Multiplanar 3D ultrasound imaging to assess the anatomy of the upper airway and measure the subglottic and tracheal diameters in adults

Or, Derevianko; Karmakar, Manoj K.; Lam, Gattett; Jing, Hui; Li, J W; Chen, P P

doi:10.1259/bjr.20130253

Cited by 25 publications

(19 citation statements)

References 21 publications

(15 reference statements)

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“…Overall trends demonstrate the increasing use of cross-sectional imaging of the neck [15]. Ultrasound technology has been previously utilized to demonstrate the structural anatomy of the upper airway and trachea [16] with good correlation observed when compared with MRI-derived soft tissue anatomy [17].…”

Section: Resultsmentioning

confidence: 98%

Ultrasonographic Detection of Airway Obstruction in a Model of Obstructive Sleep Apnea

Isaiah

Mezrich

Wolf

2017

Ultrasound Int Open

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Purpose Obstructive sleep apnea (OSA) is a common clinical disorder characterized by repetitive airway obstruction during sleep. The gold standard for diagnosis of OSA, polysomnogram (PSG), cannot anatomically localize obstruction. Precise identification of obstruction has potential to improve outcomes following surgery. Current diagnostic modalities that provide this information require anesthesia, involve ionizing radiation or disrupt sleep. To mitigate these problems, we conceived that ultrasound (US) technology may be adapted (i) to detect, quantify and localize airway obstruction and (ii) for translational application to home-based testing for OSA. Materials and Methods Segmental airway collapse was induced in 4 fresh cadavers by application of negative pressure. Following visualization of airway obstruction, a rotary US probe was used to acquire transcervical images of the airway before and after induction of obstruction. These images (n=800) were analyzed offline using image processing algorithms. Results Our results show that the non-obstructed airway consistently demonstrated the presence of a US air-tissue interface. Importantly, automated detection of the air-tissue interface strongly correlated with manual measurements. The algorithm correctly detected an air-tissue interface in 90% of the US images while incorrectly detecting it in 20% (area under the curve=0.91). Conclusion The non-invasive detection of airway obstruction using US represents a major step in expanding OSA diagnostics beyond PSG. The preliminary data obtained from our model could spur further research in non-invasive localization of obstruction. US offers the benefit of precise localization of the site of obstruction, with potential for improving outcomes in surgical management

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Section: Resultsmentioning

confidence: 98%

Ultrasonographic Detection of Airway Obstruction in a Model of Obstructive Sleep Apnea

Isaiah

Mezrich

Wolf

2017

Ultrasound Int Open

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“…Lakhal et al 8 reported a good correlation between ultrasound and MRI measurements of the transverse diameter of the cricoid cartilage, and that ultrasound could accurately measure the transverse diameter of the subglottic space. However, Or DYL et al 11 found that, compared with the MRI results, ultrasound overestimated the transverse diameter of the subglottic space.…”

Section: Discussionmentioning

confidence: 94%

Accuracy of ultrasound to measure the cricoid cartilage diameter in children

Hao

Zhang

et al. 2020

Acta Anaesthesiol Scand

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Background: Ultrasonography is used to pre-operatively predict the endotracheal tube size required for intubation by measuring the cricoid cartilage diameter. This study aimed to determine the accuracy of ultrasound measurements of the transverse diameters of the cricoid cartilage in children. Methods: We examined 50 children who underwent magnetic resonance imaging (MRI) scans at the HongHui Hospital, Xi'an Jiaotong University, from February 2019 to December 2019. Each child underwent MRI and ultrasound scans for measurement of the transverse diameters of the cricoid cartilage. The data measured by each technique were compared using Bland-Altman analysis and linear regression analysis. Results: Results of linear regression and Bland-Altman analysis showed strong correlation in the level of agreement between MRI and ultrasound measurements (r = 0.94, P < .001). The estimated bias was 0.11 mm; precision, 0.25 mm; and the limit of agreement, −0.47 to 0.70 mm. Conclusion: Ultrasound is a reliable tool for measuring the transverse diameters of the cricoid cartilage in children.

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“…Size is generally selected by age‐based formulas, which in turn are based on morphometric data of the tracheal dimensions and the effective functional area needed by a child for breathing. The methods of tracheal measurement have included cadaver measurement, chest radiograph, ultrasound, magnetic resonance imaging (MRI), and CT scan . However, most of the measurement data are based on Western literature, with very few Asian studies .…”

Section: Discussionmentioning

confidence: 99%

Pediatric tracheal dimensions on computed tomography and its correlation with tracheostomy tube sizes

et al. 2019

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Objective: Age-based formulas for selecting the appropriate size of tracheostomy tubes in children are based on data on tracheal dimensions. This study aims to measure the tracheal dimensions of Indian children by computerized tomography (CT) and to compare this with the dimensions of age-appropriate tracheostomy tubes.Methods: CT scans of children aged less than 16 years that were taken for indications other than respiratory distress were included. Tracheal diameters at the tracheostomy point and tracheal length from the tracheostomy point to the carina were calculated from the scans. These dimensions were correlated with age, weight, and height. The measurement on the CT scan was used to predict the appropriate size of tracheostomy tube, which was compared with the tracheostomy tube sizes.Results: Two hundred and fourteen CT scans of children aged below 16 years were included in the study. On multiple logistic regression analysis, tracheal diameter correlated well with age and weight (P = 0.04 and 0.001, respectively), whereas tracheal length correlated well with age and height of the child (P = 0.03 and 0 < 0.001, respectively).On comparison with dimensions of the tracheostomy tube, tracheal diameter correlated well, and the length was found to be longer than needed to prevent endobronchial intubation. The regression value was used to predict the size of an ideal tracheostomy tube.Conclusion: Tracheal diameter of Indian children correlates well with the outer diameter of age-appropriate tracheostomy tubes, but the length of these tubes is longer than the ideal length. This would necessitate a change in the design of these tubes.

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Multiplanar 3D ultrasound imaging to assess the anatomy of the upper airway and measure the subglottic and tracheal diameters in adults

Abstract: This is the first report to describe the use of 3D ultrasound to evaluate the anatomy of the upper airway and accurately measure the AP diameter of the subglottic space and the transverse diameter of the upper trachea.

Cited by 25 publications

References 21 publications

Ultrasonographic Detection of Airway Obstruction in a Model of Obstructive Sleep Apnea

Ultrasonographic Detection of Airway Obstruction in a Model of Obstructive Sleep Apnea

Accuracy of ultrasound to measure the cricoid cartilage diameter in children

Pediatric tracheal dimensions on computed tomography and its correlation with tracheostomy tube sizes

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