Reformatted 3D airway imaging in patients with airway obstruction and micrognathia

Cathy R. Henry, Arlen D. Denny

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Purpose Mandibular distraction osteogenesis (MDO) is an effective treatment for patients with micrognathia and severe recurrent airway obstruction (Denny, 2004; Denny and Amm, 2005; Denny, 2009; Cicchetti et al., 2012; Flores et al., 2014). However the efficacy of the procedure is based on selecting the appropriate patient. Presence of central apnea or airway obstruction anywhere other than the tongue base will make MDO futile. The availability of three dimensional reformatting of the airway has greatly improved the accuracy of correct patient selection, providing a powerful tool to further characterize the pathology in these patients. Methods We conducted a retrospective review of the last thirty patients with micrognathia and severe recurrent airway obstruction seen in consult by the senior author for potential role of surgery in their management. Results Twenty-one patients met our inclusion criteria, with fourteen treated appropriately with MDO. The remaining patients had findings on the 3D airway CT scans with other anatomic causes of obstruction making them inappropriate candidates for mandibular distraction osteogenesis. Conclusions The use of three dimensional formatting of the airway from CT scans obtained using low dose protocols has improved the accuracy of evaluation and treatment of Pierre Robin patients. Most valuable is the non-invasive identification of airway abnormalities that would make mandibular distraction osteogenesis ineffective in correcting the airway obstruction.

Original languageEnglish (US)
Pages (from-to)2004-2011
Number of pages8
JournalJournal of Cranio-Maxillofacial Surgery
Volume43
Issue number10
DOIs
StatePublished - Dec 1 2015

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Micrognathism
Airway Obstruction
Distraction Osteogenesis
Central Sleep Apnea
Songbirds
Tongue
Patient Selection
Pathology

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oral Surgery
  • Otorhinolaryngology

Cite this

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abstract = "Purpose Mandibular distraction osteogenesis (MDO) is an effective treatment for patients with micrognathia and severe recurrent airway obstruction (Denny, 2004; Denny and Amm, 2005; Denny, 2009; Cicchetti et al., 2012; Flores et al., 2014). However the efficacy of the procedure is based on selecting the appropriate patient. Presence of central apnea or airway obstruction anywhere other than the tongue base will make MDO futile. The availability of three dimensional reformatting of the airway has greatly improved the accuracy of correct patient selection, providing a powerful tool to further characterize the pathology in these patients. Methods We conducted a retrospective review of the last thirty patients with micrognathia and severe recurrent airway obstruction seen in consult by the senior author for potential role of surgery in their management. Results Twenty-one patients met our inclusion criteria, with fourteen treated appropriately with MDO. The remaining patients had findings on the 3D airway CT scans with other anatomic causes of obstruction making them inappropriate candidates for mandibular distraction osteogenesis. Conclusions The use of three dimensional formatting of the airway from CT scans obtained using low dose protocols has improved the accuracy of evaluation and treatment of Pierre Robin patients. Most valuable is the non-invasive identification of airway abnormalities that would make mandibular distraction osteogenesis ineffective in correcting the airway obstruction.",
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Reformatted 3D airway imaging in patients with airway obstruction and micrognathia. / Henry, Cathy R.; Denny, Arlen D.

In: Journal of Cranio-Maxillofacial Surgery, Vol. 43, No. 10, 01.12.2015, p. 2004-2011.

Research output: Contribution to journalArticle

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