Multi-Detector Computed Tomography Cephalometry of the Upper Airway in Snorers and Non-snorers: An Analysis of Anatomical Risk Factors in a North-East Indian Population

Snoring is an upper airway (UA) dysfunction, and it is considered to be a precursor of obstructive sleep apnea. This study uses multidetector computed tomography (MDCT) cephalometry to identify specific skeletal and soft tissue risk factors with an aim to characterize the UA morphology in habitual snorers compared to non-snorers in a North-East Indian population. It identifies anatomical predisposing factors that are present during wakefulness. This hospital-based observational case–control study included 72 subjects (36 snorers and 36 non-snorers) matched for age, sex, and body mass index. Subjects were patients from a tertiary care center in North-East India undergoing medically indicated computed tomography scans for other pathologies and were opportunistically screened using the Berlin Questionnaire. MDCT cephalometry measured neck circumference (NC), mandibular plane–hyoid distance (MP-H), anterior–posterior nasal spine length, retroglossal width, retropalatal width, UA length (UAL), soft palate thickness, and soft palate length (PNS-U). Snorers demonstrated significantly higher mean values for NC (375.23 ± 22.99 vs. 339.80 ± 24.35 mm; p < 0.001), MP-H (15.85 ± 3.33 vs.11.22 ± 3.83 mm; p < 0.001), UAL (56.39 ± 4.75 vs. 51.27 ± 6.17 mm; p = 0.0002), and PNS-U (32.93 ± 4.20 vs. 29.56 ± 3.52 mm; p = 0.0004). Airway widths were significantly narrower in snorers at the retroglossal (14.57 ± 2.73 vs. 15.99 ± 2.28 mm; p = 0.0187) and retropalatal levels (8.08 ± 2.58 vs. 9.63 ± 1.56 mm; p = 0.0029). Even in the awake state, MDCT effectively identifies significant anatomical deviations in snorers, specifically narrowed retropalatal and retroglossal airways, elongated soft palates, inferiorly positioned hyoid bones, and increased NC.