Cranial base characteristics in adults with obstructive sleep apnea and matched controls: a retrospective CBCT study
Aida Kurbanova, Seçil Aksoy, Ulaş Öz, Finn Rasmussen, Kaan OrhanAbstract
Objectives
This study aimed to investigate cranial base and clival morphology using cone-beam CT (CBCT) in patients with obstructive sleep apnea (OSA) and matched controls, with particular emphasis on angular measurements and anatomical variations of the clivus and surrounding structures.
Methods
Cone-beam CT scans of 73 OSA patients and 73 age- and sex-matched controls were retrospectively evaluated. The skull base angle (SBA) and clivus angle (CA) were measured, and anatomical variants, including sphenoid sinus pneumatization (SSP) types, sella turcica (ST) morphology, fossa navicularis magna (FNM), canalis basilaris medianus (CBM), and craniopharyngeal canal (CPC), were assessed. Group comparisons and regression analyses were performed to identify associations between these parameters and apnea-hypopnea index (AHI).
Results
Compared with controls, patients with OSA exhibited a significantly smaller SBA and a significantly larger CA (both P < .001). The distribution of SSP patterns differed significantly between the groups (P = .018). Pre-sellar SSP was more frequent in the OSA group. Post-sellar pneumatization was the predominant pattern in both the groups and was more frequent in the controls. No significant differences were observed in ST morphology, CBM, or FNM between the groups. The CPC was not detected in any participant.
Conclusion
Cone-beam CT-based evaluation demonstrated that adults with OSA had a smaller cranial base angle, a larger CA, and more frequent SSP anterior to the ST compared with the matched controls. Although these findings should be interpreted within a multifactorial framework, their assessment may provide complementary anatomical information in the radiologic evaluation of OSA.
Advances in knowledge
This study presents a CBCT-based assessment of cranial base characteristics in adults with OSA, identifying angular features and anatomical variants that may be associated with upper airway narrowing. These findings suggest a potential role for cranial base configuration in OSA risk assessment, particularly in patients without overt maxillofacial abnormalities.