Research Article
BibTex RIS Cite

Nasopharyngeal Morphometry in Adults with Cleft Lip/Palate and Obstructive Sleep Apnea: Analysis by Computed Tomography and Three- Dimensional Reconstruction

Year 2025, Volume: 8 Issue: 1, 12 - 18, 20.04.2025

Abstract

Objective: The aim of this article is to perform nasopharyngeal airway (NPA) morphometry of adults with cleft lip/ palate (CL/P); verify correlation with obstructive sleep apnea (OSA) severity; and compare !ndings with CL/P without OSA (N-OSA) and OSA without cleft (N-CL/P).
Methods: Patients were divided into 3 groups: (G1) CL/P OSA; (G2) CL/P N-OSA; and (G3) N-CL/P OSA. Cone beam computed tomography images were used for three-dimensional reconstruction and morphometric analysis.
Results: Volume NPA was larger in G1 than in G3. Length, width, inferior depth, areas, and inferior perimeter of NPA in G1 did not di"er from G2 or G3. The superior perimeter of G1 NPA di"ered signi!cantly from G3. Severity of OSA did not di"er between G1 and G3. Morphological variables and severity of OSA did not present a statistically signi!cant correlation.
Conclusions: Cleft lip/palate obstructive sleep apnea patients presented larger nasopharyngeal areas than N-CL/P OSA. Findings suggest that OSA physiopathology in CLP patients has di"erent pathways than in OSA patients without a cleft.

References

  • Reference 1. Gorucu-Coskuner$H, Saglam-Aydinatay$B, Aksu$M, Ozgur$FF, Taner$T. Compari- son of positive screening for obstructive sleep apnea in patients with and without cleft lip and palate. Cleft Palate Craniofac J. 2020;57(3):364-370. [CrossRef]
  • Reference 2. Eckert$DJ. Phenotypic approaches to obstructive sleep apnoea - New path- ways for targeted therapy. Sleep Med Rev. 2018;37:45-59. [CrossRef]
  • 3. Värendh$M, Andersson$M, Bjørnsdottir$E, et$al. Nocturnal nasal obstruction is frequent and reduces sleep quality in patients with obstructive sleep apnea. J Sleep Res. 2018;27(4):e12631. [CrossRef]
  • 4. Awad$MI, Kacker$A. Nasal obstruction considerations in sleep apnea. Otolar- yngol Clin North Am. 2018;51(5):1003-1009. [CrossRef]
  • 5. Rodrigues$ MM, Gabrielli$ MFR, Garcia Junior$ OA, Pereira Filho$ VA, Passeri$ LA. Nasal airway evaluation in obstructive sleep apnoea patients: volumetric tomography and endoscopic !ndings. Int J Oral Maxillofac Surg. 2017;46(10):1284-1290. [CrossRef]
  • 6. Dos Inocentes$ RJM, Marzano-Rodrigues$ MN, de Espíndola$ GG, et$ al. Adults with unilateral cleft lip and palate present reduced internal nasal volumes: !ndings of a three-dimensional morphometric assessment in cone-beam computed tomography scans. J Craniofac Surg. 2021;32(1):e15-e19. [CrossRef]
  • 7. Fukushiro$ AP, Trindade$ IEK. Nasal airway dimensions of adults with cleft lip and palate: di"erences among cleft types. Cleft Palate Craniofac J. 2005;42(4):396-402. [CrossRef]
  • 8. Trindade-Suedam$IK, Lima$TF, Campos$LD, Yaedú$RYF, Filho$HN, Trindade$IEK. Tomographic pharyngeal dimensions in individuals with unilateral cleft lip/ palate and Class III malocclusion are reduced when compared with controls. Cleft Palate Craniofac J. 2017;54(5):502-508. [CrossRef]
  • 9. Xu$Y, Zhao$S, Shi$J, et$al. 3-dimensional computed tomographic analysis of the pharynx in adult patients with unrepaired isolated cleft palate. J Oral Max- illofac Surg. 2013;71(8):1424-1434. [CrossRef]
  • 10. Cheung$T, Oberoi$S. Three dimensional assessment of the pharyngeal airway in individuals with non-syndromic cleft lip and palate. PLoS One. 2012;7(8):e43405. [CrossRef]
  • 11. Campos$ LD, Trindade$ IEK, Yatabe$ M, et$ al. Reduced pharyngeal dimensions and obstructive sleep apnea in adults with cleft lip/palate and Class III maloc- clusion. Cranio. 2021;39(6):484-490. [CrossRef]
  • 12. Loureiro$NB, Marzano-Rodrigues$MN, Trindade-Suedam$IK, D Aquino$A, Trin- dade$SHK. Assessment of internal nasal dimensions of individuals with cleft lip and palate and obstructive sleep apnea syndrome by computed tomog- raphy. Cleft Palate Craniofac J. 2024;61(4):574-583. [CrossRef]
  • 13. Harada$T, Yamanishi$T, Kurimoto$T, et$al. Long-term morphological changes of the velum and the nasopharynx in patients with cleft palate. Cleft Palate Crani- ofac J. 2022;59(10):1264-1270. [CrossRef]
  • 14. Singla$S, Utreja$A, Singh$SP, Lou$W, Suri$S. Increase in sagittal depth of the bony nasopharynx following maxillary protraction in patients with unilateral cleft lip and palate. Cleft Palate Craniofac J. 2014;51(5):585-592. [CrossRef]
  • 15. Scarfe$WC, Farman$AG. What is cone-beam CT and how does it work? Dent Clin North Am. 2008;52(4):707-v. [CrossRef]
  • 16. Kapur$VK, Auckley$DH, Chowdhuri$S, et$al. Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medi- cine clinical practice guideline. J Clin Sleep Med. 2017;13(3):479-504. [CrossRef]
  • 17. Collop$NA, Anderson$WM, Boehlecke$B, et$al. Clinical guidelines for the use of unattended portable monitors in the diagnosis of obstructive sleep apnea in adult patients. Portable Monitoring task force of the american academy of sleep medicine. J Clin Sleep Med. 2007;3(7):737-747. [CrossRef]
  • 18. Hasan$ R, Genta$ PR, Pinheiro$ GDL, et$ al. Validation of an overnight wireless high-resolution oximeter for the diagnosis of obstructive sleep apnea at home. Sci Rep. 2022;12(1):15136. [CrossRef]
  • 19. Pinheiro$GDL, Cruz$AF, Domingues$DM, et$al. Validation of an overnight wire- less high-resolution oximeter plus cloud-based algorithm for the diagnosis of obstructive sleep apnea. Clinics (Sao Paulo). 2020;75:e2414. [CrossRef]
  • 20. Yushkevich$PA, Piven$J, Hazlett$HC, et$al. User-guided 3D active contour seg- mentation of anatomical structures: signi!cantly improved e%ciency and reliability. Neuroimage. 2006;31(3):1116-1128. [CrossRef]
  • 21. Engineering simulation & 3D. Design Software. [ANSYS Internet]; 2017. https:// www.ansys.com/
  • 22. Fisher$RA. XV—the Correlation between relatives on the supposition of Men- delian inheritance. Trans R Soc Edinb. 1919;52(2):399-433. [CrossRef]
  • 23. Kruskal$WH, Wallis$WA. Use of ranks in one-criterion variance analysis. J Am Stat Assoc. 1952;47(260):583-621. [CrossRef]
  • 24. Lyons$MM, Bhatt$NY, Pack$AI, Magalang$UJ. Global burden of sleep-disordered breathing and its implications. Respirology. 2020;25(7):690-702. [CrossRef]
  • 25. Senaratna$CV, Perret$JL, Lodge$CJ, et$al. Prevalence of obstructive sleep apnea in the general population: a systematic review. Sleep Med Rev. 2017;34:70-81. [CrossRef]
  • 26. Cunningham$J, Hunter$M, Budgeon$C, et$al. The prevalence and comorbidities of obstructive sleep apnea in middle-aged men and women: the Busselton Healthy Ageing Study. J Clin Sleep Med. 2021;17(10):2029-2039. [CrossRef]
  • 27. Hnin$K, Mukherjee$S, Antic$NA, et$al. The impact of ethnicity on the prevalence and severity of obstructive sleep apnea. Sleep Med Rev. 2018;41:78-86. [CrossRef]
  • 28. Lida$S, Kogo$M, Ishii$S, Kohara$H, Matsuya$T. Changes of arterial oxygen satura- tion (SpO2) following push-back operation. Int J Oral Maxillofac Surg. 1998;27(6):425-427. [CrossRef]
  • 29. Gilbert$F, Leclerc$JE, Deschênes$M, Julien$AS, Grenier-Ouellette$I. Furlow pala- toplasty, nasopharyngeal size, and sleep oximetry. Cleft Palate Craniofac J. 2020;57(7):819-827. [CrossRef]
  • 30. Neelapu$BC, Kharbanda$OP, Sardana$HK, et$al. Craniofacial and upper airway morphology in adult obstructive sleep apnea patients: A systematic review and meta-analysis of cephalometric studies. Sleep Med Rev. 2017;31:79-90. [CrossRef]
There are 30 citations in total.

Details

Primary Language English
Subjects Allergy
Journal Section Research Article
Authors

Alessandro D Aquino This is me

Maria Noel Marzano-rodrigues This is me

Natalia Bortotti Loureiro This is me

Ivy Kiemle Trindade-suedam This is me

Sergio Henrique Kiemle Trindade This is me

Submission Date November 6, 2024
Acceptance Date November 19, 2024
Publication Date April 20, 2025
Published in Issue Year 2025 Volume: 8 Issue: 1

Cite

APA Aquino, A. D., Marzano-rodrigues, M. N., Loureiro, N. B., … Trindade-suedam, I. K. (2025). Nasopharyngeal Morphometry in Adults with Cleft Lip/Palate and Obstructive Sleep Apnea: Analysis by Computed Tomography and Three- Dimensional Reconstruction. European Journal of Rhinology and Allergy, 8(1), 12-18.
AMA Aquino AD, Marzano-rodrigues MN, Loureiro NB, Trindade-suedam IK, Trindade SHK. Nasopharyngeal Morphometry in Adults with Cleft Lip/Palate and Obstructive Sleep Apnea: Analysis by Computed Tomography and Three- Dimensional Reconstruction. Eur J Rhinol Allergy. April 2025;8(1):12-18.
Chicago Aquino, Alessandro D, Maria Noel Marzano-rodrigues, Natalia Bortotti Loureiro, Ivy Kiemle Trindade-suedam, and Sergio Henrique Kiemle Trindade. “Nasopharyngeal Morphometry in Adults With Cleft Lip Palate and Obstructive Sleep Apnea: Analysis by Computed Tomography and Three- Dimensional Reconstruction”. European Journal of Rhinology and Allergy 8, no. 1 (April 2025): 12-18.
EndNote Aquino AD, Marzano-rodrigues MN, Loureiro NB, Trindade-suedam IK, Trindade SHK (April 1, 2025) Nasopharyngeal Morphometry in Adults with Cleft Lip/Palate and Obstructive Sleep Apnea: Analysis by Computed Tomography and Three- Dimensional Reconstruction. European Journal of Rhinology and Allergy 8 1 12–18.
IEEE A. D. Aquino, M. N. Marzano-rodrigues, N. B. Loureiro, I. K. Trindade-suedam, and S. H. K. Trindade, “Nasopharyngeal Morphometry in Adults with Cleft Lip/Palate and Obstructive Sleep Apnea: Analysis by Computed Tomography and Three- Dimensional Reconstruction”, Eur J Rhinol Allergy, vol. 8, no. 1, pp. 12–18, 2025.
ISNAD Aquino, Alessandro D et al. “Nasopharyngeal Morphometry in Adults With Cleft Lip Palate and Obstructive Sleep Apnea: Analysis by Computed Tomography and Three- Dimensional Reconstruction”. European Journal of Rhinology and Allergy 8/1 (April2025), 12-18.
JAMA Aquino AD, Marzano-rodrigues MN, Loureiro NB, Trindade-suedam IK, Trindade SHK. Nasopharyngeal Morphometry in Adults with Cleft Lip/Palate and Obstructive Sleep Apnea: Analysis by Computed Tomography and Three- Dimensional Reconstruction. Eur J Rhinol Allergy. 2025;8:12–18.
MLA Aquino, Alessandro D et al. “Nasopharyngeal Morphometry in Adults With Cleft Lip Palate and Obstructive Sleep Apnea: Analysis by Computed Tomography and Three- Dimensional Reconstruction”. European Journal of Rhinology and Allergy, vol. 8, no. 1, 2025, pp. 12-18.
Vancouver Aquino AD, Marzano-rodrigues MN, Loureiro NB, Trindade-suedam IK, Trindade SHK. Nasopharyngeal Morphometry in Adults with Cleft Lip/Palate and Obstructive Sleep Apnea: Analysis by Computed Tomography and Three- Dimensional Reconstruction. Eur J Rhinol Allergy. 2025;8(1):12-8.

You can find the current version of the Instructions to Authors at: https://www.eurjrhinol.org/en/instructions-to-authors-104

Starting on 2020, all content published in the journal is licensed under the Creative Commons Attribution-NonCommercial (CC BY-NC) 4.0 International
License which allows third parties to use the content for non-commercial purposes as long as they give credit to the original work. This license
allows for the content to be shared and adapted for non-commercial purposes, promoting the dissemination and use of the research published in
the journal.
The content published before 2020 was licensed under a traditional copyright, but the archive is still available for free access.