11h30 Three-dimensional CBCT definition of the anatomical subregions of the upper airway using the IPSCaseDesigner® software: A validation study.
Authors : B. Leyman1, T. Maly1, A. Diez-Fraile1,2, J. Abeloos3, T. De Backer1,3,5, J. De Ceulaer1,3,5, C. De Clercq3, F. De Ketelaere4, M. Desmedt1,5, P. Lamoral1,3,4, K. Nagy1,6, N. Neyt1,5, K. Supply4, C. Spaas1,5, B. Veys1,3,4, G. Swennen1,4.
1 Department of Maxillo-Facial Surgery, Department of Surgery, AZ Sint-Jan Brugge, Ruddershove 10, 8000 Bruges, Belgium
2 Clinical Research Scientist, Clinical Trial Center, AZ Sint Jan Brugge, Ruddershove 10, 8000 Bruges, Belgium
3 Department of Maxillo-Facial Surgery, Department of Surgery, AZ Sint-Jan Brugge, Campus SFX, Spaanse Loskaai 1, 8000 Bruges, Belgium
4 Department of Maxillo-Facial Surgery, Department of Surgery, AZ Sint-Lucas, Sint-Lucaslaan 29, 8310 Bruges, Belgium
5 Department of Maxillo-Facial Surgery, Department of Surgery, AZ ZENO, Kalvekeetdijk 260, 8300 Knokke, Belgium
6 1st Department of Paediatrics, Semmelweis University School of Medicine, Budapest, Hungary.
Introduction: The exact boundaries of the total upper airway and its subregions have been evaluated in the past with the Dolphin® three-dimensional (3D) software. The 3D anatomical limits, however, still vary among different research groups and impede unbiased comparisons. The aim of this study was to reevaluate the clinical relevant 3D anatomical limits for the upper airway subregions by the IPSCaseDesigner® 3D software and its dedicated “3D airway evaluation tool”.
Methods: A retrospective analysis was performed. The upper airway of the same 40 normative individuals (aged 23-35 years) that were evaluated in the past with the Dolphin® 3D software, were now re-analysed and evaluated with the IPSCaseDesigner® 3D software. The appropriate grey-scale threshold value (400) was pre-calculated. After adapting specific head positioning and virtual orientation protocols, the volume and minimum cross-sectional area of the nasopharynx, oropharynx and hypopharynx, as previously defined with the Dolphin® 3D software, were calculated. Intra- and inter-observer reliability was evaluated for 3D volumes and cross-sectional areas.
Results: Sexual dimorphism analysis revealed again significantly a greater oropharyngeal volume, hypopharyngeal volume and minimum cross-sectional oropharyngeal area in males. The “3D airway evaluation tool” of the IPSCaseDesigner® 3D software proved technical feasibility and statistical reliability, especially for 3D volume calculations. The reliability of two-dimensional (2D) calculations may be, however, increased with improved head positioning during CBCT scanning and subsequent virtual head orientation.
Conclusion: Standardisation of the proposed anatomical limits has the potential to homogenise upper airway subregion analysis and permit comparisons among future studies.
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