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<p>Oropharyngeal airway constriction influences craniofacial development and is associated with significant clinical morbidity. Cone-beam computed tomography (CBCT) positions itself as a three-dimensional imaging modality capable of quantifying airway morphology in clinical settings. However, substantial heterogeneity in imaging protocols, segmentation techniques, and measurement approaches limits cross-study comparability. This systematic review aimed to synthesize evidence on CBCT-based methodologies, airway measurements, and clinical associations pertaining to oropharyngeal airway narrowing assessment. A systematic search of PubMed, Embase, Scopus, and Web of Science was conducted through February 2026. Study selection, data extraction, and risk of bias assessment were performed by two independent reviewers in accordance with PRISMA 2020 guidelines. The ROBINS-I tool was employed for assessing the risk of bias. Sixteen studies met the eligibility criteria. Marked heterogeneity was identified across imaging protocols, anatomic boundary definitions, segmentation methods, and reported airway parameters. Reliability was generally excellent (intraclass correlation coefficient &gt; 0.90). Volumetric measurements were the most frequently reported outcome, with minimum cross-sectional area (MCA) identified as the most clinically relevant parameter. CBCT demonstrated clinically meaningful associations across adenoid hypertrophy, obstructive sleep apnoea (OSA), orthognathic surgery, and cleft lip and palate populations. CBCT is a reliable and valid tool for three-dimensional oropharyngeal airway assessment. Standardization of imaging protocols, anatomic definitions, and segmentation methodology is essential for clinical and research translation. A structured CBCT-based grading system serves as a consistent framework to facilitate multidisciplinary airway evaluation. PROSPERO Registration: CRD420251245736.</p>

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Cone-Beam Computed Tomography-Based Oropharyngeal Airway Narrowing Assessment: A Systematic Review of Methodologies, Measurements, and Clinical Associations

  • 期刊论文

  • 发表日期：

    2026年6月25日

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  • Sunanda Bhatnagar,
  • Ajay G. Nayak

摘要

Oropharyngeal airway constriction influences craniofacial development and is associated with significant clinical morbidity. Cone-beam computed tomography (CBCT) positions itself as a three-dimensional imaging modality capable of quantifying airway morphology in clinical settings. However, substantial heterogeneity in imaging protocols, segmentation techniques, and measurement approaches limits cross-study comparability. This systematic review aimed to synthesize evidence on CBCT-based methodologies, airway measurements, and clinical associations pertaining to oropharyngeal airway narrowing assessment. A systematic search of PubMed, Embase, Scopus, and Web of Science was conducted through February 2026. Study selection, data extraction, and risk of bias assessment were performed by two independent reviewers in accordance with PRISMA 2020 guidelines. The ROBINS-I tool was employed for assessing the risk of bias. Sixteen studies met the eligibility criteria. Marked heterogeneity was identified across imaging protocols, anatomic boundary definitions, segmentation methods, and reported airway parameters. Reliability was generally excellent (intraclass correlation coefficient > 0.90). Volumetric measurements were the most frequently reported outcome, with minimum cross-sectional area (MCA) identified as the most clinically relevant parameter. CBCT demonstrated clinically meaningful associations across adenoid hypertrophy, obstructive sleep apnoea (OSA), orthognathic surgery, and cleft lip and palate populations. CBCT is a reliable and valid tool for three-dimensional oropharyngeal airway assessment. Standardization of imaging protocols, anatomic definitions, and segmentation methodology is essential for clinical and research translation. A structured CBCT-based grading system serves as a consistent framework to facilitate multidisciplinary airway evaluation. PROSPERO Registration: CRD420251245736.