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计算机断层扫描上咽腔容积的三维评估:在麻醉学和内窥镜检查中的应用

Three-Dimensional Assessment of Pharyngeal Volume on Computed Tomography Scans: Applications to Anesthesiology and Endoscopy.

作者信息

Gibelli Daniele, Cellina Michaela, Gibelli Stefano, Oliva Antonio Giancarlo, Termine Giovanni, Sforza Chiarella

机构信息

Dipartimento di Scienze Biomediche per la Salute, Università degli Studi di Milano.

Reparto di Radiologia, Ospedale Fatebenefratelli, ASST Fatebenefratelli Sacco.

出版信息

J Craniofac Surg. 2020 May/Jun;31(3):755-758. doi: 10.1097/SCS.0000000000006094.

Abstract

Pharyngeal volume is important in anesthesiology for correctly assessing intubation procedures. However, most of studies are based on patients in upright position and do not assess possible relationships between pharyngeal volume and cranial size. This study aims at measuring pharyngeal volume in CT-scans and to assess possible statistically significant differences according to sex.Eighty healthy subjects (40 males and 40 females) aged between 21 and 86 years were retrospectively chosen from a hospital database of maxillofacial CT-scans; 3D segmentation was performed separately for naso-, oro- and laryngopharyngeal portion through ITK-SNAP software, and their volume was calculated. Three cranial measurements were obtained: distance between anterior and posterior nasal spine, upper facial height (nasion-prosthion) and biorbital breadth (ectoconchion-ectoconchion distance).The effect of sex on volume for each pharyngeal portion was assessed through one-way ANCOVA test using each of the 3 cranial measurements as covariate (P < 0.05).On average, the volume of nasopharynx, oropharynx and laryngopharynx was 7.2 ± 2.7 cm, 7.5 ± 4.2 cm, 3.5 ± 2.2 cm respectively in males, and 6.4 ± 2.9 cm, 5.2 ± 2.1 cm, 3.0 ± 1.8 cm in females. Statistically significant differences according to sex were found only for oropharyngeal volume, independently from cranial measurements (P < 0.05).This study provides data concerning volume of pharyngeal air space in supine subjects: these reference standards can be useful for anaesthesiologic procedures.

摘要

咽容积在麻醉学中对于正确评估插管操作很重要。然而,大多数研究是基于直立位的患者,并未评估咽容积与颅骨大小之间可能存在的关系。本研究旨在通过CT扫描测量咽容积,并根据性别评估可能存在的统计学显著差异。从一家医院的颌面CT扫描数据库中回顾性选取了80名年龄在21至86岁之间的健康受试者(40名男性和40名女性);通过ITK-SNAP软件分别对鼻、口和喉咽部进行三维分割,并计算其容积。获得了三项颅骨测量值:鼻前棘与鼻后棘之间的距离、面中高(鼻根点-前鼻棘)和双眶宽(眶外侧缘间距)。使用这三项颅骨测量值中的每一项作为协变量,通过单因素协方差分析评估性别对各咽部容积的影响(P<0.05)。平均而言,男性的鼻咽、口咽和喉咽容积分别为7.2±2.7cm³、7.5±4.2cm³、3.5±2.2cm³,女性分别为6.4±2.9cm³、5.2±2.1cm³、3.0±1.8cm³。仅在口咽容积方面发现了根据性别存在的统计学显著差异,与颅骨测量无关(P<0.05)。本研究提供了关于仰卧位受试者咽部气腔容积的数据:这些参考标准可用于麻醉操作。

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