3D Evaluation and Analysis of the Growth Pattern of the Upper Airway Space in Normal Pediatric to Early Adult Patients

BACKGROUND & PURPOSE: To evaluate, quantify and analyze growth of the upper airway space of normal pediatric to early adult group of patients.

METHODS: 180 DICOM files from cone-beam CAT Scan study of individuals in orthodontic treatment were evaluated for the upper airway space (UAS) using 3dMDvaultus software (Atlanta, GA). Patients’ age ranged from 6 to 25 years of age and consisted of 90 male, 90 female patients. Patients were categorized into six age groups ranging from, 6-8, 9-11, 12-14, 15-17, 18-20 and 21-25. Patients were other wise healthy individuals and did not have symptoms or history of sleep apnea. The UAS was identified between the PNS to the hyoid. The UAS divided into retropalatal (PNS-soft palate) and retroglossal (soft palate-hyoid) space. The total volume of the UAS, retropalatal and retroglossal measured. The surface area, transverse and AP dimensions at the PNS, hyoid, occlusal plane, retropalatal and retroglossal choke points measured. The vertical length of the UAS, soft palatal length and the distance from the hyoid to the mandibular plane measured.

RESULTS:The UAS volume at age 6-8 is 5.67cm3 and at age 21-25 is 14.23cm3, this is a 250% increase. The UAS height is 44mm at age 6-8 and at age 21-25 is 59.77mm, this is a 135% increase. The retropalatal volume, choke point surface area and length is larger than retroglossal but the retroglossal volume, choke point surface area and length increased more in percentage growth. The soft palate measured 29.23mm at ages 6-8 and 37.50mm at age 21-25, this is a 128% increase. The distance hyoid to the mandibular plane measured 8.34mm at age 6-8 and 14.6mm at age 21-25, this a 175% increase. There is a growth spur between the ages 9-17 in all 3 dimensions of the airway, this also affects the length and width of the soft palate and the decent of the hyoid.

CONCLUSIONS:The UAS can be evaluated and quantified. There is growth in 3 planes, the growth spur accounts for vertical growth of the face. This data can be used as a norm and base line to evaluate, classify and treat pedatric to early adult group of patients with craniofacial anomalies (Pierre Roban Sequence) effecting the upper airway causing obstructive sleep apnea.

MAIN OBJECTIVES OF PRESENTATION: Evaluate, quantify and analyze growth of the upper airway in normal heallthy pedatric patients. 

REFFERENCE:

1. Schendel SA et al. Airway analysis: with bilateral distraction of infanr mandible. J Craniofac Surg. 2009 Sep:20(5):1341-6.

2.Schendel SA et al. Airway growth and development: A computerized 3-dimensional analysis. J Oral Maxillofac Surg. 2012 Feb 9.