# A Pilot Study on the Relationship between Obstructive Sleep Apnoea–Hypopnea Syndrome, Neurodevelopment, and Ricketts’ Cephalometry

## TL;DR

This study explores how facial features and sleep apnea in children with neurodevelopmental issues can be linked using cephalometric analysis to aid early diagnosis and prevent complications.

## Contribution

The study introduces a method using mandibular plane angle and facial depth measurements for early differential diagnosis of OSAHS in children with neurodevelopmental deficits.

## Key findings

- The mandibular plane angle was higher in patients with OSAHS compared to controls.
- Facial depth and mandibular plane indices showed significant variation between OSAHS patients and the control group.
- The VERT index alone is insufficient for diagnosing OSAHS in children with neurodevelopmental deficits.

## Abstract

Background: The aim of this research is to achieve the early detection of facial characteristics in patients diagnosed with neurodevelopmental deficits and obstructive sleep apnoea–hypopnea syndrome (OSAHS) through the analysis of the VERT index and Ricketts’ cephalometry to minimise the neurocognitive morbidity associated with these disorders. Methods: This clinical study was conducted on 44 patients aged 4 to 15 years. Participants completed an initial questionnaire about sleep disturbances, followed by a polysomnography, a radiographic study, and an oral examination. Results: The maximum variability in the data was obtained in the mandibular plane angle, where we observed that the measurement was higher in patients diagnosed with OSAHS. The relative and normalised indices of facial depth and the mandibular plane showed variations between patients with a clinical picture compatible with OSAHS and the control group without pathology. Conclusions: Our findings indicate that Ricketts’ VERT index by itself is unable to provide evidence of a diagnosis compatible with OSAHS in patients with early neurodevelopmental deficits, but, after analysing the results obtained, we observed that for the cephalometric measurements of the mandibular plane angle and facial depth relative to the patient’s age, there are sufficiently strong variations for creating a solid method of differential diagnosis, thus preventing complications at the neurocognitive level.