Optical-thermal simulation of human tonsillar tissue irradiation: clinical implications

Volume estimation of tonsil phantoms using an oral camera with 3D imaging

Three-dimensional (3D) visualization of oral cavity and oropharyngeal anatomy may play an important role in the evaluation for obstructive sleep apnea (OSA). Although computed tomography (CT) and magnetic resonance (MRI) imaging are capable of providing 3D anatomical descriptions, this type of technology is not readily available in a clinic setting. Current imaging of the oropharynx is performed using a light source and tongue depressors. For better assessment of the inferior pole of the tonsils and tongue base flexible laryngoscopes are required which only provide a two dimensional (2D) rendering. As a result, clinical diagnosis is generally subjective in tonsillar hypertrophy where current physical examination has limitations. In this report, we designed a hand held portable oral camera with 3D imaging capability to reconstruct the anatomy of the oropharynx in tonsillar hypertrophy where the tonsils get enlarged and can lead to increased airway resistance. We were able to precisely reconstruct the 3D shape of the tonsils and from that estimate airway obstruction percentage and volume of the tonsils in 3D printed realistic models. Our results correlate well with Brodsky's classification of tonsillar hypertrophy as well as intraoperative volume estimations.

Optical-thermal simulation of tonsillar tissue irradiation

BACKGROUND AND OBJECTIVE

Despite laser applications targetted toward tonsillar tissue, there has been no characterization of underlying optical and thermal events during laser irradiation of tonsillar tissue.

STUDY DESIGN/MATERIALS AND METHODS

The optical properties of canine and human tonsils were determined at 805 nm (diode laser) and 1,064 nm (Nd:YAG laser). An optical-thermal simulation was developed to predict the temperature rise in irradiated human tonsils.

RESULTS

The optical properties of human and canine tonsillar tissue are similar at both wavelengths. The optical-thermal simulation was validated and predicts that at 10 W and 1 minute of irradiation, the heat will be contained within the human tonsil. The diode laser causes more superficial heating than the Nd:YAG laser.

CONCLUSIONS

The safety of irradiating human tonsils was shown. The diode laser is superior to the Nd:YAG laser because less heat affects collateral structures. The optical-thermal simulation detailed in this study can be used to predict the temperature rise in tissues undergoing irradiation.