Quantitative assessment of the upper airway in infants and children with subglottic stenosis.
Quantitative assessment of the upper airway in infants and children with subglottic stenosis.
复制标题
对婴儿和整个狭窄儿童的上呼吸道的定量评估。
DOI：
10.1002/lary.25482
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发表时间：
2016-05
期刊：
影响因子：
--
通讯作者：
Superfine R
中科院分区：
文献类型：
--
作者：
Zdanski C;Davis S;Hong Y;Miao D;Quammen C;Mitran S;Davis B;Niethammer M;Kimbell J;Pitkin E;Fine J;Fordham L;Vaughn B;Superfine R
Determine whether quantitative geometric measures and a computational fluid dynamic (CFD) model derived from medical imaging of children with subglottic stenosis (SGS) can be effective diagnostic and treatment planning tools. Retrospective chart and imaging review. Tertiary Care Hospital CT scans (n=17) of children with SGS were analyzed by geometric and CFD methods. Polysomnograms (n=15) were also analyzed. Radiographic data was age/weight flow normalized and compared to an Atlas created from radiographically normal airways. Five geometric, seven CFD, and five polysomnography measures were analyzed. Statistical analysis utilized a two-sample t-test with Bonferroni correction and area under the curve analysis. Two geometric indices (the ratio of the subglottic to mid-tracheal airway; the percent relative reduction of the subglottic airway) and one CFD measure (the percent relative reduction of the hydraulic diameter of the subglottic airway) were significant for determining which children with SGS received surgical intervention. Optimal cutoffs for these values were determined. Polysomnography, the respiratory effort related arousals index was significant only prior to Bonferroni correction for determining which children received surgical intervention. Geometric and CFD variables were sensitive at determining which patients with SGS received surgical intervention. Discrete, quantitative assessment of the pediatric airway was performed, yielding preliminary data regarding possible objective thresholds for surgical versus non-surgical treatment of disease. This study is limited by its small, retrospective, single institution nature. Further studies to validate these findings and possibly optimize treatment threshold recommendations are warranted.
