Hyoid Bone Position and Upper Airway Morphology of Children With Obstructive Sleep Apnea: A Systematic Review and Meta‐analysis
Bibliographic record
Abstract
ABSTRACT The objective of this systematic review was to summarise the existing evidence regarding hyoid bone position and upper airway morphology of children with obstructive sleep apnea (OSA). Electronic searches were carried out in PubMed, Embase, Web of Science, CINAHL and WorldCat databases without any restrictions on language from inception to March 2024. The studies which compared the hyoid bone position and upper airway morphology using lateral cephalograms between children with and without OSA will be included. The methodological quality of the included studies was assessed using Newcastle‐Ottawa Scale, and the meta‐analysis was conducted utilising random‐effects model. Twelve cross‐sectional studies and one case–control study were included. One study was rated as low quality, three as medium quality, five as high quality, and four as very high quality. Meta‐analysis showed that compared to healthy children, children with OSA tended to have increased distance between hyoid bone and mandibular plane (Hy‐MP, MD: 3.33, 95% CI: 1.90 to 4.77, p < 0.00001, I 2 = 72%), increased distance between hyoid bone and cervical vertebra (Hy‐C3, MD: 1.54, 95% CI: 0.62 to 2.46, p = 0.001, I 2 = 68%), and a smaller airway space behind the soft palate (U‐MPW, MD: −3.07, 95% CI: −4.76 to −1.38, p = 0.0004, I 2 = 68%). Whereas there was no significant difference in inferior posterior airway space between children with OSA and healthy controls (IPAS, MD: −1.51, 95% CI: −3.37 to 0.35, p = 0.11, I 2 = 71%). In children with OSA, the hyoid bone may exhibit a more anterior and inferior position and the airway posterior to the soft palate demonstrated a narrower dimension. Registration: PROSPERO (CRD42024528171)
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.008 | 0.001 |
| Bibliometrics | 0.002 | 0.002 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.002 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".