Neonatal micrognathia is associated with small upper airways on radiographic measurement

In order to determine if infants with clinical micrognathia identified in t he newborn period have smaller upper airways than do normal infants, and if their airway size is related to risk of later apnoea, respiration-timed up per airway radiographic measurements were performed in 21 asymptomatic neon ates with clinical micrognathia. Their radiographic measurements were compa red with those of a previously reported cohort of 35 normal infants. The mi crognathic infants and a control group of 27 infants referred for parental anxiety were followed for 6 mo on home apnoea monitors. Sleep apnoea at hom e requiring stimulation by the parents occurred in 6 of 7 infants with micr ognathia associated with craniofacial anomalies, 9 of 14 (64%) infants with isolated micrognathia, but only 1 of the 27 control infants (p < 0.001). U pper airway measurements at term of the infants with isolated micrognathia who later experienced apnoea were significantly smaller than either those o f normal infants (p < 0.01) or of micrognathic infants who did not have apn oea requiring stimulation (p < 0.05). In conclusion, upper airway measureme nts on timed lateral radiographs in asymptomatic micrognathic infants at te rm (corrected age) revealed them to be smaller than those of normal infants . Narrower upper airways were associated with increased risk of subsequent apnoea requiring stimulation.