Effect of Craniofacial Morphology on Pharyngeal Airway Volume Measured Using Cone-Beam Computed Tomography (CBCT)—A Retrospective Pilot Study (original) (raw)
Related papers
Curēus, 2024
Background: When it comes to orthodontic diagnosis and treatment planning, the structures of the upper and lower airway space are crucial because of the role they play in craniofacial development. Aim: The major objective of this study was to evaluate the accuracy of lateral cephalogram in the evaluation of upper and lower pharyngeal space by comparing it to clinical usage of cone-beam computed tomography (CBCT) in quantifying the 3D morphology of the pharyngeal airway. Methods and materials: In total, 70 patients were included in the study. They had both a CBCT scan and a lateral cephalogram performed within a week of each other. Different cephalometric landmarks have been utilized to estimate linear and area dimensions for use in lateral cephalogram airway investigations. By superimposing the lateral cephalogram measurement of the vertical height of the pharyngeal airway over axial CBCT slices of 0.8 to 1 mm in thickness, airway volumes were calculated. For this study, we measured the pharyngeal airway space in each patient in two dimensions (2D) using the airway area from the lateral cephalogram and in three dimensions (3D) using the airway volume from the CBCT scan over the same region of interest, using a uniform scale and magnification throughout all split 3D volumes. Results: The mean value of the area of pharyngeal space calculated by lateral cephalograph analysis (LCA) was 336.35 ± 86.49 mm 2. The maximum value was 551.234 mm 2. The minimum value was 206.32 mm 2. The mean value of the volume of the same area calculated using CBCT was 3409.11 ± 1237.96 mm 3. The maximum value was 5887.23 mm 3. When the area calculated using LCA was compared with the volume calculated using CBCT, the correlation between them was significant statistically (r=0.831, p-value =0.000). The mean values of volume evaluated in 3D CBCT in males were 4198±1008 mm 3 while for females it was 2980±1134.5 mm 3. During the statistical analysis, these observations were found to have a positive correlation with increased volume of pharyngeal space in males as compared to that of females (p=0.006). The values of the area of pharyngeal space calculated using LCA in males was 370.1±60.9 mm 2. while it was 301.9±88 mm 2 in females. Conclusion: The area estimated for the pharyngeal airway on LCA correlates strongly with the volume determined by a CBCT scan. Since we have considered pharyngeal space analysis using CBCT to be a reliable and standard methodology, therefore a positive correlation of area calculated using LCA with volume calculated using CBCT shows that the analysis made by LCA can be reliable.
The Journal of Indian Orthodontic Society, 2015
The aim of the present study was to evaluate pharyngeal airway in cleft individuals and normally growing individuals using cone beam computed tomography. Materials and Methods: Cone beam computed tomography scans of 22 individuals were obtained from the Department of Orthodontics and divided in two groups. Group 1 includes 11 cases with complete unilateral cleft lip and palate (mean age, 12 years) and group 2 includes 11 noncleft cases (mean age, 14 years). The oropharyngeal, nasopharyngeal, and oronasal pharyngeal airway was evaluated between the two groups. Results: In the cleft group, the volume of the nasopharyngeal airway was found to be 3.66 cm 3 ; of the oropharyngeal airway, 9.28 cm 3 ; and of the oronasal pharyngeal airway, 12.67 cm 3. The volume of the nasopharyngeal airway was found to be significantly reduced in the cleft palate group when compared with the noncleft group. Conclusion: The nasopharyngeal airway was found to be significantly smaller among the children with cleft palate than among those in the control group.
Pharyngeal Airway and Craniocervical Angle among Different Skeletal Patterns
BioMed Research International, 2021
Purpose. The aim of the present study was to investigate the pharyngeal airway dimensions and their correlations among the craniocervical angle and skeletal patterns. Materials and Methods. Cephalometric radiographs were obtained from 300 patients (≥15 years of age), of whom 150 were male patients and 150 were female patients. The patients were divided into three groups according to their skeletal patterns. The following dimensions were measured: NP: nasopharyngeal airway; PS: shortest distance from the soft palate to the pharyngeal wall; MP: Me-Go line intersecting the pharyngeal airway; TS: shortest distance from posterior tongue to pharyngeal wall; LP: laryngopharyngeal airway; UE length: shortest distance from the uvula to the epiglottis; PW: width of soft palate; PL: length of soft palate; ANB angle; palatal angle; and craniocervical angle. Paired t -test, one-way analysis of variance (ANOVA), and Pearson correlation were applied for statistical analysis. The null hypothesis wa...
Journal of Oral and Maxillofacial Surgery, 2011
Purpose: The purpose of the present prospective study was to develop a 3-dimensional analysis of the airway using cone-beam computed tomography (CBCT) and to determine whether changes in the airway before and after orthognathic surgery correlate on 2-dimensional lateral cephalogram and 3-dimensional CBCT images. Materials and Methods: Patients requiring orthognathic surgery during 2004 to 2005 were recruited for the present study. Lateral cephalograms and CBCT scans were obtained at 3 points: preoperatively, within 1 month postoperatively, and after 6 months postoperatively. The nasopharynx, oropharynx, and hypopharynx were segmented on both the radiograph and the CBCT scan for each patient in a repeatable manner at each point. For the lateral cephalogram, linear measurements in the middle of each of the 3 segments were obtained. For the CBCT, volumetric measurements of each of the 3 segments were obtained. The intrarater variability was assessed, and Pearson's correlation was used to compare the 2 imaging modalities. Results: A total of 20 patients scheduled for orthognathic surgery were recruited for the present study. Of the 20 patients, 13 were female and 7 were male. The mean age at surgery was 23.85 years (range 14 to 43). Of the 20 patients, 6 underwent maxillary advancement only, 8 underwent mandibular advancement with or without genioplasty, and 6 underwent 2-jaw surgery or mandibular setback. We examined the entire cohort without separation into procedure or examination point and found a weak, but statistically significant, correlation between the linear and volume measurements in the nasopharyngeal and oropharyngeal regions but not in the hypopharyngeal region (r ϭ 0.43, P Ͻ .002; r ϭ 0.49, P Ͻ .0002; r ϭ 0.16, P ϭ .26, respectively). The maxillary advancement group (n ϭ 6) demonstrated a correlation between the linear and volume measurements in the nasopharyngeal region (r ϭ 0.53, P ϭ .03). The mandibular advancement with or without genioplasty group (n ϭ 8) showed a correlation in the nasopharyngeal and oropharyngeal regions (r ϭ 0.55, P Ͻ .02, and r ϭ 0.46, P ϭ .05, respectively). For the combination/setback procedures (n ϭ 6), a correlation was found in the oropharyngeal region (r ϭ 0.64, P Ͻ .01). All other comparisons between the linear and volume measurements did not correlate. Additionally, no correlations were found between the linear and volumetric change in airway *Private Practice, San Francisco, CA; Former Resident,
The relationship between upper airways and craniofacial morphology studied in 3D. A CBCT study
Cattaneo P. M. The relationship between upper airways and craniofacial morphology studied in 3D. A CBCT study. Orthod Craniofac Res 2014. Structured Abstract Objectives -To assess whether morphology and dimension of the upper airway differ between patients characterized by various craniofacial morphology. Setting and Sample Population -Ninety young adult patients from the Postgraduate Clinic, Section of Orthodontics, Department of Dentistry, Health, Aarhus University, Denmark, with no obvious signs of respiratory diseases and no previous adeno-tonsillectomy procedures. Thirty patients were characterized as Class I (À0.5 < ANB < 4.5), 30 as Class II (ANB > 4.5), and 30 as Class III (ANB < À0.5). Material and Methods -Cone-beam computed tomography (CBCT) scans obtained in a supine position for all patients. Cephalometric landmarks were identified in 3D. Sagittal and transversal dimensions, cross sections, and partial and total volumes of the upper airway were correlated with the cephalometric measurements in all three planes of space. The cross-sectional minimal area of the upper airway was assessed as well. Results -No statistical significant relationships between dimension and morphology of upper airways and skeletal malocclusion were found. Conclusion -Differences in craniofacial morphology as identified by the sagittal jaw relationship were not correlated with variation in upper airway volumes. A clinical significant relation was detected between minimal area and total upper airway volume.
Journal of Stomatology
Introduction: Orthodontic treatment modalities depend on individual patient's growth pattern and mandibular position. The airway is an important determinant of treatment. Therefore, a clear correlation between different growth patterns, mandibular positions, and airway would lead to better diagnosis and more specific planning. Objectives: The aim of this study was to evaluate mandibular position and its' relationship to pharyngeal airway dimensions in patients with different growth patterns using cone-beam computed tomography (CBCT). Material and methods: CBCT scans of patients were assigned to vertical, average, and horizontal growth pattern types, based on angular (S-N/Go-Me) and linear (S-Go/N-Me) measurements. Data of included patients was used for 3-dimensional reconstruction of the pharyngeal airway to assess parameters, such as total airway volume, airway length, mandibular position, and correlation with different growth patterns. For statistical analysis, one-way ANOVA, post-hoc Tukey test (for pairwise comparisons), and Spearman's correlation with a significance level of 0.05 were applied. Results: The mandibular distance from the airway was significantly higher in the horizontal growth pattern group (p = 0.035). Airway volume was lower in the vertical growth pattern group as compared with the horizontal growth pattern group (p = 0.043). A negative correlation was observed between mandibular position and airway length (p = 0.021, r =-0.338). Conclusions: Subjects with horizontal growth patterns tend to have shorter and wider airways with their mandibles farther away, as compared to those with vertical growth patterns. To avoid the risk of compromising narrow airway dimensions, clinicians must take into account these findings while planning orthodontic and surgical treatment.
Journal of Indian Orthodontic Society, 2015
Human beings are normally nasal breathers. The nasal and the oral cavities serve as pathways for respiratory airflow, however in some individuals due to nasal airway inadequacy or habit; the oral cavity becomes the predominant route for the respiratory airflow. [1] Changes in the dimensions of the respiratory tract that is, constriction can cause a decrease in airflow at times. [2] There are significant relationships between the pharyngeal dimensions and craniofacial abnormalities. [3] Literature supports the notion that mandibular deficiency is frequently associated with a narrower pharyngeal airway passage. [4] Using computed tomography (CT), Trenouth and Timms [5] found that the effects of rapid maxillary expansion (RME) on the nasal cavity are not uniform and the changes in the nasal dimensions are progressively less toward the back of the nasal cavity. Mean cross-sectional nasal cavity enlargements of between 1.4 and 4 mm for rapid expansion, 0.8 mm for a quad helix, and 0.5 mm for a removable appliance have been reported. [6,7] According to Saitoh, [8] the growth of the face (excluding the mandible) is completed at a relatively early age. Sixty percent of craniofacial development takes place during the first 4 years of life and 90% by age 12. Based on these observations, any intervention to open the airway must take place at an early
The Cleft Palate-Craniofacial Journal, 2015
Aims The aim of the present study was to evaluate pharyngeal airway in cleft individuals and normally growing individuals using cone beam computed tomography. Materials and Methods Cone beam computed tomography scans of 22 individuals were obtained from the Department of Orthodontics and divided in two groups. Group 1 includes 11 cases with complete unilateral cleft lip and palate (mean age, 12 years) and group 2 includes 11 noncleft cases (mean age, 14 years). The oropharyngeal, nasopharyngeal, and oronasal pharyngeal airway was evaluated between the two groups. Results In the cleft group, the volume of the nasopharyngeal airway was found to be 3.66 cm3; of the oropharyngeal airway, 9.28 cm3; and of the oronasal pharyngeal airway, 12.67 cm3. The volume of the nasopharyngeal airway was found to be significantly reduced in the cleft palate group when compared with the noncleft group. Conclusion The nasopharyngeal airway was found to be significantly smaller among the children with cl...
Author eBooks, 2015
BACKGROUND: Airway dimensions are closely linked to the bone and soft tissue cranio-facial anatomy. Reduction of the airway is seen with airway disorders and can cause impairments to life. The purpose of this retrospective study was to determine whether changing from open to closed jaw position affects the volume of the nasal cavity, nasopharynx, oropharynx, soft palate, soft tissue thickness of the airway and most constricted area of the airway. MATERIALS AND METHODS: Following reliability studies, this retrospective study analyzed CBCT scans taken in both closed jaw and open jaw positions of 60 subjects who were undergoing diagnosis and treatment of temporomandibular disorder. On each scan, condyle/fossa measures, the volume of airway segments (nasal cavity, nasopharynx, oropharynx), soft palate area, soft tissue thickness of the airway and the most constricted area of the airway and its location were measured using Dolphin® imaging software version 11.5. Differences between the two jaw positions were analyzed using paired t-tests, accepting p≤0.05 as significant. RESULTS: Significant changes in airway dimensions were found between closed and open jaw positions. With jaw opening the nasopharynx volume increased, while oropharynx volume decreased. Significant decreases were also found for measurements of Ba-Posterior airway wall, CV2ia-Posterior airway wall, most constricted area, nasal cavity volume, and soft palate area when the jaw was open. CONCLUSIONS: Changing jaw position significantly affects airway dimensions.
Cephalometrics of Pharyngeal Airway Space in Lebanese Adults
International Journal of Dentistry
Purpose. The upper airway space is significant in orthodontic diagnosis and treatment planning. The objectives of this study are to assess the dimensions of soft tissue elements of the upper pharyngeal space and evaluate potential correlations with modifying variables such as gender, skeletal class, and anthropometric parameters.Materials and Methods. Lateral cephalograms were obtained from 117 healthy young adult Lebanese subjects. Nineteen cephalometric linear/angular measurements of the nasopharynx, oropharynx, and hypopharynx were recorded. Anthropometric parameters including body mass index and neck circumference were measured.Results. Significant differences were demonstrated for 12 out of the 19 parameters considered between genders. Uvula and tongue dimensions and the distances between epiglottis-posterior pharyngeal wall and epiglottis-posterior nasal spine were significantly larger in males. The anteroposterior inclination of the uvula and the distances between the uvula a...