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

<b>Background</b>: 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. <b>Objective</b>: We aimed to assess the effectiveness of three-dimensional airway evaluation via CBCT as a complementary diagnostic tool for OSAS. <b>Methods</b>: 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. <b>Results</b>: The minimum cross-sectional area and airway volume showed statistically significant differences between the OSAS and control groups (<i>p</i> = 0.038 and <i>p</i> = 0.0055, respectively). Anteroposterior and lateral distances showed trends toward significance but were not statistically significant. <b>Conclusions</b>: 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.