Anatomic Optical Coherence Tomography of Upper Airways

Loy, Anthony Chin; Jing, Joseph C.; Zhang, Jun; Wang, Yueshe; Elghobashi, S.; Chen, Zhongping; Wong, Brian J. F.

doi:10.1007/978-3-319-06419-2_77

Cited by 4 publications

(4 citation statements)

References 23 publications

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“…AOTC is an endoscopic imaging modality that can be used to quantify size and shape of the upper airway in real time and with movement. It has the potential to provide a model for testing patients undergoing nasal valve surgery, and a functional model is forthcoming …”

Section: Discussionmentioning

confidence: 99%

Evolution of the butterfly graft technique: 15‐year review of 500 cases with expanding indications

Howard

Clark

2019

The Laryngoscope

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Objectives/Hypothesis To describe the evolution of the butterfly graft technique for the treatment of nasal valve compromise, with specific attention to technical developments allowing for expanded indications. To review the impact on patient‐reported outcomes of nasal airway function and nasal aesthetics. Study Design Retrospective chart review. Methods A review of a single surgeon's patients at a private practice and tertiary care center undergoing surgical correction for nasal valve compromise using the butterfly graft technique between July 2002 and April 2017. Data collected included etiology of nasal valve compromise, additional procedures performed, complications, and functional and aesthetic patient‐reported outcomes. Results Over the study period, 512 patients underwent surgery to correct nasal valve compromise utilizing the butterfly graft technique. The overall patient‐reported relief of nasal obstructive symptoms was complete in 87%, improved but not completely relieved in 10%, and not improved in 4%. No patients reported a worsening in their nasal obstructive symptoms. The overall patient‐reported change in nasal appearance was improved 53%, the same 32%, worse in 15%. The patients in the latter half of the study tended to report better aesthetic results. Conclusions The results of this study suggest that the surgical technique for the butterfly graft evolved over time and allowed for improved aesthetic outcomes, without reduction in the efficacy in correction of nasal valve compromise. The evolution in technique allowed for expansion of the indications for the butterfly graft while maintaining the favorable patient‐reported aesthetic and functional results. Level of Evidence 4 Laryngoscope, 129:S1‐S10, 2019

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Section: Discussionmentioning

confidence: 99%

Evolution of the butterfly graft technique: 15‐year review of 500 cases with expanding indications

Howard

Clark

2019

The Laryngoscope

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“…Endoscopic optical coherence tomography (OCT) systems equipped with single-mode fiber-optic probes have been shown to be valuable in a wide range of clinical applications [1,2]. Endoscopic OCT imaging of the nasal cavity, the upper airway, the trachea, and the mainstem bronchi is a promising approach for the diagnosis and monitoring of conditions like nasal valve compromise [3], obstructive sleep apnea [4,5], subglottic stenosis [6] and central airway obstruction [7]. Unlike other endoscopic OCT applications, such as intravascular or esophageal imaging, large airway imaging is particularly challenging owing to the large size of the organs being imaged and the inability to center the probe within the lumen using a balloon catheter or capsule [2], which would relax requirements on the depth of focus (DoF).…”

Section: Introductionmentioning

confidence: 99%

“…Owing to these considerations, probes designed for large airway OCT imaging usually utilize a side-looking, low numerical aperture (NA) beam with working distances (WDs) typically greater than 10 mm. To achieve such a beam profile, a probe design consisting of a bulk gradient refractive index (GRIN) lens and a glass spacer, combined with a prism to deflect the beam, has been most commonly employed [4,5].…”

Section: Introductionmentioning

confidence: 99%

All-fiber probes for endoscopic optical coherence tomography of the large airways

Balakrishnan

Oldenburg

2021

Appl. Opt.

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Endoscopic optical coherence tomography of large airways poses unique challenges. A hybrid lens is described that consists of a section of coreless fiber and graded index fiber (GIF), followed by a ball lens section. This design produces low numerical aperture beams better suited for large airway imaging. The performance of this lens is compared against conventional GIF and ball lens designs. Forward- and side-viewing probes were modeled, fabricated, and tested. The impact of a sheath on the beam profile was also investigated. Probes with working distances larger than 10 mm and depth-of-focus exceeding 12 mm are demonstrated with the proposed design.

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“…Anatomical Optical Coherence Tomography (aOCT) is a promising modality for airway imaging that can be performed in the physician’s office and can yield high resolution, quantitative airway morphology information for improved diagnoses of airway disorders 1 . Several authors have explored the use of OCT for imaging various regions of the airway, both in humans 6, 4, 12 and in animal models 5, 10, 16 .…”

Section: Introductionmentioning

confidence: 99%

Multi-modal anatomical optical coherence tomography and CT for in vivo dynamic upper airway imaging

Balakrishnan

Price

et al. 2017

SPIE Proceedings

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We describe a novel, multi-modal imaging protocol for validating quantitative dynamic airway imaging performed using anatomical Optical Coherence Tomography (aOCT). The aOCT system consists of a catheter-based aOCT probe that is deployed via a bronchoscope, while a programmable ventilator is used to control airway pressure. This setup is employed on the bed of a Siemens Biograph CT system capable of performing respiratory-gated acquisitions. In this arrangement the position of the aOCT catheter may be visualized with CT to aid in co-registration. Utilizing this setup we investigate multiple respiratory pressure parameters with aOCT, and respiratory-gated CT, on both ex vivo porcine trachea and live, anesthetized pigs. This acquisition protocol has enabled real-time measurement of airway deformation with simultaneous measurement of pressure under physiologically relevant static and dynamic conditions- inspiratory peak or peak positive airway pressures of 10–40 cm H2O, and 20–30 breaths per minute for dynamic studies. We subsequently compare the airway cross sectional areas (CSA) obtained from aOCT and CT, including the change in CSA at different stages of the breathing cycle for dynamic studies, and the CSA at different peak positive airway pressures for static studies. This approach has allowed us to improve our acquisition methodology and to validate aOCT measurements of the dynamic airway for the first time. We believe that this protocol will prove invaluable for aOCT system development and greatly facilitate translation of OCT systems for airway imaging into the clinical setting.

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Anatomic Optical Coherence Tomography of Upper Airways

Cited by 4 publications

References 23 publications

Evolution of the butterfly graft technique: 15‐year review of 500 cases with expanding indications

Evolution of the butterfly graft technique: 15‐year review of 500 cases with expanding indications

All-fiber probes for endoscopic optical coherence tomography of the large airways

Multi-modal anatomical optical coherence tomography and CT for in vivo dynamic upper airway imaging

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