Two-dimensional upper airway normative values in children aged 7 to 17 years

Objective: To develop two-dimensional (2D) upper airway normative values in pediatric patients and correlate upper airway measurements with age. Methods: Cone beam computed tomography scans of 3738 patients were examined, and a sample of 61 patients, divided into two age groups (7–11 and 12–17 years), was used to reconstruct lateral cephalograms. Results: The mean adenoid–nasopharynx (A/N) ratio was 0.45 and 0.44 for age groups 1 and 2, respectively. The mean PNS-ad1 and PNS-ad2 were 24 and 18.7 mm, respectively, for age group 1, and 26.7 and 21.2 mm, respectively, for age group 2. Additional normative values for the hyoid bone, airway space, uvula, and tongue are presented. The highest correlation with age was the upper airway length (r = 0.557, p < 0.001). Conclusion: Although cephalometric radiographs remain 2D reconstructions of three-dimensional structures, they have significant value and can aid clinicians in the screening process for pediatric sleep apnea.