• Title/Summary/Keyword: Airway size

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Effect of Mandibular Repositioning Device on Airway Size and Airway Collapsibility in Obstructive Sleep Apnea Syndrome : Cine CT during Sleep (수면무호흡증 환자에서 Mandibular Repositioning Device가 Airway size와 Airway Collapsibility에 미치는 효과)

  • Hong, Seung-Bong;Kyung, Seung-Hyun;Han, Hyun-Jung;Na, Dong-Kyu;Son, Young-Ik;Park, Young-Chel
    • Sleep Medicine and Psychophysiology
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    • v.6 no.2
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    • pp.110-115
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    • 1999
  • Objectives: To investigate the effect of mandibular repasitioning device on airway sige and airway collapsibility in patients with obstructive sleep apnea syndrome(OSAS). Methods: Cine CT with polysomnographic monitoring was performed during sleep in nine(OSAS) patients before and after manibular repositioning device(MRD) application. Axial CT images were obtained in five upper airway levels(retropalatal-high, retroalatal-low, retroglossal, epiglottis, and hypopharynx levels). In each airway level, one axial CT image was obtained during sleep apnea period and 10 serial axial CT images were scanned every 1 second during normal sleep breathing. After wearing MRD, all CT images were obtained by the same method. The cross-sectional areas of airway were measured by automatic tracing method. The changes of minimum airway size and maximum airway size after MRD were evaluated. The airway collapsibility was calculaed before and after MRD. Results: During sleep apnea, the airway of retropalatal-low level was the most frequently narrowest site. During normal sleep breahing the minimum airway size was increased significantly after MRD at retropalatal-low level(p=0.011). The mean airway collapsibility was the highest at retropalatal-low level. MRD decreased the airway collapsibility significantly at retropalatal-low level(p=0.021) and epiglottis level(p=0.038). Conclusions: The enlargement of the minimum airway size and decreased airway collapsibility may be the therapeutic mechanism of MRD in obstructive sleep apnea.

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Evaluation of hyoid bone position and airway size in Class III malocclusion (골격성 III급 부정교합자의 설골 위치와 기도에 대한 평가)

  • Son, Woo-Sung;Choi, Yang-Sook
    • The korean journal of orthodontics
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    • v.26 no.3
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    • pp.247-254
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    • 1996
  • This study was performed to evaluate the hyoid bone position and airway in skeletal class III malocclusion and to prove the correlation between airway, hyoid bone position and mandibular position. The sample, considered of 47 class III malocclusion patients for experimmtal group and 52 class I malocclusion students for control group. Twenty three linear and angular measurements about hyoid bone position, airway size, mandibular position were taken from the lateral cephalograms. The differences between skeletal class III malocclusion group and normal occlusion group were compared and the correlation were evaluated statistically. The results obtained were as follows, 1. There were significant difference in S-APH, A-APH, N-APH, LAH-PBR, AA-PNS, PNS-ad between class I and class III malocclusion groups. 2. The hyoid bone was more anteriorly positioned in class III malocclusion group than class I malocclusion group and skeletal airway size in class III malocclusion group was smaller than class I malocclusion group. 3. There were significant difference in several measurements especially vertical and angular measurements of hyoid bone position and airway size between male and female. Usually the measurements in male were larger than female. 4. There were no significant correlation between hyoid bone position and airway size also airway size, and didn't showe significant correlation with mandibular position, 5. S-APH showed negative correlation with Wits appraisal and A-APH, N-APH showed positive correlation with Wits appraisal. On the contrary vertical measurements of hyoid bone position showed positive correlation with lower facial height.

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Upper Airway Studies in Patients with Obstructive Sleep Apnea Syndrome (폐쇄성 수면 무호흡증 환자의 상기도 검사법)

  • Kim, Jung-Soo;Lee, Kyu-Yup
    • Sleep Medicine and Psychophysiology
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    • v.11 no.1
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    • pp.5-9
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    • 2004
  • Obstructive sleep apnea (OSA) is a common disorder characterized by recurrent cessation of breathing due to complete or partial upper airway occlusion during sleep. The incompetent tone of palatal, pharngeal, and glossal muscles which fail to maintain airway patency during sleep causes narrowing of the airway dimension and increased resistance of breathing. The identification of the sites of upper airway obstruction in patients with OSA is important in understanding the pathogenesis and deciding the treatment modality of snoring and/or OSA. Various upper airway imaging modalities have been used to assess upper airway size and precise localization of the sites of upper airway obstruction during sleep. Dynamic imaging modalities enabled assessment of dimensional changes in the upper airway during respiration and sleep. This article focused on reviews of various upper airway imaging modalities, especially dynamic upper airway imaging studies providing important information on the pathogenesis of OSA.

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Wall Thickness Measurement of Respiratory Airway in CT Images: Signal Processing Aspects

  • Park, Sang-Joon;Kim, Jong-Hyo;Kim, Kwang-Gi;Lee, Sang-Ho
    • Proceedings of the IEEK Conference
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    • 2007.07a
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    • pp.279-280
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    • 2007
  • Airway wall thickness is an important bio-marker for evaluation of pulmonary diseases such as stenosis, bronchiectasis. Nevertheless, an image-based analysis of the airway tree can provide precise and valuable airway size information, quantitative measurement of airway wall thickness in CT images involves various sources of error and uncertainty. So we have developed an accurate airway wall measurement technique for small airways with three-dimensional (3-D) approach. To illustrate performance of these techniques, we used airway phantom that consisted of 4 acryl tubes with various inner and outer diameters. Results show that evaluation of interpolation and deconvolution methods of airways in 3-D CT images, and significant improvement over the full-width-half-maximum method for measurement of not only location of the luminal and outer edge of the airway wall but airway wall thickness.

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Airway Remodelling in Asthma (기관지 천식에서의 기도 개형)

  • Lim, Dae Hyun
    • Clinical and Experimental Pediatrics
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    • v.48 no.10
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    • pp.1038-1049
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    • 2005
  • Asthma is characterized by a chronic inflammatory disorder of the airways that leads to tissue injury and subsequent structural changes collectively called airway remodelling. Characteristic changes of airway remodelling in asthma include goblet cell hyperplasia, deposition of collagens in the basement membrane, increased number and size of microvessels, hypertrophy and hyperplasia of airway smooth muscle, and hypertrophy of submucosal glands. Apart from inflammatory cells, such as eosinophils, activated T cells, mast cells and macrophages, structural tissue cells such as epithelial cells, fibroblasts and smooth muscle cells can also play an important effector role through the release of a variety of mediators, cytokines, chemokines, and growth factors. Through a variety of inflammatory mediators, epithelial and mesenchymal cells cause persistence of the inflammatory infiltrate and induce airway structural remodelling. The end result of chronic airway inflammation and remodelling is an increased thickness of the airway wall, leading to a increased the bronchial hyperresponsiveness and fixed declined lung function.

Three-dimensional evaluation of the relationship between nasopharyngeal airway shape and adenoid size in children

  • Oh, Kyung-Min;Kim, Min-Ah;Youn, Jong-Kuk;Cho, Hyung-Jun;Park, Yang-Ho
    • The korean journal of orthodontics
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    • v.43 no.4
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    • pp.160-167
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    • 2013
  • Objective: To evaluate the shapes and sizes of nasopharyngeal airways by using cone-beam computed tomography and to assess the relationship between nasopharyngeal airway shape and adenoid hypertrophy in children. Methods: Linear and cross-sectional measurements on frontal and sagittal cross-sections containing the most enlarged adenoids and nasopharyngeal airway volumes were obtained from cone-beam computed tomography scans of 64 healthy children ($11.0{\pm}1.8$ years), and the interrelationships of these measurements were evaluated. Results: On the basis of frontal section images, the subjects' nasopharyngeal airways were divided into the following 2 types: the broad and long type and the narrow and flat type. The nasopharyngeal airway sizes and volumes were smaller in subjects with narrow and flat airways than in those with broad and long airways (p < 0.01). Children who showed high adenoid-nasopharyngeal ratios on sagittal imaging, indicating moderate to severe adenoid hypertrophy, had the narrow and flat type nasopharyngeal airway (p < 0.01). Conclusions: Cone-beam computed tomography is a clinically simple, reliable, and noninvasive tool that can simultaneously visualize the entire structure and a cross section of the nasopharyngeal airway and help in measurement of adenoid size as well as airway volume in children with adenoid hypertrophy.

A Case of Bronchial Foreign Body Removal During Trans-Laryngeal Mask Airway Fiberoptic Bronchoscopy (소아에서 후두 마스크를 이용한 기관지이물 제거 경험 1예 보고)

  • Suhr, Ji-Won;Kim, Jong-Yul;Park, Kyu-Ho;Kang, Jun-Goo;Choi, Jin
    • Tuberculosis and Respiratory Diseases
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    • v.44 no.6
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    • pp.1433-1439
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    • 1997
  • Bronchial foreign body is not a rare disease in children and it is urgently necessary to remove this foreign body from the airway to relive life or to prevent further damages and complications. But the innate small size of airways in infants makes it difficult to access by interventional methods such as intubation or bronchoscopy and etc. Laryngeal mask airway is a new way of method of airway management which is relatively recently introduced into medical practice. It gives way to access to airways without reducing the size of airway or incresing airway pressure during procedure through it and have many other advantages compared to the previous traditional endotracheal intubation, especially in infants. We successfully removed a case of bronchial foreign body, peanut, via laryngeal mask airway during fiberoptic bronchoscopy and by this method we can avoid the unnecessary tracheostomy in this 1 year old infant.

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A study on the correlation between airway space and facial morphology in Class III malocclusion children with nasal obstruction (비폐쇄를 보이는 III급 부정교합아동의 기도 공간 형태와 안모 골격 형태와의 상관관계 연구)

  • Jung, Ho-Lim;Chung, Dong-Hwa;Cha, Kyung-Suk
    • The korean journal of orthodontics
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    • v.37 no.3 s.122
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    • pp.192-203
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    • 2007
  • Objective: The aim of this study was assessment of the relationship between airway space and facial morphology in Class III children with nasal obstruction. Methods: For this study, 100 Class III children (50 boys and 50 girls) were chosen. All subjects were refered to ENT, due to nasal obstruction. Airway space measurements and facial morphology measurements were measured on lateral cephalometric radiograph. Pearson correlation analysis was used to assess the relationship between airway space and facial morphology Results: Ramal height, SNA, SNB, PFH, FHR and facial plane angle were positively related to upper PAS, and sum of saddle angle, articular angle, and genial angle, SN-GoGn, Y-axis to SN and FMA negatively related to upper PAS. Genial angle, FMA were positively related to lower PAS, and articular angle, facial depth, PFH and FHR negatively related to lower PAS. PCBL, ramal height, Mn. body length, Mn. body length to ACBL, facial depth, facial length, PFH and AFH were positively related to tonsil size. Sum of saddle angle, articular angle, genial angle, facial length, AFH, FMA and LFH were positively related to tongue gap, and IMPA and overbite was negatively related to tongue gap. Upper PAS, related to size of adenoid tissue, was mainly related to posterior facial dimension following a vertical growth pattern of face and mandibular rotation. Lower PAS and tonsil size, related to anterior-posterior tongue base position, were significantly related to each other. Lower PAS was related to growth pattern of mandible, and tonsil size was related to size of mandible and horizontal growth pattern of face. Tongue gap was related to anterior facial dimension following a vertical growth pattern of face. Conclusion: Significant relationship exists between airway space and facial morphology.

Differentiation of tidal volume & mean airway pressure with different Bag-Valve-Mask compression depth and compression rate (Bag-Valve-Mask의 사용방법에 따른 일회호흡량과 평균기도압의 변화 연구)

  • Jo, Seung-Mook;Jung, Hyung-Keon
    • The Korean Journal of Emergency Medical Services
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    • v.16 no.2
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    • pp.67-74
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    • 2012
  • Purpose : The purpose of this study is to get basal user guidelines of safer bag-valve-mask application on patient with normal pulmonary patho-physiologic condition. Methods : This study was accomplished by pre-qualified 25 EMS junior grade students. Participants were instructed randomly compress bag to one-third, half and total and also with differesnt compression speed. Resultant tidal volumes and mean airway pressures obtained in RespiTrainer were analysed in relation to the each compression depth and rate. Results : Demographic difference does not affect tidal volume with any compression depth and rate change. Increasing compression depth is correlated with tidal volume increasement at any compression rate and also with mean airway pressure. If the compression depth is same, compression rate change did not affect significantly the resultant tidal volume or mean airway pressure. Conclusion : Hand size, Experience, BMI dose not affect tidal volume. Compress the 1600 ml bag half to total amount is safe way to offer sufficient tidal volume without risky high airway pressure delivery to patient airway who with normal lung patho-physiologic condition.

Split orthodontic airway plate: An innovation to the utilization method of conventional orthodontic airway plate for neonates with Robin sequence

  • Choo, HyeRan;Kim, Seong-Hun;Ahn, Hyo-Won;Poets, Christian F.;Chung, Kyu-Rhim
    • The korean journal of orthodontics
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    • v.52 no.4
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    • pp.308-312
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    • 2022
  • Since the emergence of neonatal infant orthodontics for treatments of cleft lip and palate with or without Robin sequence (RS) in Europe in the 1950s, advancements in design and scope of its application have been remarkable. As the first institution to adopt orthodontic airway plate (OAP) treatment in the United States in 2019, we saw a need for innovation of the original design to streamline the most labor-intensive and time-consuming aspects of OAP utilization. A solution is introduced using a systematic split expansion mechanism to re-size the OAP periodically to accommodate the neonate's maxillary growth. To date, seven RS patients have received this modified treatment protocol at our institution. Each patient completed full treatment using only one OAP. This innovative utilization method is aptly named the split orthodontic airway plate (S-OAP). Details of the S-OAP and its modifications from conventional OAP are reported.