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Alqaryan S, Alrabiah A, Alhussinan K, Alyousef M, Alosamey F, Aljathlany Y, Aljasser A, Bukhari M, Almohizea M, Khan A, Alqahtani K, Alammar A. Measurement of the lengths of different sections of the upper airway and their predictive factors. Surg Radiol Anat 2024:10.1007/s00276-024-03345-6. [PMID: 38735016 DOI: 10.1007/s00276-024-03345-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 03/08/2024] [Indexed: 05/13/2024]
Abstract
BACKGROUND No studies have been conducted to define the lengths of the upper airway's different segments in normal healthy adults. AIMS/OBJECTIVES This study aimed to determine the length of the subglottis and extrathoracic trachea and the factors affecting it. MATERIAL AND METHODS This was an observational retrospective review study. Included 102 adult patients who underwent CT scan during the quiet inspiration phase of the upper airway. RESULTS The results revealed significant positive linear relationships between height and both anterior and posterior subglottic measurements (p < 0.001). Additionally, a statistically significant, moderately strong negative correlation between age and extrathoracic tracheal measurements (p > 0.001) was observed. Men exhibited longer anterior (p < 0.001) and posterior (p > 0.001) subglottic measurements. In both sexes, the average length of the anterior subglottis was 14.16 (standard deviation [SD]: 2.72) mm, posterior subglottis was 14.51 (SD: 2.85) mm and extrathoracic trachea was 66.37 (SD: 13.71) mm. CONCLUSION AND SIGNIFICANCE We concluded that a normal healthy adult's anterior subglottis length is 6.3-19.3 mm (mean: 14.16 [SD: 2.72] mm), posterior subglottis length is 6.1-20.0 mm (mean: 14.51 [SD: 2.85] mm) and extrathoracic trachea length is 25.2-98.5 mm (mean: 66.37 [SD: 13.71] mm). Age, height and sex affected the upper airway length.
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Affiliation(s)
- Saleh Alqaryan
- Department of Otolaryngology - Head & Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, 11411, Riyadh, Saudi Arabia
- Division of Otolaryngology - Head and Neck Surgery, Department of Surgery, Ministry of National Guard Health Affairs, Riyadh, Saudi Arabia
| | - Abdulaziz Alrabiah
- Department of Otolaryngology - Head & Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, 11411, Riyadh, Saudi Arabia
- Department of Otolaryngology - Head & Neck Surgery, Prince Sultan Military Medical City, Riyadh, Saudi Arabia
| | - Khaled Alhussinan
- Department of Otolaryngology - Head & Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, 11411, Riyadh, Saudi Arabia.
| | - Mohammed Alyousef
- Department of Otolaryngology - Head & Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, 11411, Riyadh, Saudi Arabia
| | - Faisal Alosamey
- Department of Otolaryngology - Head & Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, 11411, Riyadh, Saudi Arabia
| | - Yousef Aljathlany
- Department of Otolaryngology - Head & Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, 11411, Riyadh, Saudi Arabia
| | - Abdullah Aljasser
- Department of Otolaryngology - Head & Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, 11411, Riyadh, Saudi Arabia
- Otorhinolaryngology - Head and Neck Surgery, Security Forces Hospital, Riyadh, Saudi Arabia
| | - Manal Bukhari
- Department of Otolaryngology - Head & Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, 11411, Riyadh, Saudi Arabia
| | - Mohammed Almohizea
- Department of Otolaryngology - Head & Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, 11411, Riyadh, Saudi Arabia
| | - Adeena Khan
- Department of Radiology, King Saud University Medical City, Riyadh, Saudi Arabia
| | - Khalid Alqahtani
- Department of Otolaryngology - Head & Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, 11411, Riyadh, Saudi Arabia
| | - Ahmed Alammar
- Department of Otolaryngology - Head & Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, 11411, Riyadh, Saudi Arabia
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Almothahbi A, Bukhari M, Almohizea M, Alsubaie N, Alharbi TF, Alhazzani HM, Zagzoog F. Recent updates in laryngeal hemangioma management: a scoping review. Eur Arch Otorhinolaryngol 2024; 281:2211-2222. [PMID: 38158419 DOI: 10.1007/s00405-023-08378-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Accepted: 11/24/2023] [Indexed: 01/03/2024]
Abstract
PURPOSE To provide a comprehensive review of the current strategies in the management of laryngeal hemangiomas, with an aim to introduce a management algorithm that aligns with the variable clinical presentations and anatomical complexities of these lesions. METHODS We conducted an extensive literature search across major databases using specific and general terms, combined with Boolean operators, to ensure comprehensiveness. Articles from January 2004 to August 2023 were included, with findings categorized by management approach. RESULTS Laryngeal hemangiomas exhibit a spectrum of manifestations, ranging from asymptomatic lesions to those causing severe airway obstruction. Optimal management demands an individualized approach tailored to the patient's unique presentation and anatomical considerations. Diverse treatment modalities, each with distinct indications, advantages, and limitations, are explored. Notable highlights encompass the prominent role of Beta-blockers, notably Propranolol, in addressing problematic infantile hemangiomas, the nuanced efficacy of laser therapies contingent upon hemangioma type and depth, and the critical relevance of tracheotomy in emergencies. Novel approaches like transoral robotic surgery and transoral ultrasonic surgery, demonstrate promise in specific scenarios. We propose a management algorithm based on the complexity and presentation of laryngeal hemangiomas, emphasizing individualized treatment strategies, thereby addressing the unique challenges and nuances of each case. CONCLUSION Laryngeal hemangioma management requires personalized approaches informed by diverse therapies, clinical expertise, and collaboration. The review introduces an algorithm spanning observation to advanced interventions, adapting to each case's complexity. Ongoing research promises innovative treatments.
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Affiliation(s)
- Ali Almothahbi
- King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia.
| | - Manal Bukhari
- King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia
| | | | - Nawaf Alsubaie
- King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia
| | - Talal F Alharbi
- King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia
| | | | - Faisal Zagzoog
- King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia
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Almothahbi A, Bukhari M, Almohizea M, Alshammari H, Alammari G, Zagzoog F. Evaluating Interventions for Sulcus Vocalis or Vocal Fold Scar: A Systematic Review and Meta-analysis. J Voice 2024:S0892-1997(23)00386-7. [PMID: 38195335 DOI: 10.1016/j.jvoice.2023.11.026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 11/28/2023] [Accepted: 11/29/2023] [Indexed: 01/11/2024]
Abstract
BACKGROUND Sulcus vocalis reflects varying degrees of vocal cord lamina propria (LP) damage. Many interventions have been discussed in the literature for addressing sulcus vocalis, but there is no universally accepted gold standard for its management. AIM We aim in our study to collectively evaluate the effectiveness of different relevant interventions in the literature used for sulcus vocalis or vocal fold scar. METHODS We searched five electronic databases to collect all relevant studies. Records were screened for eligibility. Data were extracted from the included studies independently. Our continuous outcomes were pooled in our single-arm meta-analysis as mean change (MC) and with 95% confidence interval (CI). RESULTS Our systematic review and meta-analysis included 43 studies encompassing 1302 patients. The jitter parameter indicated that laser degeneration and LP regeneration/scar degradation led to the highest improvements compared to their baseline, with pooled MC of -0.897 and -0.893, respectively. Graft interposition showed a MC of -0.848, while medialization and dissection had less pronounced changes at -0.200. Shimmer parameter results were similar, with medialization and laser degeneration leading to MC of -2.129 and -2.123, while LP regeneration/scar degradation and graft interposition showed smaller changes MC -1.530 and -1.217. For the noise-to-harmonic ratio (NHR) parameter, LP regeneration/scar degradation demonstrated MC = -0.028. In aerodynamics outcomes, graft interposition and LP regeneration/scar degradation showed the highest MCs in mean phonatory time (MPT) (4.214 and 3.467, respectively). Endoscopic outcomes for mucosal wave showed high improvements in medialization and graft interposition (MC = 10.40 and 10.18, respectively). Perceptual outcomes favored graft interposition in various parameters, while laser degeneration performed well in most categories. Graft interposition and LP regeneration/scar degradation had a high voice handicap index (VHI) (MC = -27.195 and -19.269, respectively). CONCLUSION Laser degeneration and LP regeneration/scar degradation were particularly effective in improving acoustic parameters. In aerodynamics, graft interposition and LP regeneration/scar degradation improved vocal efficiency compared to their baselines. Medialization and laser degeneration had the largest impact compared to their baseline on shimmer and MPT. Endoscopic assessments showed that medialization and graft interposition had high improvement in mucosal waves, and perceptual outcomes were generally high with graft interposition and laser degeneration.
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Affiliation(s)
- Ali Almothahbi
- Otolaryngolgy Department, King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia.
| | - Manal Bukhari
- Otolaryngolgy Department, King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia
| | - Mohammed Almohizea
- Otolaryngolgy Department, King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia
| | - Hind Alshammari
- Otolaryngolgy Department, King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia
| | - Ghada Alammari
- Otolaryngolgy Department, King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia
| | - Faisal Zagzoog
- Otolaryngolgy Department, King Abdulaziz University Hospital, Riyadh, Kingdom of Saudi Arabia
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Alkhunaizi AA, Bukhari M, Almohizea M, Malki KH, Mesallam TA. Voice Problems Among School Teachers employing the Tele-teaching Modality. J Voice 2022:S0892-1997(22)00190-4. [PMID: 35872105 DOI: 10.1016/j.jvoice.2022.06.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 06/22/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To assess the prevalence of voice problems among teachers in Riyadh during tele-teaching and examine the relationship between the Voice Handicap Index 10 (VHI10) scores and a variety of risk factors believed to be related to voice problems. We also assessed awareness of voice hygiene and therapy among teachers. STUDY DESIGN An observational cross-sectional study conducted using a multistage random sampling method among Riyadh school teachers who taught by tele-teaching for a minimum of one year. METHODS A self-assessment questionnaire which included demographic information about teachers, factors related to their teaching backgrounds, tele-teaching settings, effects of tele-teaching on the voice, medical and social histories, reports of voice and reflux symptoms, VHI10, and general knowledge about voice hygiene. This was distributed to school teachers using an SMS link through the Ministry of Education's IT department. RESULTS A total 495 were included in the study after exclusions. The prevalence of teachers who had significant voice problems during tele-teaching (VHI10>11) was 21.6%. Multiple risk factors significantly increased the risk of voice problems during tele-teaching. These factors included being female, teacher age, the presence of background noise from both teachers and students, loud voices, using an open camera during the teaching, stress and anxiety, allergies, respiratory disease, reflux, hearing problems, and a family history of voice problems. Only 4.6% of respondents were familiar with voice hygiene and voice therapy, but 65% believe that it is important for teachers to be knowledgeable about them. CONCLUSIONS Due to the lower prevalence of voice disorders among tele-teaching compared to traditional teaching methods, tele-teaching may be a viable option for teachers who have voice problems. There are still several factors influencing voice problems among tele-teachers. To attenuate potential risks, it is crucial that teachers are aware of the concepts of voice hygiene and voice therapy.
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Affiliation(s)
- Arwa A Alkhunaizi
- Department of Otolaryngology, Head and Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Saudi Arabia; ENT section, Surgical Department, Prince Mohammed Bin Abdulaziz Hospital, Second Health Cluster Riyadh, Kingdom of Saudi Arabia
| | - Manal Bukhari
- Department of Otolaryngology, Head and Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed Almohizea
- Department of Otolaryngology, Head and Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Khalid H Malki
- Research Chair of Voice, Communication, and Swallowing Disorders, Otolaryngology Department, King Saud University, Riyadh, Saudi Arabia; Department of Otolaryngology, Head and Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Tamer A Mesallam
- Research Chair of Voice, Communication, and Swallowing Disorders, Otolaryngology Department, King Saud University, Riyadh, Saudi Arabia; Department of Otolaryngology, Head and Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Saudi Arabia
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Alkhunaizi AA, Almohizea M, Bukhari M, Alhajress RI, Malki KH, Mesallam TA. Validation and Cultural Adaptation of the Arabic Version of the Aging Voice Index. J Voice 2022:S0892-1997(22)00032-7. [PMID: 35382955 DOI: 10.1016/j.jvoice.2022.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Revised: 01/30/2022] [Accepted: 02/04/2022] [Indexed: 11/24/2022]
Abstract
BACKGROUND The aging voice index (AVI) is a 23-item self-administered, patient-reported outcome measure. It was developed in the English language to assess the impact of voice disorders on the elderly population. OBJECTIVES This study aimed to develop an Arabic version of the AVI (A-AVI), test its reliability and validity, and assess its psychometric aspects in Arabic-speaking elderly persons with voice disorders. STUDY DESIGN/METHODS This was an observational, cross-sectional study involving elderly patients aged ≥60 years. Eighty-two patients with voice disorders were included in the dysphonia group and 77 patients without voice disorders were included in the vocally healthy group. The translated A-AVI and Arabic voice handicap index 10 (A-VHI10) were distributed to the study groups. The A-AVI was tested for its reliability (test-retest reliability and internal consistency) and validity (content, construct, and concurrent with A-VHI10). RESULTS The A-AVI showed excellent test-retest reliability and internal consistency (intraclass correlation coefficient = 0.987 and Cronbach's alpha = 0.954, respectively). There was a significant difference in A-AVI scores between the elderly in the dysphonia and vocally healthy groups (P < 0.001). In addition, a significant correlation was demonstrated between A-AVI and A-VHI10 (r = 0.89). Unilateral vocal fold immobility and inflammatory laryngeal disorders were most frequently reported by the dysphonia group (28%). CONCLUSIONS A-AVI has excellent validity and reliability in Arab-speaking elderly patients with voice disorders. It can be considered in the assessment of the effect of voice disorders on the quality of life of the elderly.
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Affiliation(s)
- Arwa A Alkhunaizi
- Department of Otolaryngology, Head and Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Saudi Arabia; ENT section, Surgical Department, Prince Mohammed Bin Abdulaziz Hospital, Riyadh, Saudi Arabia.
| | - Mohammed Almohizea
- Department of Otolaryngology, Head and Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Manal Bukhari
- Department of Otolaryngology, Head and Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Rafeef I Alhajress
- Department of Otolaryngology, Head and Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Khalid H Malki
- Department of Otolaryngology, Head and Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Research Chair of Voice, Communication, and Swallowing Disorders, Otolaryngology Department, King Saud University, Riyadh, Saudi Arabia
| | - Tamer A Mesallam
- Department of Otolaryngology, Head and Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Saudi Arabia; Research Chair of Voice, Communication, and Swallowing Disorders, Otolaryngology Department, King Saud University, Riyadh, Saudi Arabia
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Alrabiah A, Jomah M, Alduraywish S, Shaikh S, Meo S, Aljasser A, Almohizea M, Bukhari M, Alammar A. Significance of the pulmonary function test for the diagnosis of subglottic stenosis: a systematic review. B-ENT 2021. [DOI: 10.5152/b-ent.2021.20056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Alrabiah A, Almohanna S, Aljasser A, Zakzouk A, Habib SS, Almohizea M, Bukhari M, Alammar A. Utility of Spirometry Values for Evaluating Tracheal Stenosis Patients Before and After Balloon Dilation. Ear Nose Throat J 2020; 101:NP62-NP67. [PMID: 32692288 DOI: 10.1177/0145561320936968] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Tracheal stenosis is defined as a narrowing of the airway distal to the lower edge of the cricoid cartilage. It is initially diagnosed based on clinical presentation and then confirmed using direct laryngobronchoscopy. Other adjunctive diagnostic methods, including spirometry, have been proposed. This study aimed to evaluate the relationship between tracheal stenosis severity and pre- and post-balloon dilatation spirometry parameters in order to assess for significant changes in spirometry values and to evaluate for the effects of stenosis-associated factors on post-dilation spirometry values, including vertical length and grade of the stenosis, as well as the role of wound-modifying agents. METHODS This retrospective study included adults (>18 years of age) with isolated tracheal stenosis who underwent endoscopic balloon dilations at King Saud University Medical City from June 2015 to May 2019, with detailed documentation of operative findings and valid spirometry measurements pre- and post-balloon dilation. Basic demographic data and operative note details, including information about the percentage of tracheal stenosis, distance of tracheal stenosis from vocal cords, vertical length of stenotic segment, and use of wound-modifying agents (topical mitomycin C or triamcinolone injections), were extracted. RESULTS Fourteen patients with spirometry measurements obtained on 50 occasions (25 pre-balloon dilation and 25 post-balloon dilation) were included. Each 1-unit increase in the vertical length of the stenosis showed a statistically significant negative relationship (-1.47 L/s) with pre-balloon dilation peak expiratory flow (PEF; P = .034). Post-balloon dilation spirometric values showed statistically significant improvements for most variables. CONCLUSIONS The vertical length of an isolated tracheal stenosis can be predicted before surgical interventions using PEF values and may be a significant indicator of anticipated post-balloon dilation surgical success. Our study suggested that spirometry is a very useful technique for evaluating patients with tracheal stenosis due to its noninvasiveness, cost-effectiveness, with a good clinical value.
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Affiliation(s)
- Abdulaziz Alrabiah
- Department of Otolaryngology-Head & Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia.,Department of Otolaryngology-Head & Neck Surgery, Prince Sultan Military Medical City, Riyadh, Kingdom of Saudi Arabia
| | - Shahad Almohanna
- Department of Otolaryngology-Head & Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Abdullah Aljasser
- Department of Otolaryngology-Head & Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Abdulmajeed Zakzouk
- Department of Otolaryngology-Head & Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Syed Shahid Habib
- Department of Physiology, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Mohammed Almohizea
- Department of Otolaryngology-Head & Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Manal Bukhari
- Department of Otolaryngology-Head & Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Ahmed Alammar
- Department of Otolaryngology-Head & Neck Surgery, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia
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Aljathlany Y, Aljasser A, Alhelali A, Bukhari M, Almohizea M, Khan A, Alammar A. Proposing an Endotracheal Tube Selection Tool Based on Multivariate Analysis of Airway Imaging. Ear Nose Throat J 2020; 100:629S-635S. [PMID: 31914813 DOI: 10.1177/0145561319900390] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES We aimed to comprehensively investigate different upper airway segments in adults, determine the predictors of the size of each segment, and identify an appropriate endotracheal tube (ETT) size chart. STUDY DESIGN Retrospective chart review. SETTING Tertiary care center. MATERIALS AND METHODS The data for patients aged >18 years who underwent neck computed tomography were screened. Patients with existing tumors, trauma, or any pathology that can alter the normal airway anatomy and those with intubation, tracheostomy, or nasogastric tubes were excluded. Computed tomography software was used to measure the anteroposterior diameter (APD), transverse diameter (TD), and cross-sectional area (CSA) at the glottic, proximal subglottic, distal subglottic, and tracheal levels. Multiple regression analysis was used to identify the predictors of the airway size. RESULTS One hundred patients were reviewed. The TD was consistently smaller than or equal to the APD at each level in all but 3 patients. The mean CSA and TD (170 mm2 and 11.3 mm, respectively) of the glottis indicated that the glottis was most often the narrowest level, followed by the proximal subglottis where the mean CSA and TD were 192.1 mm2 and 12.7 mm, respectively. Moreover, the mean APD was the smallest at the level of the trachea (20.1 mm). Multiple regression analysis confirmed that height and sex were the predominant predictors of measurements for the 4 airway segments. In addition, age was associated with the TD and CSA of the distal subglottic and tracheal segments, respectively. CONCLUSION One-third of our participants exhibited a proximal subglottic diameter that was equal to or smaller than the glottic diameter. Our findings also suggested that the height and sex of the patients are important variables for the selection of an appropriate ETT size.
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Affiliation(s)
- Yousef Aljathlany
- Otolaryngology, Head and Neck Surgery Department, 191082King Saud University Medical City, Riyadh, Saudi Arabia
| | - Abdullah Aljasser
- Otolaryngology, Head and Neck Surgery Department, 191082King Saud University Medical City, Riyadh, Saudi Arabia
| | - Abdullah Alhelali
- Otolaryngology, Head and Neck Surgery Department, 191082King Saud University Medical City, Riyadh, Saudi Arabia
| | - Manal Bukhari
- Otolaryngology, Head and Neck Surgery Department, 191082King Saud University Medical City, Riyadh, Saudi Arabia
| | - Mohammed Almohizea
- Otolaryngology, Head and Neck Surgery Department, 191082King Saud University Medical City, Riyadh, Saudi Arabia
| | - Adeena Khan
- Department of Radiology, 191082King Saud University Medical City, Riyadh, Saudi Arabia
| | - Ahmed Alammar
- Otolaryngology, Head and Neck Surgery Department, 191082King Saud University Medical City, Riyadh, Saudi Arabia
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Aljathlany Y, Alamari K, Aljasser A, Alhelali A, Bukhari M, Almohizea M, Khan A, Alammar A. Comparison Between Mathematical and Software Calculation Methods for the Measurement of the Cross-sectional Area in Upper Airway Imaging. Cureus 2019; 11:e6106. [PMID: 31886046 PMCID: PMC6901374 DOI: 10.7759/cureus.6106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objectives This study aimed to compare the results of a software calculation method (SCM) and the mathematical calculation method (MCM) in measuring the cross-sectional area (CSA) at four different upper airway segments. Methods The data from the retrospective chart reviews of patients older than 18 years who had undergone computed tomography (CT) of the neck at our tertiary care center between September 2014 and September 2018 were reviewed. Data of patients who were intubated, tracheostomized, had nasogastric tubes, tumors, craniofacial anomalies, trauma, or any pathology that may affect the normal airway anatomy were excluded. We measured the anteroposterior (APD) and transverse diameter (TD) utilizing the CT software. CSA was calculated using both the mathematical formula (MCM) and software (SCM) at the glottis, proximal subglottis, distal subglottis, and tracheal levels. A paired sample t-test was used to determine the significant difference between SCM and MCM at each level. Results The data of 100 patients (59% female) were reviewed. There was a significant difference between the SCM and MCM at all four levels. The mean differences between the SCM and MCM were -33.63 mm2, -24.20 mm2, 6.04 mm2 (p < 0.001) at the glottis, proximal subglottis, and trachea, respectively. The mean difference at the distal subglottis was -4.08 mm2 (p = 0.01). Conclusion Our study found a significant difference between the SCM and MCM in measuring the CSA of the four airway segments. Theoretically, the SCM is more accurate and precise than MCM in measuring CSA; however, we could not prove the superiority of either method.
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Affiliation(s)
- Yousef Aljathlany
- Otolaryngology, Head and Neck Surgery Department, King Saud University Medical City, Riyadh, SAU
| | - Kholoud Alamari
- Otolaryngology, Head and Neck Surgery Department, King Saud University Medical City, Riyadh, SAU
| | - Abdullah Aljasser
- Otolaryngology, Head and Neck Surgery Department, King Saud University Medical City, Riyadh, SAU
| | - Abdullah Alhelali
- Otolaryngology, Head and Neck Surgery Department, King Saud University Medical City, Riyadh, SAU
| | - Manal Bukhari
- Otolaryngology, Head and Neck Surgery Department, King Saud University Medical City, Riyadh, SAU
| | - Mohammed Almohizea
- Otolaryngology, Head and Neck Surgery Department, King Saud University Medical City, Riyadh, SAU
| | - Adeena Khan
- Radiology, King Saud University Medical City, Riyadh, SAU
| | - Ahmed Alammar
- Otolaryngology, Head and Neck Surgery Department, King Saud University Medical City, Riyadh, SAU
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