate Sutherland6Fernanda R. Almeida7Preventive Dental Sciences Department, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh 14611, Saudi ArabiaFaculty of Dental Medicine, Université de Montréal, Montreal, QC 2001, CanadaFaculty of Medicine, University of British Columbia, Vancouver, BC 2312, CanadaFaculty of Dentistry, University of British Columbia, Vancouver, BC 2199, CanadaFaculty of Dentistry, University of British Columbia, Vancouver, BC 2199, CanadaFaculty of Dentistry, University of British Columbia, Vancouver, BC 2199, CanadaSleep Research Group, Charles Perkins Centre, Faculty of Medicine and Health, University of Sydney, Sydney, NSW 2006, AustraliaFaculty of Dentistry, University of British Columbia, Vancouver, BC 2199, Canada<b>Introduction:</b> Obstructive sleep apnea (OSA) is a disorder in which ventilation becomes disrupted due to a complete or partial upper airway obstruction Altered craniofacial morphology is one of the most important anatomical factors associated with obstructive sleep apnea (OSA). Studies have assessed craniofacial features in the non-syndromic pediatric population. The aim of this study was to analyze the orthodontic and facial characteristic of craniofacial syndromic children referred for polysomnography (PSG) and to assess the correlation with the apnea–hypopnea index (AHI). <b>Methods:</b> In the current cross-sectional study, consecutive syndromic patients referred for PSG were invited to participate. A systematic clinical examination including extra- and intra-oral orthodontic examination was performed by calibrated orthodontists. Standardized frontal and profile photographs with reference points were taken and analyzed using ImageJ<sup>®</sup> software to study the craniofacial morphology. PSG data were analyzed for correlation with craniofacial features. STROBE guidelines were strictly adopted during the research presentation. <b>Results:</b> The sample included 52 syndromic patients (50% females, mean age 9.38 ± 3.36 years) diagnosed with 17 different syndromes, of which 24 patients had craniofacial photography analysis carried out. Most of the sample (40%) had severe OSA, while only 5.8% had no OSA. Down’s syndrome (DS) was the most common syndrome (40%) followed by Goldenhar syndrome (5%), Pierre Robin Sequence (5%), and other syndromes. The severity of AHI was significantly correlated with decreased midfacial height. increased thyromental angle and cervicomental angle, decreased mandibular angle, and decreased upper facial height. All patients with DS were diagnosed with OSA (57% severe OSA), and their ODI was significantly correlated with increased intercanthal distance. Obesity was not correlated to the severity of AHI for syndromic patients. <b>Conclusions:</b> Decreased midfacial height and obtuse thyromental angle were correlated with increased AHI for syndromic patients. Increased intercanthal distance of DS patients could be a major predictor of OSA severity. Obesity does not seem to play a major role in the severity of OSA for syndromic patients. Further studies with larger samples are necessary to confirm these findings.https://www.mdpi.com/2075-4418/13/13/2213pediatricsyndromespolysomnographyapnea–hypopnea indexdiagnostic imaging
spellingShingle Suliman Alsaeed
Nelly Huynh
David Wensley
Kevin Lee
Mona M. Hamoda
Evan Ayers
Kate Sutherland
Fernanda R. Almeida
Orthodontic and Facial Characteristics of Craniofacial Syndromic Children with Obstructive Sleep Apnea
Diagnostics
pediatric
syndromes
polysomnography
apnea–hypopnea index
diagnostic imaging
title Orthodontic and Facial Characteristics of Craniofacial Syndromic Children with Obstructive Sleep Apnea
title_full Orthodontic and Facial Characteristics of Craniofacial Syndromic Children with Obstructive Sleep Apnea
title_fullStr Orthodontic and Facial Characteristics of Craniofacial Syndromic Children with Obstructive Sleep Apnea
title_full_unstemmed Orthodontic and Facial Characteristics of Craniofacial Syndromic Children with Obstructive Sleep Apnea
title_short Orthodontic and Facial Characteristics of Craniofacial Syndromic Children with Obstructive Sleep Apnea
title_sort orthodontic and facial characteristics of craniofacial syndromic children with obstructive sleep apnea
topic pediatric
syndromes
polysomnography
apnea–hypopnea index
diagnostic imaging
url https://www.mdpi.com/2075-4418/13/13/2213
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