Assessment of Upper Airway Dimensions From Preadolescence to Young Adulthood in Correlation With Skeletal Maturation Stages

The purpose of this study was to investigate the upper airway (UA) dimensional growth in normal subjects from preadolescence to young adulthood in correlation with skeletal maturation stages. The samples consisted of 518 subjects (255 males, 263 females; age: 6–18 y) who underwent 3-dimensional computed tomography (3D-CT) scans of the head and neck. They were divided into 26 groups based on sex and age. After reorientation of 3D-images, cervical vertebrae maturation index (CVMI) stages were assessed using a 6-stage scoring method. The UA dimensions, including volume, cross-sectional area (CSA), and length, were measured, and statistical analyses were performed. On the basis of chronological age, females exhibited larger volume and mean CSA values during early adolescence, with earlier appearance of plateaus; whereas males showed later but greater enlargement during late adolescence, especially after age 17. According to CVMI stage, females reached plateaus around CVMI stages 4 and 5. However, males demonstrated continuous increases across CVMI stages. Combination of longer length and smaller volume in preadolescent males might be related to higher susceptibility to UA collapsibility. Despite a late onset of UA enlargement in males, steady UA development persisted into late adolescence. As age and CVMI stage were significantly correlated with UA variables (all P <0.001), CVMI stages 3 and 4 (male: 11.7–12.8 y; females: 10.1–11.3 y) may represent the period of UA dimensional growth peak. Sex-related differences in the magnitude and timing of UA dimensional growth may serve as basic reference for assessing the risk of UA obstruction from preadolescents to young adulthood.