Novel three-dimensional methods to analyze the morphology of the nasal cavity and pharyngeal airway

Abstract

Objectives To assess the intraexaminer and interexaminer reliabilities of novel semiautomatic methods to segment the nasal cavity (NC) and pharyngeal airway (PA) and to determine the minimal cross-sectional area (CS) and hydraulic diameter (HD) of the PA. Materials and Methods To test reproducibility, two examiners analyzed the NC and PA independently in 10 retrospectively selected cone beam computed tomography (CBCT) images using semiautomatic segmentation. The PA centerline was determined to assess the minimal CS and HD. The intraclass correlation coefficient (ICC) was used to calculate intraexaminer and interexaminer reliabilities. Measurement errors were assessed by Dahlberg's formula and paired t-tests. The level of agreement was assessed using the Bland-Altman method. Results Intraexaminer and interexaminer reliabilities were excellent (minimal ICC, 0.960). The error of the method was good except for interexaminer values for the oropharynx (P = .016). The minimal CS and HD measurements were reliable (minimal ICC, 0.993; narrow limits of agreement). Conclusions The novel methods for analysis of the NC and PA are reliable. The minimal CS and HD demonstrated excellent reliabilities, which are critical to detect the most constricted part of the PA. Separation of the oropharynx from the voids close to the retroglossal area is not trivial and should be considered with caution.

Does rapid maxillary expansion enlarge the nasal cavity and pharyngeal airway? A three‐dimensional assessment based on validated analyses

“…The main purpose of this study was to precisely evaluate changes in NC and PA morphology following RME treatment at long-term follow-up using an innovative and validated evaluation method. 21 Many studies have reported that RME seems to enlarge the nasal airway, including the NC and nasopharynx. 18,23,24 However, a recent systematic review and meta-analysis showed that long-term stable results could not be demonstrated.…”

Restricted upper airway dimensions in patients with dentofacial deformity from juvenile idiopathic arthritis

“…To further elucidate the airway dynamics and the risk of upper airway resistance and risk of obstruction/collapse, we used two additional upper airway outcome variables: 8) The minimal cross-sectional area of the upper airway (CS) and 9) the minimal hydraulic diameter (D H ) [ 36 ]. Both CS and D H and are indicators of the upper airway intra-luminal space.…”

“…The shape of the upper airways is mostly irregular and not round. This change in shape greatly influences the CS, whereas the D H may, to a greater extent, take into account the change in shape throughout the upper airways, which is an argument for including both measures [ 36 ]. Importantly, the positions of the minimal D H and the minimal CS do not necessarily coincide in the same upper airway positions.…”

“…The CS and D H were assessed using the method described by Niu et al [ 36 ] where an upper airway centerline is defined and consecutive “slices” are established perpendicular to the centerline to assess the CS and D H at continuous positions (slice levels) along the upper airways. The CS and D H were assessed on 50 consecutive slice levels from the top of the nasopharynx (slice 1) to the bottom of the oropharynx (slice 50).…”

Association between Rapid Maxillary Expansion and Nocturnal Enuresis in Children: A Pilot Study for a Randomized Controlled Clinical Trial

“…The segmentation was performed following the same method as described elsewhere [25]. Landmark definitions for the dental, skeletal, and airway parameters, as well as plane definitions, are presented in Table 1.…”