The Application Of Polysomnography And 3D CT Reconstruction And Virtual Endoscopy In Difficult Airway Prediction

Objective: To evaluate the airway condition more precisely by using three-dimensional CT reconstruction(3D-CT)and virtual endoscopy(VE)in patients with difficult airway during preoperative assessment.Materials and Methods: Materials: 1.18 patients with gastric volume reduction operation accompanied by respiratory and sleep pause syndrome who were admitted to the general surgery of " Ninth People’s Hospital affiliated by Shanghai Jiaotong University " in general anesthesia under the during January 2016 to December 2016.2.18 normal controls were selected from the normal database from division of the plastic and reconstruction surgery,Oral and Maxillofacial Surgery of Ninth People’s Hospital affiliated by Shanghai Jiaotong University Methods: The parameters of PSG and mask ventilation difficulties were used to study the correlation between them.Mimics 11.04(Materialise,Belgium)and virtual endoscopy were used to analysis the airway of the patients and the controls by reviewing the upper airway three-dimensional CT examination which included the minimum area and the volumn of the airway.It was used to figure out the difference of the airway between the patients and the controls in 3D-CT reconstruction and to visualize the difficult airway with virtual endoscopy.Results:(1)Apnea hypoventilation index was correlated with neck circumference(r=0.633,P=0.037),body mass index(BMI)(r=0.471,P=0.035)and Mallampati score(r=0.767,P=0.006).(2)Patients’ volume of total airway,retropalatal region and epiglottal region was smaller than the controls(P <0.05).(3)6 of the 18 patients showed the complete airway obstruction,the narrowest area was 0 mm2,VE reconstruction fully displayed it.Conclusion:(1)Apnea hypoventilation index can be used as an evaluation of DMV which was closely related to cervical circumference,BMI and Mallampati score.(2)3D-CT reconstruction can confirm the airway stenosis and can be used as a good preoperative assessment of difficulty Airway(3)Virtual endoscopy can visualize the patient’s airway conditions for preoperative airway assessment and difficult intubation.