Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Irvine, CA, USA; Beckman Laser Institute, University of California Irvine, Irvine, CA, USA.
Beckman Laser Institute, University of California Irvine, Irvine, CA, USA.
Int J Pediatr Otorhinolaryngol. 2024 Mar;178:111900. doi: 10.1016/j.ijporl.2024.111900. Epub 2024 Feb 22.
Drug induced sleep endoscopy (DISE) is often performed for pediatric obstructive sleep apnea (OSA) when initial diagnostic studies do not provide adequate information for therapy. However, DISE scoring is subjective and with limitations. This proof-of-concept study demonstrates the use of a novel long-range optical coherence tomography (LR-OCT) system during DISE of two pediatric patients.
LR-OCT was used to visualize the airway of pediatric patients during DISE. At the conclusion of DISE, the OCT probe was guided in the airway under endoscopic visual guidance, and cross-sectional images were acquired at the four VOTE locations. Data processing involved image resizing and alignment, followed by rendering of three-dimensional (3D) volumetric models of the airways.
Two patients were included in this study. Patient one had 18.4%, 20.9%, 72.3%, and 97.3% maximal obstruction at velum, oropharynx, tongue base, and epiglottis, while patient two had 40.2%, 41.4%, 8.0%, and 17.5% maximal obstruction at these regions, respectively. Three-dimensional reconstructions of patients' airways were also constructed from the OCT images.
This proof-of-concept study demonstrates the successful evaluation of pediatric airway during DISE using LR-OCT, which accurately identified sites and degrees of obstruction with respective 3D airway reconstruction.
药物诱导睡眠内镜检查(DISE)常用于儿科阻塞性睡眠呼吸暂停(OSA),当初始诊断研究不能为治疗提供充分信息时。然而,DISE 评分具有主观性和局限性。本概念验证研究展示了一种新型长距离光学相干断层扫描(LR-OCT)系统在两名儿科患者 DISE 中的应用。
LR-OCT 用于在 DISE 期间可视化儿科患者的气道。在 DISE 结束时,OCT 探头在内镜视觉引导下引导进入气道,并在四个 VOTE 位置获取横截面图像。数据处理包括图像缩放和对齐,然后对气道进行三维(3D)容积模型渲染。
本研究纳入了两名患者。患者 1 在软腭、口咽、舌基底和会厌处的最大阻塞率分别为 18.4%、20.9%、72.3%和 97.3%,患者 2 分别为 40.2%、41.4%、8.0%和 17.5%。还从 OCT 图像构建了患者气道的三维重建。
本概念验证研究表明,LR-OCT 可成功用于 DISE 评估儿科气道,能够准确识别阻塞部位和程度,并相应地进行 3D 气道重建。