Age-Related Changes of the Upper Airway Assessed by 3-Dimensional Computed Tomography

Abstract

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.

Changes in the oropharyngeal airway of Class II patients treated with the mandibular anterior repositioning appliance

“…Although the experimental group had a significantly narrower A-P dimension than did controls at T1, functional appliance treatment resulted in significant widening of the airway in the transverse and A-P dimensions. Hence, the oropharynx became wider in the transverse dimension from T1 to T2 and more elliptical in shape, as described by Abramsom et al 21 The present study demonstrated an anterior change in A-P hyoid bone position in the experimental group that was three times that of controls. This may indicate an alteration in tongue posture with functional appliance treatment.…”

The relationship of vertical skeletofacial morphology to oropharyngeal airway shape using cone beam computed tomography: Possible implications for airway restriction

“…Other anatomical factors exist that have an influence upon airway patency, but they are not fully understood. [25][26][27][28] The present study was designed to clarify the relationship between airway shape, craniofacial morphology, and the hyoid using i-CATH (Imaging Sciences International, Hatfield, Pa) CBCT images of adults that presented for orthodontic treatment. The specific aims were to (1) determine if the airway is laterally elliptical when the hyoid is lower, further back, angled, or smaller in width and (2) determine the correlation with vertical and horizontal facial morphology.…”

Dimensões nasofaríngeas em indivíduos sem anomalias craniofaciais: dados normativos

“…When analyzing the average values of nasopharyngeal minimum cross-sectional area of studies using computed tomography in normal individuals, it is observed that the average values determined by imaging are superior to those obtained by rhinomanometry in this study (26)(27)(28) . A study (28) (26) .…”

“…From the 1990s, the technological advancement of imaging enabled by means of computed tomography, determining the airways dimensions in various segments of the pharynx. By means of this technique, subsequent studies have shown a proportional increase of the nasopharyngeal space along the craniofacial growth and determined the normative values for different age groups, from the age of 6 years (26) . According to the study that analyzed 1300 CT scans of healthy individuals aged 6 to 60 years, (27) .…”

“…A study (28) (26) . Thus, it is possible to assume that the dimensions could be even greater than observed, especially in adults.…”