PDF(Pubmed)
Abstract：
BACKGROUND: Craniofacial skeletal discrepancies have been associated with upper airway dimensions.
OBJECTIVE: To identify differences in upper airway volume across different sagittal and vertical skeletal patterns.
METHODS: Unrestricted literature searches in eight databases/registers for human studies until May 2023.
METHODS: Cross-sectional studies measuring upper airway volumes using three-dimensional imaging in healthy patients of different sagittal (Class I, Class II, and Class III) or vertical (normodivergent, hypodivergent, and hyperdivergent) craniofacial morphology.
METHODS: Duplicate independent study selection, data extraction, and risk of bias assessment. Random-effects frequentist network meta-analysis was performed followed by subgroup-analyses and assessment of the quality of clinical recommendations (confidence in effect estimates) with the CINeMA (Confidence in Network Meta-Analysis) approach.
RESULTS: Seventy publications pertaining to 66 unique studies were included with 56 studies (5734 patients) contributing to meta-analyses. Statistically significant differences were found for total pharyngeal airway volume, with Class II having decreased airway volume (-2256.06 mm3; 95% Confidence Interval [CI] -3201.61 to -1310.51 mm3) and Class III increased airway volume (1098.93 mm3; 95% CI 25.41 to 2172.45 mm3) compared to Class I. Significant airway volume reductions for Class II were localized mostly at the oropharynx, followed by the palatopharynx, and the glossopharynx. Significant airway volume increases for Class III were localized mostly at the oropharynx, followed by the intraoral cavity, and hypopharynx. Statistically significant differences according to vertical skeletal configuration were seen only for the oropharynx, where hyperdivergent patients had reduced volumes compared to normodivergent patients (-1716.77 mm3; 95% CI -3296.42 to -137.12 mm3). Airway differences for Class II and Class III configurations (compared to Class I) were more pronounced in adults than in children and the confidence for all estimates was very low according to CINeMA.
CONCLUSIONS: Considerable differences in upper airway volume were found between sagittal and vertical skeletal configurations. However, results should be interpreted with caution due to the high risk of bias, owing to the retrospective study design, inconsistencies in anatomic compartment boundaries used, samples of mixed children-adult patients, and incomplete reporting.
BACKGROUND: PROSPERO (CRD42022366928).
OBJECTIVE: To identify differences in upper airway volume across different sagittal and vertical skeletal patterns.
METHODS: Unrestricted literature searches in eight databases/registers for human studies until May 2023.
METHODS: Cross-sectional studies measuring upper airway volumes using three-dimensional imaging in healthy patients of different sagittal (Class I, Class II, and Class III) or vertical (normodivergent, hypodivergent, and hyperdivergent) craniofacial morphology.
METHODS: Duplicate independent study selection, data extraction, and risk of bias assessment. Random-effects frequentist network meta-analysis was performed followed by subgroup-analyses and assessment of the quality of clinical recommendations (confidence in effect estimates) with the CINeMA (Confidence in Network Meta-Analysis) approach.
RESULTS: Seventy publications pertaining to 66 unique studies were included with 56 studies (5734 patients) contributing to meta-analyses. Statistically significant differences were found for total pharyngeal airway volume, with Class II having decreased airway volume (-2256.06 mm3; 95% Confidence Interval [CI] -3201.61 to -1310.51 mm3) and Class III increased airway volume (1098.93 mm3; 95% CI 25.41 to 2172.45 mm3) compared to Class I. Significant airway volume reductions for Class II were localized mostly at the oropharynx, followed by the palatopharynx, and the glossopharynx. Significant airway volume increases for Class III were localized mostly at the oropharynx, followed by the intraoral cavity, and hypopharynx. Statistically significant differences according to vertical skeletal configuration were seen only for the oropharynx, where hyperdivergent patients had reduced volumes compared to normodivergent patients (-1716.77 mm3; 95% CI -3296.42 to -137.12 mm3). Airway differences for Class II and Class III configurations (compared to Class I) were more pronounced in adults than in children and the confidence for all estimates was very low according to CINeMA.
CONCLUSIONS: Considerable differences in upper airway volume were found between sagittal and vertical skeletal configurations. However, results should be interpreted with caution due to the high risk of bias, owing to the retrospective study design, inconsistencies in anatomic compartment boundaries used, samples of mixed children-adult patients, and incomplete reporting.
BACKGROUND: PROSPERO (CRD42022366928).
摘要：
背景：颅面骨骼差异与上气道尺寸相关。
目的：确定不同矢状和垂直骨骼模式上呼吸道容积的差异。
方法：直到2023年5月，在八个数据库/登记册中进行无限制的文献检索。
方法：在不同矢状面的健康患者中使用三维成像测量上气道容积的横断面研究（I类，二级,和III类)或垂直(normodivergent，分歧过大，和高度发散）颅面形态。
方法：重复的独立研究选择，数据提取,和偏见风险评估。进行随机效应频率网络荟萃分析，然后进行亚组分析，并使用CINeMA（网络荟萃分析信心）方法评估临床建议的质量（对效应估计的信心）。
结果：纳入了66项独特研究的70篇出版物，其中56项研究（5734例患者）有助于荟萃分析。咽气道总容积有统计学意义的差异，与I类相比，II类气道容积减少（-2256.06mm3；95％置信区间[CI]-3201.61至-1310.51mm3）和III类气道容积增加（1098.93mm3；95％CI25.41至2172.45mm3）。接着是腭咽,还有舌咽.III类的显著气道容积增加主要局限于口咽，其次是口腔，和下咽。根据垂直骨骼结构，仅在口咽观察到统计学上的显着差异，与正常发散患者相比，过度发散患者的体积减少（-1716.77mm3；95％CI-3296.42至-137.12mm3）。II类和III类配置的气道差异（与I类相比）在成人中比在儿童中更明显，并且根据CINeMA，所有估计的置信度都非常低。
结论：在矢状和垂直骨骼构型之间发现上呼吸道容积存在相当大的差异。然而,由于偏倚的高风险，结果应谨慎解释，由于回顾性研究设计，使用的解剖隔室边界不一致，混合儿童-成人患者的样本，和不完整的报告。
背景：PROSPERO（CRD42022366928）。
目的：确定不同矢状和垂直骨骼模式上呼吸道容积的差异。
方法：直到2023年5月，在八个数据库/登记册中进行无限制的文献检索。
方法：在不同矢状面的健康患者中使用三维成像测量上气道容积的横断面研究（I类，二级,和III类)或垂直(normodivergent，分歧过大，和高度发散）颅面形态。
方法：重复的独立研究选择，数据提取,和偏见风险评估。进行随机效应频率网络荟萃分析，然后进行亚组分析，并使用CINeMA（网络荟萃分析信心）方法评估临床建议的质量（对效应估计的信心）。
结果：纳入了66项独特研究的70篇出版物，其中56项研究（5734例患者）有助于荟萃分析。咽气道总容积有统计学意义的差异，与I类相比，II类气道容积减少（-2256.06mm3；95％置信区间[CI]-3201.61至-1310.51mm3）和III类气道容积增加（1098.93mm3；95％CI25.41至2172.45mm3）。接着是腭咽,还有舌咽.III类的显著气道容积增加主要局限于口咽，其次是口腔，和下咽。根据垂直骨骼结构，仅在口咽观察到统计学上的显着差异，与正常发散患者相比，过度发散患者的体积减少（-1716.77mm3；95％CI-3296.42至-137.12mm3）。II类和III类配置的气道差异（与I类相比）在成人中比在儿童中更明显，并且根据CINeMA，所有估计的置信度都非常低。
结论：在矢状和垂直骨骼构型之间发现上呼吸道容积存在相当大的差异。然而,由于偏倚的高风险，结果应谨慎解释，由于回顾性研究设计，使用的解剖隔室边界不一致，混合儿童-成人患者的样本，和不完整的报告。
背景：PROSPERO（CRD42022366928）。
