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The difference in upper airway morphology between supine and upright posture

Cedric Van Holsbeke, Wim Vos, Samir Vinchurkar, Jan De Backer, Oswald Peters, Nasser Nadjmi, Wilfried De Backer
European Respiratory Journal 2012 40: P651; DOI:
Cedric Van Holsbeke
1Respiratory, FluidDA nv, Kontich, Belgium
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Wim Vos
1Respiratory, FluidDA nv, Kontich, Belgium
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Samir Vinchurkar
1Respiratory, FluidDA nv, Kontich, Belgium
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Jan De Backer
1Respiratory, FluidDA nv, Kontich, Belgium
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Oswald Peters
1Respiratory, FluidDA nv, Kontich, Belgium
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Nasser Nadjmi
3Maxillofacial Surgery, A.Z. Monica, Antwerpen, Belgium
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Wilfried De Backer
2Respiratory Medicine, University Hospital Antwerp, Edegem, Belgium
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Abstract

Introduction

The effect of upper airway (UA) morphology and especially the effect of the minimal cross sectional area (CSA) on lung deposition of inhaled medication (IM) is significant. However since IM is used when a patient is upright, conventional computed tomography (CT) data may not provide accurate information on the influence of the UA on lung deposition. The objective of this study is to evaluate variability in UA morphology for supine posture using CT vs. upright posture using cone beam CT (CBCT).

Materials and Methods

A total of 20 normal subjects were included. 15 valid CBCT scans could be included as the rotating gantry of the CBCT touched the shoulders of the broad-shouldered subjects, causing motion artifacts. The UA CT scans were performed using the GE VCT LightSpeed scanner and the CBCT scans were performed using the ISI i-CAT scanner.

Results

It is found that the CT scans were characterized by lower CSAs as compared to CBCT (Minimal CSA, p = 0.036, Average CSA, p = 0.006). The minimal CSA in the CT scan could accurately predict the difference in minimal CSA between CT and CBCT as indicated in the figure.

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Conclusions

It can be concluded that the UA morphology is different between upright and supine position. From the supine CT image, it can be predicted how large the minimal CSA will be when the subject is in an upright position. This function can be used to generate a correction factor for assessing lung deposition of IM.

  • Imaging
  • Morphology
  • © 2012 ERS
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The difference in upper airway morphology between supine and upright posture
Cedric Van Holsbeke, Wim Vos, Samir Vinchurkar, Jan De Backer, Oswald Peters, Nasser Nadjmi, Wilfried De Backer
European Respiratory Journal Sep 2012, 40 (Suppl 56) P651;

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The difference in upper airway morphology between supine and upright posture
Cedric Van Holsbeke, Wim Vos, Samir Vinchurkar, Jan De Backer, Oswald Peters, Nasser Nadjmi, Wilfried De Backer
European Respiratory Journal Sep 2012, 40 (Suppl 56) P651;
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