Utility of endoscopic anatomical optical coherence tomography in functional rhinoplasty

Abstract

Objective measurement of the nasal valve region is valuable for the assessment of functional rhinoplasty surgical outcomes. Anatomical optical coherence tomography (aOCT) is an imaging modality that may be used to obtain real-time, quantitative, and volumetric scans of the nasal airway. We aim to evaluate if volumetric aOCT imaging is useful for the examination of the nasal valve region before and after functional rhinoplasty procedures. aOCT scans of the nasal valves were performed on four cadaveric heads before and after spreader graft and butterfly graft procedures. The resulting aOCT images were compared against video endoscopy images, and the segmented volumes of the nasal airway obtained from aOCT scans were compared with computed tomography (CT) derived volumes acquired under the same conditions. The aOCT-derived volumes match the CT volumes closely, with a mean Dice similarity coefficient of 0.88 and a mean Hausdorff distance of 2.3 mm. Furthermore, the aOCT images were found to represent the shape of the nasal cavity accurately. Due to its ability to perform realtime, quantitative, and accurate evaluation of the nasal airway, aOCT imaging is a promising modality for the objective assessment of the nasal valves before and after functional rhinoplasty procedures.

Nasal Airflow Changes With Bioabsorbable Implant, Butterfly, and Spreader Grafts

“…Future studies will use a method for data collection that will be able to detect movement of the nasal sidewall (e.g., dynamic nasal sidewall collapse) and will allow for objective comparison of various methods for correction of NVC. One such method is anatomic optical coherence tomography 29 . A more comprehensive analysis using this imaging modality may be the key to improved comparisons between methods for correcting NVC.…”

“…One such method is anatomic optical coherence tomography. 29 A more comprehensive analysis using this imaging modality may be the key to improved comparisons between methods for correcting NVC.…”

Anatomic Optical Coherence Tomography (aOCT) for Evaluation of the Internal Nasal Valve

“…Settings for CT scanning included 0.33 mm pixels and 0.66 mm increments. aOCT scans of the INV were obtained, using a system described previously, 26 separately for each side of the airway using a 143 cm‐long fiber‐optic probe with a side‐looking beam. To protect the probe, it was passed through a fixed transparent sheath during scanning.…”

“…Placement of the probe in the nasal cavity was performed by coupling the sheath‐probe system to a 0‐degree endoscope (diameter 4 mm, length 18 cm; Karl Storz SE & Co., Germany). This endoscopic video confirmation of placement was supplemented by reviewing real‐time aOCT images 26 . Details of the experimental setup for aOCT acquisition are shown in Figure 1.…”

“…O: aOCT probe tip within protective guiding sheath; MT: middle turbinate; L: lateral nasal wall; S: septum; A: apex of INV; FO: fold‐over/aliasing artifact from nasal structures beyond the maximum imaging radius (12 mm) of aOCT. Reprinted with permission from Balakrishnan et al 26 [Color figure can be viewed in the online issue, which is available at www.laryngoscope.com. ]…”