CT digital radiography: alternative technique for airway evaluation in physically disabled patients

Area of Science:

• Radiology
• Pulmonology
• Neurosurgery

Background:

• Tracheostomy removal requires airway evaluation for granulation tissue to prevent obstruction.
• Assessing the airway in brain/spinal cord injured patients is challenging due to limited mobility and overlying bone.
• Fluoroscopy offers poor visualization in these patients, hindering accurate assessment.

Purpose of the Study:

• To evaluate a CT localization view (digital view) as an alternative to traditional fluoroscopy for airway examination.
• To assess the efficacy of digital view in detecting obstructing lesions prior to tracheostomy removal in immobile patients.

Main Methods:

• A CT localization view technique was used for airway examination in eleven patients.
• Digital data manipulation and magnification allowed visualization of the trachea.
• Bronchoscopy served as the gold standard for comparison.

Main Results:

• The CT digital view technique was successfully performed in thirteen examinations across eleven patients.
• This method required minimal time, physical exertion, and radiation exposure.
• Sensitivity, specificity, and accuracy were 100%, 67%, and 92%, respectively, compared to bronchoscopy.

Conclusions:

• CT localization view (digital view) is a valuable, efficient, and safe alternative for airway assessment before tracheostomy removal.
• This technique enhances the detection of granulation tissue and obstructing lesions in challenging patient populations.
• Improved airway visualization can prevent respiratory decompensation and improve patient outcomes.