Developing pediatric three-dimensional upper airway normative values using fixed and interactive thresholds

Oral Radiol. 2020 Jan;36(1):89-99. doi: 10.1007/s11282-019-00384-3. Epub 2019 Apr 8.

Abstract

Objective: To develop and compare pediatric upper airway three-dimensional normative values using the two most commonly used cone beam computed tomography (CBCT) software: Invivo5 (fixed threshold) and Dolphin 3D (interactive threshold).

Study design: Out of 3738 CBCT scans, scans of 81 pediatric patients were utilized after applying strict exclusion criteria. The sample was grouped into two age groups (7-11 and 12-17 years). Intra-class correlation coefficient was used to test intra-rater and inter-rater reliability and showed coefficients greater than 0.9 indicating good reliability of the methods used.

Results: Paired t tests showed that volumetric and area measurements obtained using Dolphin 3D were significantly larger than those obtained using Invivo5 (p < 0.05). The mean minimal cross-sectional areas (MCSA) for Dolphin 3D were 151 mm2 and 177 mm2 for age groups 1 and 2, respectively. The mean MCSA values for Invivo5 for age groups 1 and 2 were 120 mm2 and 145 mm2, respectively.

Conclusion: Pediatric upper airway volumetric, area, and linear measurements were reported after applying strict exclusion criteria including a validated sleep questionnaire. Our goal is that clinicians utilize the proposed-here normative values for screening and assist in the timely diagnosis and management of pediatric sleep apnea.

Keywords: Adenoids; Airway; CBCT; OSA; Sleep apnea.

MeSH terms

  • Child
  • Cone-Beam Computed Tomography*
  • Humans
  • Nose*
  • Reproducibility of Results
  • Software