Age-related changes of the upper airway assessed by 3-dimensional computed tomography

J Craniofac Surg. 2009 Mar:20 Suppl 1:657-63. doi: 10.1097/SCS.0b013e318193d521.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Image Processing, Computer-Assisted / methods
  • Imaging, Three-Dimensional / methods*
  • Infant
  • Infant, Newborn
  • Larynx / anatomy & histology
  • Larynx / diagnostic imaging
  • Larynx / growth & development*
  • Male
  • Middle Aged
  • Nose / anatomy & histology
  • Nose / diagnostic imaging
  • Nose / growth & development*
  • Pharynx / anatomy & histology
  • Pharynx / diagnostic imaging
  • Pharynx / growth & development*
  • Reference Values
  • Retrospective Studies
  • Sex Factors
  • Sleep Apnea, Obstructive / pathology*
  • Tomography, X-Ray Computed
  • Young Adult