Age-related changes of the upper airway assessed by 3-dimensional computed tomography.
The purposes of this study were to establish normative data for airway size and shape and to evaluate differences associated with age and sex using 3-dimensional (3-D) imaging. Patients being evaluated by computed tomography (CT) for pathologic conditions not related to the airway were included. Using 3-D Slicer (Harvard Surgical Planning Laboratory, Brigham and Women's Hospital, Boston, MA), a software program, digital 3-D CT reconstructions were made and parameters of airway size analyzed: volume (VOL), surface area (SA), length (L), mean cross-sectional area (mean CSA), minimum retropalatal (RP), minimum retroglossal (RG), minimum cross-sectional area (min CSA), and lateral (LAT) and anteroposterior (AP) retroglossal airway dimensions. Evaluation of airway shape included LAT/AP and RP/RG ratios, uniformity (U), and sphericity, a measure of compactness (Psi). Children were stratified by stage of dentition: primary, 0 to 5 years; mixed, 6 to 11 years; permanent, 12 to 16 years; and adults, older than 16 years. Differences in airway parameters by age and sex were analyzed. Forty-six CT scans (31 males) were evaluated. Adults had larger (VOL, SA, L, mean CSA, and LAT), more elliptical (increased LAT/AP, P = 0.01), less uniform (U, P = 0.02), and less compact (decreased Psi, P = 0.001) airways than children. Among children, those in the permanent dentition demonstrated greater VOL (P < 0.01), SA (P < 0.01), L (P < 0.01), and mean CSA (P < 0.01) than those in the primary dentition. There were no gender differences in airway parameters. Understanding differences in 3-D airway size and morphology by age may serve as a basis for evaluation of patients with obstructive sleep apnea and may help to predict and to evaluate outcomes of treatment.
Abramson
Zachary
Z
Department of Oral and Maxillofacial Surgery, Massachusetts General Hospital, Harvard School of Dental Medicine, Boston, Massachusetts, USA. LKaban@Partners.org
Susarla
Srinivas
S
Troulis
Maria
M
Kaban
Leonard
L
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D021621:Imaging, Three-Dimensional / Q000379:methods*; D007223:Infant; D007231:Infant, Newborn; D007830:Larynx / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000254:growth & development*; D008297:Male; D008875:Middle Aged; D009666:Nose / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000254:growth & development*; D010614:Pharynx / Q000033:anatomy & histology / Q000000981:diagnostic imaging / Q000254:growth & development*; D012016:Reference Values; D012189:Retrospective Studies; D012737:Sex Factors; D020181:Sleep Apnea, Obstructive / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D055815:Young Adult