scholarly journals Assessment of Upper Airway Anatomy in Awake, Sedated and Anaesthetised Patients Using Magnetic Resonance Imaging

1994 ◽  
Vol 22 (2) ◽  
pp. 165-169 ◽  
Author(s):  
G. D. Shorten ◽  
N. J. Opie ◽  
P. Graziotti ◽  
I. Morris ◽  
M. Khangure
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
General Anaesthesia ◽  
Soft Palate ◽  
Upper Airway ◽  
Posterior Pharyngeal Wall ◽  
Resonance Imaging ◽  
Pharyngeal Wall ◽  
Airway Anatomy ◽  
Clinically Significant

Magnetic Resonance Imaging was used to quantify the effects of 1. sedation and 2. general anaesthesia with a laryngeal mask airway (LMA) in place on the minimum antero-posterior (A-P) diameters of the naso-, oro- and hypopharynx and on the angle of the epiglottis relative to the adjacent posterior pharyngeal wall. Median saggital T1-weighted images of the pharynx were obtained in 46 patients (16 awake, 14 sedated, 16 under general anaesthesia). In sedated patients, the A-P diameters of the pharynx were less than in awake patients, in particular at the levels of the epiglottis and soft palate. General anaesthesia and placement of a LMA was also associated with a reduced A-P diameter at the level of the soft palate, but with increased diameters at the levels of the tongue and epiglottis. Placement of a LMA caused abnormal downfolding of the epiglottis in most cases but this did not cause clinically significant airway obstruction.

Dynamic Analysis of Articulatory Movement Using Magnetic Resonance Imaging Movies: Methods and Implications in Cleft Lip and Palate

2005 ◽  
Vol 42 (3) ◽  
pp. 225-230 ◽  
Author(s):  
Hideo Shinagawa ◽  
Takashi Ono ◽  
Ei-Ichi Honda ◽  
Shinobu Masaki ◽  
Yasuhiro Shimada ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Cleft Lip ◽  
Cleft Lip And Palate ◽  
Posterior Pharyngeal Wall ◽  
Normal Volunteer ◽  
Resonance Imaging ◽  
Pharyngeal Wall ◽  
Articulatory Movement ◽  
The Subject

Objectives To visualize articulatory movement using a magnetic resonance imaging (MRI) movie of a subject with cleft lip and palate (CLP) and to demonstrate the usefulness of this method for studying oropharyngeal function. Material and Methods Dynamic changes in oropharyngeal structures were assessed with an MRI movie of a man with cleft lip and palate and in a normal adult male volunteer during the articulation of /pa/, /ta/, and /ka/. Results and Conclusions Different movement patterns were observed during articulation in the subject with CLP compared with the normal volunteer. Posterosuperior movement of the tongue and the anterior movement of the posterior pharyngeal wall were clearly visualized in the subject with CLP. Thus, MRI movies appear to be a promising tool for evaluating speech function in patients with CLP because of their noninvasive and nonradiation nature.

Effect of Combined Mouth Closure and Chin Lift on Upper Airway Dimensions during Routine Magnetic Resonance Imaging in Pediatric Patients Sedated with Propofol

1999 ◽  
Vol 90 (6) ◽  
pp. 1617-1623. ◽  
Author(s):  
Adrian Reber ◽  
Stephan G. Wetzel ◽  
Karl Schnabel ◽  
Georg Bongartz ◽  
Franz J. Frei
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Soft Palate ◽  
Pediatric Patients ◽  
Upper Airway ◽  
Resonance Imaging ◽  
Cross Sectional ◽  
Propofol Sedation ◽  
Routine Magnetic Resonance Imaging ◽  
Airway Dimensions

Background In pediatric patients, obstruction of the upper airway is a common problem during general anesthesia. Chin lift is a commonly used technique to improve upper airway patency. However, little is known about the mechanism underlying this technique. Methods The authors studied the effect of the chin lift maneuver on airway dimensions in 10 spontaneously breathing children (aged 2-11 yr) sedated with propofol during routine magnetic resonance imaging. The minimal anteroposterior and corresponding transverse diameters of the pharynx were determined at the levels of the soft palate, dorsum of the tongue, and tip of the epiglottis before and during the chin lift maneuver. Additionally, cross-sectional areas were calculated at these sites, including tracheal areas 2 cm below the glottic level. Results Minimal anteroposterior diameter of the pharynx increased significantly during chin lift at all three levels in all patients. The diameters of the soft palate, tongue, and epiglottis increased from 6.7+/-2.8 mm (SD) to 9.9+/-3.6 mm, from 9.6+/-3.6 mm to 16.5+/-3.1 mm, and from 4.6+/-2.5 mm to 13.1+/-2.8 mm, respectively. The corresponding transverse diameter of the pharynx also increased significantly at all three levels in all patients but without significant predominance. The diameters at the levels of the soft palate, tongue, and epiglottis increased from 15.8+/-5.1 mm to 22.8+/-4.5 mm, from 13.5+/-4.9 mm to 18.7+/-5.3 mm, and from 17.2+/-3.9 mm to 21.2+/-3.7 mm, respectively. Cross-sectional pharyngeal areas increased significantly at all levels (soft palate, from 0.88+/-0.58 cm2 to 1.79+/-0.82 cm2; tongue, from 1.15+/-0.45 cm2 to 2.99+/-1.30 cm2; epiglottis, from 1.17+/-0.70 cm2 to 3.04+/-0.99 cm2), including the subglottic level (from 0.44+/-0.15 cm2 to 0.50+/-0.14 cm2). Conclusions This study shows that all children had a preserved upper airway at all measured sites during propofol sedation. Chin lift caused a widening of the entire pharyngeal airway that was most pronounced between the tip of the epiglottis and the posterior pharyngeal wall. In pediatric patients, chin lift may be used as a standard procedure during propofol sedation.

Anatomic Changes After Hyoid Suspension for Obstructive Sleep Apnea: An MRI Study

2005 ◽  
Vol 133 (3) ◽  
pp. 397-402 ◽  
Author(s):  
Boris A. Stuck ◽  
Wolfgang Neff ◽  
Karl Hörmann ◽  
Thomas Verse ◽  
Gregor Bran ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Upper Airway ◽  
Resonance Imaging ◽  
X Ray ◽  
Disturbance Index ◽  
Airway Anatomy ◽  
Obstructive Sleep ◽  
Hyoid Suspension ◽  
Respiratory Disturbance

OBJECTIVE: To assess the effects of isolated hyoid suspension on subjective and objective parameters of obstructive sleep apnea and to evaluate changes in upper airway anatomy with the help of standardized magnetic resonance imaging. STUDY DESIGN AND SETTING: Fifteen patients received isolated hyoid suspension. Changes in respiratory disturbance index were assessed with polysomnography, and anatomical changes with standardized magnetic resonance imaging. Snoring, daytime sleepiness, and functional parameters were assessed with questionnaires. Lateral x-ray cephalometry was performed preoperatively. RESULTS: Mean respiratory disturbance index was reduced from 35.2 ± 19.1 to 27.4 ± 26.2. Forty percent of the patients were classified as responders. Daytime sleepiness improved significantly. Relevant changes in upper airway anatomy could not be detected. There were no remarkable differences between responders and nonresponders in regard to imaging. CONCLUSIONS: Hyoid suspension is effective only in a subgroup of patients and does not lead to relevant changes in airway diameters in the awake patient. Magnetic resonance imaging and x-ray cephalometry do not add additional information for patient selection. SIGNIFICANCE: The reported clinical effects of hyoid suspension are more likely due to functional changes in airway collapsibility than to an enlargement of the upper airway.

scholarly journals A Novel Volumetric Magnetic Resonance Imaging Paradigm to Study Upper Airway Anatomy

SLEEP ◽  
2002 ◽  
Vol 25 (5) ◽  
pp. 530-540 ◽  
Author(s):  
Kevin C. Welch ◽  
Gary D. Foster ◽  
Christen T. Ritter ◽  
Thomas A. Wadden ◽  
Raanan Arens ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Upper Airway ◽  
Resonance Imaging ◽  
Airway Anatomy

scholarly journals Examining Age, Sex, and Race Characteristics of Velopharyngeal Structures in 4- to 9-Year-Old Children Using Magnetic Resonance Imaging

2017 ◽  
Vol 55 (1) ◽  
pp. 21-34 ◽  
Author(s):  
Jamie L. Perry ◽  
Lakshmi Kollara ◽  
David P. Kuehn ◽  
Bradley P. Sutton ◽  
Xiangming Fang
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Muscle Length ◽  
Posterior Pharyngeal Wall ◽  
Levator Muscle ◽  
Healthy Children ◽  
Resonance Imaging ◽  
Facial Skeleton ◽  
Pharyngeal Wall ◽  
Mean Values

Objective: The purpose of this study was to quantify the growth of the various craniofacial and velopharyngeal structures and examine sex and race effects. Methods: Eight-five healthy children (53 white and 32 black) with normal velopharyngeal anatomy between 4 and 9 years of age who met the inclusion criteria and successfully completed the magnetic resonance imaging (MRI) scans were included in the study. Results: Developmental normative mean values for selected craniofacial and velopharyngeal variables by race and sex are reported. Facial skeleton variables (face height, nasion to sella, sella to basion, palate height, palate width) and velopharyngeal variables (levator muscle length, angle of origin, sagittal angle, velar length, velar thickness, velar knee to posterior pharyngeal wall, and posterior nasal spine to levator muscle) demonstrated a trend toward a decrease in angle measures and increase in linear measures as age increased (with the exception of posterior nasal spine to levator muscle). Only hard palate width and levator muscle length showed a significant sex effect. However, 2 facial skeleton and 6 velopharyngeal variables showed a significant race effect. The interactions between sex, race, and age were not statistically significant across all variables, with the exception of posterior nasal spine to posterior pharyngeal wall. Conclusion: Findings established a large age- and race-specific normative reference for craniofacial and velopharyngeal variables. Data reveal minimal sexual dimorphism among variables used in the present study; however, significant racial effects were observed.

Cervical Spondylodiscitis—A Rare Complication of Palatopharyngeal Flap Surgery

2008 ◽  
Vol 45 (6) ◽  
pp. 674-676 ◽  
Author(s):  
Rikke Holmgaard ◽  
Linda P. Jakobsen
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Rare Complication ◽  
Posterior Pharyngeal Wall ◽  
Local Infection ◽  
Resonance Imaging ◽  
Surgical Wound ◽  
Flap Surgery ◽  
Pharyngeal Wall ◽  
Cervical Spondylodiscitis

Cervical spondylodiscitis was diagnosed in a 31-year-old man 2 months after palatopharyngeal flap surgery. Symptoms included pain in the neck and tingling and numbness in the left arm. The diagnosis was confirmed by magnetic resonance imaging, and the patient recovered on antibiotic treatment. We propose that the spondylodiscitis may have occurred as a result of a local infection in and around the surgical wound in the posterior pharyngeal wall.

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