Investigating anatomical determinants of OSA in children with UCLP: insights into tongue, airway, and hyoid bone.

PURPOSE: This study investigated anatomical factors associated with obstructive sleep apnea (OSA) in children with unilateral cleft lip and palate (UCLP), focusing on tongue, airway, and hyoid height, using cone-beam computed tomography (CBCT) and polysomnographic data. METHODS: CBCT data from 40 UCLP children (27 males, 13 females; mean age 9.08 ± 1.87 years) were analyzed and categorized into OSA (n = 20) and non-OSA (n = 20) groups. Measurements included oropharyngeal and hypopharyngeal airway volumes, minimum cross-sectional airway area (MCA), hyoid height, absolute tongue volume (TV), mandible volume (MV), intra-mandibular area (IMA), and relative tongue volumes (TV/MV and TV/IMA). Group differences were assessed using independent samples t-tests, and correlations among parameters were analyzed using Pearson’s correlation coefficient. RESULTS: The OSA group had significantly higher TV, TV/MV, IMA, and TV/IMA (p < 0.05). A significant positive correlation was found between body mass index (BMI) and TV (p < 0.05), as well as between hyoid height and TV, TV/MV, and TV/IMA (p < 0.001). Apnea-hypopnea index (AHI) negatively correlated with minimum oxygen saturation (p < 0.05) but demonstrated no significant association with anatomical variables. Minimum oxygen saturation correlated positively with oropharyngeal airway volume (p < 0.05) but showed no significant association with other variables. CONCLUSION: Relative tongue volume may serve as a screening parameter for OSA in UCLP children. Although hyoid height correlates with tongue volume, non-significant group differences limit its use as a clinical substitute. Oropharyngeal airway volume correlated with minimum oxygen saturation, while no anatomical variables correlated with AHI.