Reliability of lateral cephalometric radiographs in the assessment of the upper airway: a systematic review

Relevance. The problem of respiratory diseases has been studied for a long time by many specialists and remains relevant to this day. This problem has been of interest to researchers for many years due to several factors. In many studies, it was demonstrated, that a signifcant relationship exist between the upper airway condition and jaw growth, craniofacial skeleton and TMJ dysfunction. Lateral cephalometric radiographs (LCRs) have been used to assess skull parameters, jaw bones and teeth, the morphology of the upper airway, the severity of airways obstruction and adenoid size. The present study aimed to determine the reliability of LCRs compared to CBCT in the assessment of the upper respiratory tract in order to determine which variables are reliable for potential use in clinical diagnosis.

Aim. To analyze the literature on the effectiveness of the using Lateral Cephalogram in the assessment of the upper airway.

Materials and methods. Electronic search of articles was carried out using search engines and databases: Cyberleninka, eLIBRARY, Google Scholar, Pub Med, SCOPUS. The publication date criterion was selected from January 2010 to January 2021. The electronic search was conducted using the following keywords: lateral cephalogram, upper airway, cone-beam computed tomography. A total of 10 studies from the literature met the selection criteria.

Results. CBCT provides a good estimate of the transverse dimensions and volumetric measurement of the airway space. Linear measurements of CBCT and LCRs were quite reliable and reproducible. The most diffcult to study and differentiate area is the oropharynx, the variability of the pharyngeal segment cannot be predicted by LCs. LCRs method is advisable for adenoid pathology diagnosis due to its fnancial acceptability and availability. The cephalometric headflm provides a good general overall indicator for nasopharyngeal airway patency, adenoidal hypertrophy.

Conclusions. The traditional lateral cephalogram remains not only a standard, reproducible and cost-effective diagnostic method in orthodontics, but also a reliable initial tool for screening upper airway obstruction, studying the nasopharyngeal morphology and assessment of adenoid size. Based on our results, the measurement of the nasopharyngeal space on lateral cephalograms can be used as an initial screening method to estimate the nasopharynx volumes. The results demonstrate that a lateral cephalogram can provide valuable information about the severe limitations and nasopharyngeal morphology

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