Are three-dimensional airway evaluations obtained through computed and cone-beam computed tomography scans predictable from lateral cephalograms? A systematic review of evidence.
OBJECTIVE
To systematically review the literature correlating upper airway parameters between lateral cephalograms (LC) and cone-beam computed tomography (CBCT) or computed tomography (CT) scans to determine the utility of using LC to predict three-dimensional airway parameters.


MATERIALS AND METHODS
Both electronic and manual searches of the included studies were performed by two reviewers, and the quality of the studies that met selection criteria were assessed.


RESULTS
A total of 11 studies from the literature met the selection criteria. Assessed outcome variables showed correlation r < .7 between the LC and CT scans. The correlation between the LC and CBCT ranged from weak to strong with -.78 ≤ r and r ≤ .93 reported in the nasopharyngeal segment. In the oropharyngeal segment, a weak to strong correlation was reported with a range of -37 ≤ r and r ≤ .83 between the CBCT and LC. All associations in the hypopharyngeal segment showed a weak correlation. Four of studies were of weak quality, five were of moderate quality, and two were rated to be of strong quality.


CONCLUSION
No strong correlations were reported between the LC and CT scans. However, the LC-derived adenoid-nasopharyngeal ratio and the linear measurement (posterior nasal spine, PNS, to posterior pharyngeal wall) had a strong correlation with upright nasopharyngeal area and volume in the CBCTs. The area measurement in conventional LC can be also used as an initial screening tool to predict the upright three-dimensional oropharyngeal volumetric data. The variability of the hypopharyngeal segment cannot be predicted by LCs. However, more well-designed studies are needed to determine the clinical utility of using LC to predict airway size.
['Eslami|Ehsan|E|', 'Katz|Eliot S|ES|', 'Baghdady|Mariam|M|', 'Abramovitch|Kenneth|K|', 'Masoud|Mohamed I|MI|']
D000234:Adenoids D002508:Cephalometry D054893:Cone-Beam Computed Tomography D006801:Humans D007013:Hypopharynx D007091:Image Processing, Computer-Assisted D021621:Imaging, Three-Dimensional D009305:Nasopharynx D009960:Oropharynx D010614:Pharynx D011859:Radiography
Lateral cephalograms Systematic review Upper airway Cone beam computed tomography