Three-dimensional computed tomographic analysis of airway anatomy

Area of Science:

• Radiology
• Otolaryngology
• Sleep Medicine

Background:

• Obstructive sleep apnea (OSA) diagnosis and management often involve airway imaging.
• Assessing airway size and shape is crucial for understanding OSA.
• Reliability of imaging techniques for airway assessment needs validation.

Purpose of the Study:

• To evaluate the reliability of 3-dimensional computed tomography (3D-CT) for airway analysis.
• To compare 3D-CT airway measurements with lateral cephalometric measurements.
• To determine correlations between 3D-CT findings and cephalometric data in OSA patients.

Main Methods:

• 15 pairs of preoperative maxillofacial 3D-CT scans and lateral cephalograms from OSA patients were analyzed.
• 12 airway size and 4 shape measurements were derived from 3D-CT reconstructions.
• Inter- and intra-examiner reliability for both imaging modalities were assessed using intraclass correlation coefficients.
• Pearson correlation coefficients were computed to compare CT and cephalometric measurements.

Main Results:

• High intra- and inter-examiner reliability (0.86-1.0 for CT, 0.84-1.0 for cephalometry) was observed for both methods (P < .001).
• Specific 3D-CT measurements, including retroglossal anteroposterior dimension and genial tubercle-hyoid distance, positively correlated with the posterior airway space (PAS).
• The lateral/anteroposterior dimension from CT showed an inverse correlation with PAS (r = -0.68, P = .01).

Conclusions:

• Selected 3D-CT and lateral cephalometric measurements demonstrate high reliability and reproducibility for airway assessment.
• The posterior airway space (PAS) was the only cephalometric measurement showing correlation with the evaluated CT parameters.
• 3D-CT offers a reliable method for detailed airway analysis in OSA patients.