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A Simple Endoscopic Technique for Measuring the Cross-Sectional Area of the Upper Airway in a Rabbit Model
Paul R Wistermayer1, Wesley R McIlwain1, Nicholas Ieronimakis1
11 Madigan Army Medical Center, Tacoma, Washington, USA.
Objective:
Validate an accurate and reproducible method of measuring the cross-sectional area (CSA) of the upper airway.
Subjects And Methods:
This is a prospective animal study done at a tertiary care medical treatment facility. Control images were obtained using endotracheal tubes of varying sizes. In vivo images were obtained from various timepoints of a concurrent study on subglottic stenosis. Using a 0° rod telescope, an instrument was placed at the level of interest, and a photo was obtained. Three independent and blinded raters then measured the CSA of the narrowest portion of the airway using open source image analysis software.
Results:
Each blinded rater measured the CSA of 79 photos. The t testing to assess for accuracy showed no difference between measured and known CSAs of the control images ( P = .86), with an average error of 1.5% (SD = 5.5%). All intraclass correlation (ICC) values for intrarater agreement showed excellent agreement (ICC > .75). Interrater reliability among all raters in control (ICC = .975; 95% CI, .817-.995) and in vivo (ICC = .846;, 95% CI, .780-.896) images showed excellent agreement.
Conclusions:
We validate a simple, accurate, and reproducible method of measuring the CSA of the airway that can be used in a clinical or research setting.
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