# Three-Dimensional Airway Assessment as Diagnostic Aid in Obstructive Sleep Apnea

## TL;DR

This study explores using 3D airway imaging with CBCT as a helpful tool to diagnose obstructive sleep apnea, alongside traditional sleep tests.

## Contribution

The study introduces CBCT-based volumetric and cross-sectional airway analysis as a novel complementary diagnostic method for peripheral-type OSAS.

## Key findings

- Minimum cross-sectional area and airway volume showed significant differences between OSAS and control groups.
- CBCT analysis shows potential as a complementary diagnostic tool for peripheral-type OSAS.
- Polysomnography remains essential for diagnosing central OSAS.

## Abstract

Background: Obstructive Sleep Apnea Syndrome (OSAS) is a prevalent and underdiagnosed condition with significant systemic and quality-of-life impacts. While polysomnography remains the gold standard for diagnosis, cone-beam computed tomography (CBCT) presents a potential adjunctive imaging tool for anatomical airway evaluation. Objective: We aimed to assess the effectiveness of three-dimensional airway evaluation via CBCT as a complementary diagnostic tool for OSAS. Methods: A diagnostic test study (experimental pilot study) was conducted using CBCT scans of 30 patients, divided into two groups: 15 scans from patients with a confirmed OSAS diagnosis through polysomnography and 15 scans from healthy controls. Five tomographic variables were analyzed: anteroposterior distance, lateral distance, minimum cross-sectional area, airway volume, and airway shape. Statistical analysis was performed comparing both groups. Results: The minimum cross-sectional area and airway volume showed statistically significant differences between the OSAS and control groups (p = 0.038 and p = 0.0055, respectively). Anteroposterior and lateral distances showed trends toward significance but were not statistically significant. Conclusions: CBCT-based airway analysis, particularly focusing on volumetric and cross-sectional area parameters, demonstrates strong potential as a complementary tool in the diagnosis of peripheral-type OSAS. However, it cannot replace polysomnography, especially for central OSAS diagnosis.