Cephalometric Analysis

The lateral cephalogram is the most cost-effective radiographic study of the bony facial skeleton and soft tissues of the upper airway. Using these landmarks, Riley et al. (31) were first to describe anthropomorphic measurements, which can be performed to ascertain skeletal facial abnormalities. Magnetic resonance imaging (MRI) and computed tomography (CT) scanning have proven to be effective in radiographic studies; however, these tools are often reserved for investigational studies due to expense and time (32-34). Although not as detailed as CT scan or MRI, the cephalogram allows measurement of the length of the soft palate, skeletal proportions, posterior airway space, and hyoid position. Studies have shown the cephalogram to be valid in assessing obstruction, and in fact, it compares favorably to three-dimensional volumetric computed tomographic scans of the upper airway (35). As with other tests, this modality may underestimate the degree of obstruction, due to the fact that the study is not performed while the patient is sleeping.

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