Intraoperative long range optical coherence tomography as a novel method of imaging the pediatric upper airway before and after adenotonsillectomy.
Int J Pediatr Otorhinolaryngol
; 79(1): 63-70, 2015 Jan.
Article
em En
| MEDLINE
| ID: mdl-25479699
ABSTRACT
BACKGROUND/OBJECTIVES:
While upper airway obstruction is a common problem in the pediatric population, the first-line treatment, adenotonsillectomy, fails in up to 20% of patients. The decision to proceed to surgery is often made without quantitative anatomic guidance. We evaluated the use of a novel technique, long-range optical coherence tomography (LR-OCT), to image the upper airway of children under general anesthesia immediately before and after tonsillectomy and/or adenoidectomy. We investigated the feasibility of LR-OCT to identify both normal anatomy and sites of airway narrowing and to quantitatively compare airway lumen size in the oropharyngeal and nasopharyngeal regions pre- and post-operatively.METHODS:
46 children were imaged intraoperatively with a custom-designed LR-OCT system, both before and after adenotonsillectomy. These axial LR-OCT images were both rendered into 3D airway models for qualitative analysis and manually segmented for quantitative comparison of cross-sectional area.RESULTS:
LR-OCT images demonstrated normal anatomic structures (base of tongue, epiglottis) as well as regions of airway narrowing. Volumetric rendering of pre- and post-operative images clearly showed regions of airway collapse and post-surgical improvement in airway patency. Quantitative analysis of cross-sectional images showed an average change of 70.52mm(2) (standard deviation 47.87mm(2)) in the oropharynx after tonsillectomy and 105.58mm(2) (standard deviation 60.62mm(2)) in the nasopharynx after adenoidectomy.CONCLUSIONS:
LR-OCT is an emerging technology that rapidly generates 3D images of the pediatric upper airway in a feasible manner. This is the first step toward development of an office-based system to image awake pediatric subjects and thus better identify loci of airway obstruction prior to surgery.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Tonsilectomia
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Adenoidectomia
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Tomografia de Coerência Óptica
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Obstrução das Vias Respiratórias
Tipo de estudo:
Guideline
/
Prognostic_studies
/
Qualitative_research
Limite:
Adolescent
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Child
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Child, preschool
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Female
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Humans
Idioma:
En
Ano de publicação:
2015
Tipo de documento:
Article