Cranial base length in pediatric populations with sleep disordered breathing: A systematic review

The aim of this study was to review the existing literature on the association between cranial base length (CBL) and sleep disordered breathing (SDB) in children. Searches were carried out using Ovid MEDLINE, EMBASE, and Science Citation Index. Modified NIH (National Institute of Health) quality assessment tool was used to assess risk of bias. Grading of recommendations, assessment, development and evaluation (GRADE) was used to summarize the quality of evidence. Six articles met the inclusion criteria. Two studies (n = 57) showed shorter CBL in children with obstructive sleep apnea (OSA). One study (n = 29) showed shorter CBL in children that were habitual snorers. Another study (n = 15) looking at OSA-affected vs. healthy children and one (n = 56) looking at correlation of CBL with OSA severity in children, did not report a significant association/correlation. One study (n = 7) showed a longer CBL in OSA affected boys. All studies had high risks of bias and ranged from low to very low in quality. Although studies with slightly lower risks of bias may indicate shorter CBL in children with SDB, neither an association nor a lack thereof between CBL and pediatric SDB can be supported or refuted due to the low to very low quality of included studies.