Cone beam computed tomography: an innovative tool for airway assessment

Improvements in airway imaging technology provide the potential for an improved understanding of airway pathology and upper airway mechanics. We present here a preliminary report on the applicability of cone beam computed tomography technology in conjunction with multidimensional digital analysis for the purposes of clinical airway management. The use of this technology for airway imaging in anesthesiology has not been reported. Traditional skeletal and soft tissue images as well as distance and volume measurements were obtained without difficulty. Three-dimensional image reconstructions as well as "virtual laryngoscopy" were achieved with resulting excellent image quality, suggesting a broad range of possibilities for upper airway examination and analysis. A modified Muller test with volumetric rendering of the airway passages under baseline and negative pressure conditions was also performed, made possible as a result of the system's short (9 s) scanning times. We believe that cone beam computed tomography technology offers an additional dimension to airway evaluation that has considerable potential.