Measurements of craniofacial morphology using photogrammetry in children with sleep-disordered breathing

Objective: To assess the craniofacial morphology in children with sleep-disordered breathing (SDB) using non -radiation and readily accessible photogrammetry technique. Methods: Included children aged 3-18 years with SDB-related symptoms from April 2019 to February 2020 in a tertiary center. All participants underwent craniofacial photogrammetry and overnight polysomnography (PSG). Participants were stratified into 2 groups (obstructive sleep apnea [OSA] group: apnea-hypopnea index [AHI] >= 1 and non-OSA group: AHI < 1). Craniofacial photogrammetry was performed to derive variables of craniofacial features in standardized frontal and profile views. The 2 groups were propensity score matched based on age, sex, and body mass index (BMI) percentiles. Associations between craniofacial feature variables and OSA (AHI >= 1) likelihood were examined using logistic regression test. intraclass correlation coefficient (ICC) was used to evaluate the intrarater and interrater reliability. Results: In total, 58 children were enrolled for the analysis after matching. All 3 variables representing the mandibular plane angle in the profile view were increased in the OSA group (mego-tn: 34.85 +/- 5.99 vs 31.65 +/- 5.96?, odds ratio [OR]: 1.10, 95% CI:1.02 to 1.18, P = .01; tn-gogn: 28.65 +/- 6.38 vs 25.91 +/- 5.38?, OR: 1.08, 95% CI:1.02 to 1.15, P = .012; and gome-tsup: 26.71 +/- 6.13 vs 22.20 +/- 5.89?, OR: 1.13, 95% CI:1.04 to 1.23, P = .003). Conclusions: Craniofacial photogrammetry revealed increased mandibular inclination in children with OSA. A steep mandibular plane with craniofacial photogrammetry is considered a potential predictor of pediatric OSA. Further investigation with a large sample size is required to clarify the validity of photogrammetry in evaluating pediatric OSA.