"Airway Volume Simulation in Virtual Mandibular Distraction: A Cohort Study".

"Airway Volume Simulation in Virtual Mandibular Distraction: A Cohort Study".

Plast Reconstr Surg. 2017 Dec 15;:

Authors: Humphries LS, Yates EK, Mhlaba JM, Collins JM, Baroody FM, Reid RR

Abstract
BACKGROUND: We investigated the accuracy of virtual surgical planning (VSP) in predicting airway volume (AV) changes after mandibular distraction in patients with Pierre Robin Sequence (PRS) and associated tongue-based airway obstruction (TBAO).
METHODS: We completed a retrospective review of patients for whom VSP was used during MDO for treatment of TBAO at a single institution. Pre-operative AV, VSP-predicted AV, and post-operative AV were calculated from 3-D CT scans using industry software. A blinded institutional radiologist also calculated pre- and post-operative AVs using one of two software programs. Pre- and post-operative polysomnography (PSG) was used to titrate end-point of mandibular lengthening.
RESULTS: Data were available for 11 patients, who were included in the study. Mean apnea-hypopnea index (AHI) (5.42 ± 4.53 vs 44.96 ± 20.57, p<0.001) and mean nadir oxygen saturation (70.3% ± 9.72 vs 82.9% ± 9.62, p=0.003) improved with mandibular distraction. There was moderate correlation between VSP-predicted and actual mandibular distraction lengths (R2=0.65, p=0.003). There was a strong correlation between VSP-predicted and industry-calculated actual post-MDO AV (R2=0.99, p<0.001). There was no significant correlation between actual mandibular distraction length and industry-calculated actual post-MDO airway volume for the entire cohort (R2=0.05, p=0.49), but correlation approached significance by institutional calculations. No significant correlation existed between industry and institutional-calculated percent change in post-MDO AV (R2=0.06, p=0.57).
CONCLUSIONS: Predictive airway volume calculation may be an effective adjunct to determine anatomic end-point of mandibular distraction but small sample size, operator and software variability, and patient airway morphology may confound firm conclusions. Further studies are warranted.

PMID: 29257005 [PubMed - as supplied by publisher]

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