CBCT-based Evaluation of Pharyngeal Airway Alterations in Patients with Oral Submucous Fibrosis

Background: Oral submucous fibrosis (OSMF) is a chronic, progressive, and potentially malignant condition that causes fibrosis of the oral mucosa. These fibrotic changes can affect the pharyngeal airway, leading to functional impairments in respiration, speech, and swallowing. Objective: To evaluate and compare the volumetric and dimensional changes of the pharyngeal airway space among patients with OSMF using cone beam computed tomography (CBCT) and to determine the correlation of these changes with progression of clinical stages. Methods: This cross-sectional study included 130 participants: 65 clinically diagnosed OSMF patients (stages II–IV) and 65 healthy controls. CBCT scans were evaluated using CS 3D imaging software for linear airway measurements, while ITK-SNAP software was used for airway volume segmentation. Statistical analysis was performed using independent t-tests and one-way ANOVA ( P < 0.05). Results: OSMF patients showed significantly reduced soft palate length and increased soft palatal width values compared to controls ( P < 0.05). However, no statistically significant difference was observed in total airway volume. Conclusion: OSMF can cause dimensional and volumetric changes in the pharyngeal airway, with a tendency toward greater reduction in advanced stages; however, further studies with larger sample sizes are required to establish a definitive association.