title: Three-dimensional imaging of the upper airway anatomy in obstructive sleep apnea: a systematic review.
abstract: The pathogenesis of upper airway collapse in people with obstructive sleep apnea (OSA) is not fully understood. The aim of this study was to systematically review the literature in order to assess the most relevant anatomical characteristics of the upper airway related to the pathogenesis of OSA by analyzing the three-dimensional upper airway anatomy.
  
  
  
  A PICO (population/patient, intervention, comparison, outcome) search strategy, focusing on the upper airway anatomy of people with OSA, was conducted using the following databases: MEDLINE (PubMed), Excerpta Medica database (EMBASE), Web of Science, and Cochrane Library. The studies in which three-dimensional images were made from the participants who were awake and in the supine position during quiet breathing were selected in this systematic review.
  
  
  
  Of the 758 unique retrieved studies, eight fulfilled the criteria for this systematic review. The minimum cross-sectional area of the upper airways of people with OSA, which is influenced by many factors such as hard and soft tissues surrounding the upper airway, was significantly smaller than that of those without OSA.
  
  
  
  Within the limitation of the selected studies, this systematic review suggested that a small minimum cross-sectional area is the most relevant anatomical characteristic of the upper airway related to the pathogenesis of OSA.
authors.affiliation: Department of Oral and Maxillofacial Radiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, The Netherlands. Electronic address: h2.chen@acta.nl.
authors.forename: Hui
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands.
authors.forename: Ghizlane
authors.initials: G
authors.lastname: Aarab
authors.affiliation: Department of Oral and Maxillofacial Surgery, Academic Medical Centre (AMC), University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Maurits H T
authors.initials: MH
authors.lastname: de Ruiter
authors.affiliation: Department of Oral and Maxillofacial Surgery, Academic Medical Centre (AMC), University of Amsterdam, Amsterdam, The Netherlands.
authors.forename: Jan
authors.initials: J
authors.lastname: de Lange
authors.affiliation: Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, MOVE Research Institute Amsterdam, Amsterdam, The Netherlands.
authors.forename: Frank
authors.initials: F
authors.lastname: Lobbezoo
authors.affiliation: Department of Oral and Maxillofacial Radiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and VU University Amsterdam, The Netherlands.
authors.forename: Paul F
authors.initials: PF
authors.lastname: van der Stelt
mesh_terms: D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D010614:Pharynx / Q000033:anatomy & histology / Q000503:physiopathology; D020181:Sleep Apnea, Obstructive / Q000000981:diagnostic imaging* / Q000503:physiopathology*
keywords: Computed tomography; Cone beam computed tomography; Magnetic resonance imaging; Obstructive sleep apnea; Systematic review; Upper airway