Effect of Head and Tongue Posture on the Pharyngeal Airway Dimensions and Morphology in Three-Dimensional Imaging: a Systematic Review.
OBJECTIVE
Natural head position is recommended to be optimal at cone-beam computed tomography acquisition. For standardization purposes in control of treatment outcome, it is clinically relevant to discuss, if a change of posture from natural head position may have an effect on the pharyngeal airway dimensions and morphology, during computed tomography, cone-beam computed tomography or magnetic resonance imaging acquisition. This was the aim of the present literature review study for purposes of valid evidence, which was hypothesized, to be present.


METHODS
This systematic literature review has been registered in PROSPERO database with following number: CRD42015024567. A systematic literature search performed in PubMed, Embase and Cochrane was carried out in order to evaluate if the effect of human head or tongue posture has an effect on upper airway dimensions and morphology in CT, CBCT or MRI. Study quality assessment was performed. Predictor variable was head and tongue posture. Endpoints were numerical values of upper airway dimensions and morphology.


RESULTS
Overall 1344 articles (Embase 1063, PubMed 269, and Cochrane 12) resulted in four included publications. Quality assessments revealed poor quality and low-level evidence by 46 - 67% of the maximum achievable score. Heterogeneous methodology made a meta-analysis impossible, consequently a narrative synthesis was performed.


CONCLUSIONS
Limited, poor quality and low evidence level literature is available on the effect of head posture on upper airway dimensions and morphology in three-dimensional imaging. Valid evidence requires a standardized method of head and tongue posture during image acquisition in future studies.
Department of Oral & Maxillofacial Surgery, Hospital of South West Denmark, Esbjerg Denmark.
Sirwan Fernandez
SF
Gurani
Section of Orthodontics, Department of Dentistry, Faculty of Health Science, Aarhus University, AarhusDenmark.; Department of Oral and Maxillofacial Science, Sapienza University of Rome, RomeItaly.
Gabriele
G
Di Carlo
Section of Orthodontics, Department of Dentistry, Faculty of Health Science, Aarhus University, Aarhus Denmark.
Paolo M
PM
Cattaneo
Department of Oral & Maxillofacial Surgery, Hospital of South West Denmark, Esbjerg Denmark.
Jens Jørgen
JJ
Thorn
Department of Oral & Maxillofacial Surgery, Hospital of South West Denmark, EsbjergDenmark.; Faculty of Health Sciences, Institute of Regional Health Services Sciences, University of Southern DenmarkDenmark.
Else Marie
EM
Pinholt
cone-beam computed tomography; magnetic resonance imaging; obstructive sleep apnea; orthognathic surgery; posture