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Are computed tomography 3D measurements of the upper airways in mouth-breathing children in agreement with the ENT clinical diagnosis of obstruction?

Abstract：

INTRODUCTION:Imaging studies have hystorically been used to support the clinical otorhinolaryngological evaluation of the upper respiratory tract for the diagnosis of obstructive causes of oral breathing. OBJECTIVE:The objective of this study was to compare 3D volumetric measurements of nasal cavity, nasopharynx and oropharynx of obstructed mouth-breathing children with measurements of non-obstructed mouth-breathing children. METHODS:This retrospective study included 25 mouth-breathing children aged 5-9 years evaluated by otorhinolaryngological clinical examination, flexible nasoendoscopy and full-head multi-slice computed tomography. Tomographic volumetric measurements and dichotomic otorhinolaryngological diagnosis (obstructed vs. non-obstructed) in three anatomical regions (the nasal cavity, nasopharynx and oropharynx) were compared and correlated. An independent sample t-test was used to assess the association between the 3D measurements of the upper airways and the otorhinolaryngological diagnosis of obstruction in the three anatomical regions. Inter- and intra-observer intraclass correlation coefficients were used to evaluate the reliability of the 3D measurements. RESULTS:The intra-class correlation coefficients ranged from 0.97 to 0.99. An association was found between turbinate hypertrophy and nasal cavity volume reduction (p<0.05) and between adenoid hyperplasia and nasopharynx volume reduction (p<0.001). No association was found between palatine tonsil hyperplasia and oropharynx volume reduction. CONCLUSIONS:(1) The nasal cavity volume was reduced when hypertrophic turbinates were diagnosed; (2) the nasopharynx was reduced when adenoid hyperplasia was diagnosed; and (3) the oropharynx volume of mouth-breathing children with tonsil hyperplasia was similar to that of non-obstructed mouth-breathing children. The adoption of the actual anatomy of the various compartments of the upper airway is an improvement to the evaluation method.

journal_name

Braz J Otorhinolaryngol

journal_title

Brazilian journal of otorhinolaryngology

authors

Vidigal BCL,Mordente CM,Cheib PL,Manzi FR,Franco LP,Becker HMG,Souki BQ

doi

10.1016/j.bjorl.2018.01.006

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

213-221

issue

eissn

1808-8694

issn

1808-8686

pii

S1808-8694(18)30061-2

journal_volume

pub_type

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Are computed tomography 3D measurements of the upper airways in mouth-breathing children in agreement with the ENT clinical diagnosis of obstruction?