Craniofacial Development Characteristics in Children with Obstructive Sleep Apnea for Establishment and External Validation of the Prediction Model

Purpose

Aimed to analyze the developmental characteristics of craniofacial structures and soft tissues in children with obstructive sleep apnea (OSA) and to establish and evaluate prediction model.

Methods

It's a retrospective study comprising 747 children aged 2-12 years (337 patients and 410 controls) visited the Department of Otolaryngology-Head and Neck Surgery, the Second Affiliated Hospital of Xi'an Jiaotong University (July 2017 to March 2024). Lateral head radiographs were obtained to compare the cephalometric measurements. The clinical prediction model was constructed using LASSO regression analysis. We analyzed 300 children from the Xi'an Children's Hospital for external validation.

Results

Children with OSA had a higher body mass, a higher tonsil grade, larger AN ratio (ratio of the adenoids to the skeletal upper airway width), larger radius of the tonsils, a smaller angle between the skull base and maxilla (SNA) and smaller angle between the skull base and mandible (SNB), a larger distance from the hyoid to the mandibular plane (H-MP) and smaller distance between the third cervical vertebra and hyoid (H-C), a larger thickness of the soft palate (SPT) and smaller inclination angle of the soft palate than those of the controls (all p < 0.05). A prediction model was constructed for 2-12 years group (AUC of 0.812 [95% CI: 0.781-0.842]). Age-specific prediction models were developed for preschool children (AUC of 0.769 [95% CI: 0.725-0.814]), for school-aged children (AUC of 0.854 [95% CI: 0.812-0.895]).

Conclusion

Our study findings support the important role of craniofacial structures such as the hyoid, maxilla, mandible, and soft palate in pediatric OSA. Age-stratified predictive models for pediatric OSA indicated varying parameters across different age groups which underscore the necessity for stratifying by age in future research. The prediction model designed will greatly assist health care practitioners with rapidly identifying.

Genetic Insights into Skeletal Malocclusion: The Role of the FBN3 rs7351083 SNP in the Romanian Population

Background and Objectives: irregularities in the growth and development of the jawbones can lead to misalignments of maxillary and mandibular structures, a complex condition known as skeletal malocclusion, one of the most common oral health problems. Skeletal malocclusions, particularly Class II and Class III, can significantly affect facial appearance, chewing efficiency, speech, and overall oral health, often requiring orthodontic treatment or surgery to correct. These dentofacial anomalies are influenced by genetic and environmental factors and exhibit diverse phenotypic expressions. Materials and Methods: in this study, we investigated the correlation between the rs7351083 SNP of the FBN3 gene that encodes a member of the fibrillin protein family and malocclusion risk in a group of 57 patients from Romania. Results: the results shed light on the relationship between the selected genetic marker and the investigated dentofacial disorder, revealing a positive association between the reference allele (A) and Class II and that the alternate allele (G) is associated with Class III. Conclusions: cephalometric analysis revealed no significant differences among genotypes, suggesting that while genetic factors are implicated in malocclusion, they may not directly affect cephalometric parameters or that the sample size was too small to detect these differences. The discovery of an A > T transversion in one individual with a Class II deformity underscores the genetic diversity within the population and the necessity of comprehensive genotyping to uncover rare genetic variants that might influence craniofacial development and the risk of malocclusion. This study highlights the need for larger studies to confirm these preliminary associations.