BACKGROUND Solitary fibrous tumors(SFT)are rare spindle cell tumors that are usually benign.A total of 10 cases of SFTs in the upper esophagus have ever been reported.Here,we report the anesthetic management of a pati...BACKGROUND Solitary fibrous tumors(SFT)are rare spindle cell tumors that are usually benign.A total of 10 cases of SFTs in the upper esophagus have ever been reported.Here,we report the anesthetic management of a patient with a large isolated fibrous tumor of the upper esophagus compressing the tracheal membrane.We also provide a literature review of the current research.CASE SUMMARY We report the case of a 49 year old male with“cough aggravation and wheezing after exercise”,who underwent esophagectomy for a large isolated fibrous tumor compressing the tracheal membrane in the upper esophagus.We advise the use of a single-lumen tube with a blocker in patients with difficult airways to reduce the incidence of airway injury and fibrinoscopy at all stages of the perioperative period to guide airway management.This case study is the first report of the anesthetic management of a large,isolated fibrous tumor compressing the tracheal membrane in the upper esophagus.CONCLUSION This rare case emphasizes the importance of perioperative management of anesthesia in patients with large isolated fibrous tumors of the upper esophagus that compress the tracheal membrane.The use of blocker reduce the incidence of airway injury and fibrinoscopy at the perioperative period to guide airway mana-gement.展开更多
In this paper, the authors present airflow field characteristics of human upper airway and soft palate movement attitude during breathing. On the basis of the data taken from the spiral computerized tomography images ...In this paper, the authors present airflow field characteristics of human upper airway and soft palate movement attitude during breathing. On the basis of the data taken from the spiral computerized tomography images of a healthy person and a patient with Obstructive Sleep Apnea-Hypopnea Syndrome （OSAHS）, three-dimensional models of upper airway cavity and soft palate are reconstructed by the method of surface rendering. Numerical simulation is performed for airflow in the upper airway and displacement of soft palate by fluid-structure interaction analysis. The reconstructed threedimensional models precisely preserve the original configuration of upper airways and soft palate. The results of the pressure and velocity distributions in the airflow field are quantitatively determined, and the displacement of soft palate is presented. Pressure gradients of airway are lower for the healthy person and the airflow distribution is quite uniform in the case of free breathing. However, the OSAHS patient remarkably escalates both the pressure and velocity in the upper airway, and causes higher displacement of the soft palate. The present study is useful in revealing pathogenesis and quantitative mutual relationship between configuration and function of the upper airway as well as in diagnosingdiseases related to anatomical structure and function of the upper airway.展开更多
This study examined the dynamic characteristics of upper airway collapse at soft palate level in patients with obstructive sleep apnea/hypopnea syndrome（OSAHS） by using dynamic 3-Dimensional（3-D） CT imaging.A tota...This study examined the dynamic characteristics of upper airway collapse at soft palate level in patients with obstructive sleep apnea/hypopnea syndrome（OSAHS） by using dynamic 3-Dimensional（3-D） CT imaging.A total of 41 male patients who presented with 2 of the following symptoms,i.e.,daytime sleepiness and fatigue,frequent snoring,and apnea with witness,were diagnosed as having OSAHS.They underwent full-night polysomnography and then dynamic 3-D CT imaging of the upper airway during quiet breathing and in Muller＇s maneuver.The soft palate length（SPL）,the minimal cross-sectional area of the retropalatal region（mXSA-RP）,and the vertical distance from the hard palate to the upper posterior part of the hyoid（hhL） were compared between the two breathing states.These parameters,together with hard palate length（HPL）,were also compared between mild/moderate and severe OSAHS groups.Association of these parameters with the severity of OSAHS [as reflected by apnea hypopnea index（AHI） and the lowest saturation of blood oxygen（LSaO2）] was examined.The results showed that 31 patients had severe OSAHS,and 10 mild/moderate OSAHS.All the patients had airway obstruction at soft palate level.mXSA-RP was significantly decreased and SPL remarkably increased during Muller＇s maneuver as compared with the quiet breathing state.There were no significant differences in these airway parameters（except the position of the hyoid bone） between severe and mild/moderate OSAHS groups.And no significant correlation between these airway parameters and the severity of OSAHS was found.The position of hyoid was lower in the severe OSAHS group than in the mild/moderate OSAHS group.The patients in group with body mass index（BMI）≥26 had higher collapse ratio of mXSA-RP,greater neck circumference and smaller mXSA-RP in the Muller＇s maneuver than those in group with BMI26（P0.05 for all）.It was concluded that dynamic 3-D CT imaging could dynamically show the upper airway changes at soft palate level in OSAHS patients.All the OSAHS patients had airway obstruction of various degrees at soft palate level.But no correlation was observed between the airway change at soft palate level and the severity of OSAHS.The patients in group with BMI≥26 were more likely to develop airway obstruction at soft palate level than those with BMI26.展开更多
A computational fluid dynamics （CFD） approach is used to study the respiratory airflow dynamics within a human upper airway. The airway model which consists of the airway from nasal cavity, pharynx, larynx and trach...A computational fluid dynamics （CFD） approach is used to study the respiratory airflow dynamics within a human upper airway. The airway model which consists of the airway from nasal cavity, pharynx, larynx and trachea to triple bifurcation is built based on the CT images of a healthy volunteer and the Weibel model. The flow character- istics of the whole upper airway are quantitatively described at any time level of respiratory cycle. Simulation results of respiratory flow show good agreement with the clinical mea- sures, experimental and computational results in the litera- ture. The air mainly passes through the floor of the nasal cavity in the common, middle and inferior nasal meatus. The higher airway resistance and wall shear stresses are distrib- uted on the posterior nasal valve. Although the airways of pharynx, larynx and bronchi experience low shear stresses, it is notable that relatively high shear stresses are distrib- uted on the wall of epiglottis and bronchial bifurcations. Besides, two-dimensional fluid-structure interaction models of normal and abnormal airways are built to discuss the flow-induced deformation in various anatomy models. The result shows that the wall deformation in normal airway is relatively small.展开更多
This study aimed to use computer simulation to describe the fluid dynamic characteristics in patients with obstructive sleep apnea syndrome（OSAS） and to evaluate the difference between during quiet respiration and t...This study aimed to use computer simulation to describe the fluid dynamic characteristics in patients with obstructive sleep apnea syndrome（OSAS） and to evaluate the difference between during quiet respiration and the Muller maneuver（MM）. Seven patients with OSAS were involved to perform computed tomographic（CT） scanning during quiet respiration and the MM. CT data in DICOM format were transformed into an anatomically three-dimensional computational fluid dynamics（CFD） model of the upper airway. The velocity magnitude, relative pressure, and flow distribution were obtained. Numerical simulation of airflow was performed to discuss how the MM affected airflow in the upper airway. To measure the discrepancy, the SPSS19.0 software package was utilized for statistic analysis. The results showed that the shape of the upper airway became narrower, and the pressure decreased during the MM. The minimal cross-sectional area（MCSA） of velopharynx was significantly decreased（P〈0.05） and the airflow velocity in MCSAs of velopharynx and glossopharynx significantly accelerated（P〈0.05） during the MM. This study demonstrated the possibility of CFD model combined with the MM for understanding pharyngeal aerodynamics in the pathophysiology of OSAS.展开更多
Background:Obstructive sleep apnea is a sleeping disorder that has troubled a sizeable population.There is an active area of research on obstructive sleep apnea that intends to better understand airflow behaviors and ...Background:Obstructive sleep apnea is a sleeping disorder that has troubled a sizeable population.There is an active area of research on obstructive sleep apnea that intends to better understand airflow behaviors and therefore treat patients more effectively.This paper aims to investigate the airflow characteristics of the upper airway in an obstructive sleep apnea(OSA)patient under light and heavy breathing conditions by using Turbulent Kinetic Energy(TKE),an accurate method in expressing the flow concentration mechanisms of sleeping disorders.It is important to visualize the concentration of flow in the upper airway in order to identify the severity level of the obstruction during sleep.Methods:Computational fluid dynamic(CFD)analysis was used as a solution tool to evaluate the airflow during light and heavy breathing conditions.A medical imaging technique was used to extract the 3D model from the CT scan images.Additionally,mesh generation and simulation were carried out via CFD software to evaluate the light and heavy breathing characteristics related to obstructive sleep apnea.Steady state Reynold’s averaged Navier-Stoke(RANS)with the k-ωshear stress transport(SST)turbulence model was utilized.The airflow characteristics were quantified using parameters such as pressure distribution,skin friction coefficient,velocity profile,Reynolds number,turbulent Reynolds number and turbulence kinetic energy.Results:Contour plots at different planes were used to visualize the airflow distribution as it passed through different cross-sectional areas of the airway.The results revealed that the presence of a smaller cross-sectional area of the airway caused an increase in airflow parameters,especially during heavy breathing.Furthermore,turbulent airflow conditions along the airway were noticed during heavy breathing.The severity of OSA could be measured by the turbulent kinetic energy which is able to show the behavior and concentration of mean flow.This study is expected to provide crucial and important results by visualizing the concentration of airflow mechanisms and characteristics of a patient’s airway during light and heavy breathing. These findings enable TKE to be used as a new tool for characterizing theseverity of obstructive sleep apnea in the upper airways of patients.展开更多
Purpose: To measure the upper airway changes associated with maxillary distraction osteogenesis in cleft lip and palate patients in the immediate post operative period and 12 months later. Materials and Methods: Seven...Purpose: To measure the upper airway changes associated with maxillary distraction osteogenesis in cleft lip and palate patients in the immediate post operative period and 12 months later. Materials and Methods: Seven patients with repaired cleft lip and palate (CLP) presented with severe maxillary hypoplasia. They were examined initially at T1 predistraction phase. Records taken included radiographs (orthopantograms OPG, lateral cephalometric, posteroanterior). Cephalometric analysis was done to evaluate the upper airway. Mean age is 17 years and the reverse overjet > 6 mm. They underwent maxillary Le Fort I distraction using external rigid distracters (RED). Cephalometric analysis to evaluate the upper airway was repeated at the end of the consolidation phase T2 and twelve months after distractor removal T3. Results: The range of maxillary advancement was between 8 - 15 mm (mean 9 mm). The anteroposterior distance of the superior velopharynx (PPS) and middle velopharynx (SPPS) increased at T2. A small amount of reduction in these values was recorded at T3. The inferior velopharynx (MPS) and the oropharynx (IPS, EPS) showed minimum increase in anteroposterior distance in only two patients at T2 and no change at T3. Conclusion: All seven patients showed clinical improvement in the upper airway and an increase in the upper airway values on lateral cephalometric radiographs.展开更多
The wide availability, low radiation dose and short acquisition time of Cone-Beam CT (CBCT) scans make them an attractive source of data for compiling databases of anatomical structures. However CBCT has higher noise ...The wide availability, low radiation dose and short acquisition time of Cone-Beam CT (CBCT) scans make them an attractive source of data for compiling databases of anatomical structures. However CBCT has higher noise and lower contrast than helical slice CT, which makes segmentation more challenging and the optimal methods are not yet known. This paper evaluates several methods of segmenting airway geometries (nares, nasal cavities and pharynx) from typical dental quality head and neck CBCT data. The nasal cavity has narrow and intricate passages and is separated from the paranasal sinuses by thin walls, making it is susceptible to either over- or under-segmentation. The upper airway was split into two: the nasal cavity and the pharyngeal region (nasopharynx to larynx). Each part was segmented using global thresholding, multi-step level-set, and region competition methods (the latter using thresholding, clustering and classification initialisation and edge attraction techniques). The segmented 3D surfaces were evaluated against a reference manual segmentation using distance-, overlap- and volume-based metrics. Global thresholding, multi-step level-set, and region competition all gave satisfactory results for the lower part of the airway (nasopharynx to larynx). Edge attraction failed completely. A semi-automatic region-growing segmentation with multi-thresholding (or classification) initialization offered the best quality segmentation. With some minimal manual editing, it resulted in an accurate upper airway model, as judged by the similarity and volumetric indices, while being the least time consuming of the semi-automatic methods, and relying the least on the operator’s expertise.展开更多
Upper airway cough syndrome refers to a clinical syndrome with chronic cough as the main manifestation caused by the reverse flow of secretions from various upper airway diseases such as allergic rhinitis,rhino-sinusi...Upper airway cough syndrome refers to a clinical syndrome with chronic cough as the main manifestation caused by the reverse flow of secretions from various upper airway diseases such as allergic rhinitis,rhino-sinusitis,adenoid hypertrophy and other parts of the nose and pharynx.Professor Yin Dan believes that the main disease of upper airway cough syndrome is due to cold fluid retained in lung,blood stasis endogenous,compound feeling of wind evil.The pathogenesis is external wind evil and the hidden pathogen together to cause the disease.In the treatment,the warm cold fluid retention is the core,accompanied by the activation of blood and wind,so that the wind evil can go away,the cold evil can be warmed,the phlegm can be removed,and the blood stasis can be dispersed,so as to achieve the purpose of treating the upper airway cough syndrome of the children’s cold fluid retention in lung.展开更多
Tuberculosis is a potentially serious infectious disease. In otorhinolaryngology practice, lymph node infection is the most common site of predilection followed by the larynx. Laryngeal tuberculosis (LTB) typically pr...Tuberculosis is a potentially serious infectious disease. In otorhinolaryngology practice, lymph node infection is the most common site of predilection followed by the larynx. Laryngeal tuberculosis (LTB) typically presents with dysphagia, odynophagia and hoarseness. We reported a case of primary LTB presenting with acute upper airway obstruction and respiratory distress mimicking acute supraglottitis which requires emergency tracheostomy. Therefore, in acute upper airway obstruction, the appropriate initial investigation should be done to rule out TB to make sure early treatment can be given and it may prevent complications of disease to the patient. .展开更多
Racehorses in training are in situations of repeated stress that may have effects on hydration and health.It was hypothesized that daily consumption of a structured water(SW)product for 4 weeks will result in improved...Racehorses in training are in situations of repeated stress that may have effects on hydration and health.It was hypothesized that daily consumption of a structured water(SW)product for 4 weeks will result in improved hydration,improved upper airway health and increased heart rate variability.Two groups of Thoroughbred racehorses matched for physiological,training and racing attributes were studied for 4 weeks.One group(n=17)received 10 L(about 15%)of their daily water as SW(followed by ad libitum filtered deep well water)and the control group(n=15)only filtered deep well water.Blood samples and bioelectrical impedance analysis(BIA)measures were obtained at baseline,2 and 4 weeks.Hydration was assessed using BIA.The upper airway was assessed by nasopharyngeal endoscopy at baseline and weekly within 60 minutes of breezing.On weekly breeze days heart rate was recorded at rest,during exercise and recovery and data were analysed for heart rate variability.Compared to controls,horses drinking SW showed increased hydration improved upper airway health post-breezing and increased heart rate variability.It is concluded that drinking 10 L daily of SW increased hydration and may have conferred some wellness benefits.展开更多
文摘BACKGROUND Solitary fibrous tumors(SFT)are rare spindle cell tumors that are usually benign.A total of 10 cases of SFTs in the upper esophagus have ever been reported.Here,we report the anesthetic management of a patient with a large isolated fibrous tumor of the upper esophagus compressing the tracheal membrane.We also provide a literature review of the current research.CASE SUMMARY We report the case of a 49 year old male with“cough aggravation and wheezing after exercise”,who underwent esophagectomy for a large isolated fibrous tumor compressing the tracheal membrane in the upper esophagus.We advise the use of a single-lumen tube with a blocker in patients with difficult airways to reduce the incidence of airway injury and fibrinoscopy at all stages of the perioperative period to guide airway management.This case study is the first report of the anesthetic management of a large,isolated fibrous tumor compressing the tracheal membrane in the upper esophagus.CONCLUSION This rare case emphasizes the importance of perioperative management of anesthesia in patients with large isolated fibrous tumors of the upper esophagus that compress the tracheal membrane.The use of blocker reduce the incidence of airway injury and fibrinoscopy at the perioperative period to guide airway mana-gement.
基金The project supported by the National Natural Science Foundation of China(10672036,10472025 and 10421002)the Natural Science Foundation of Liaoning Province(20032109)
文摘In this paper, the authors present airflow field characteristics of human upper airway and soft palate movement attitude during breathing. On the basis of the data taken from the spiral computerized tomography images of a healthy person and a patient with Obstructive Sleep Apnea-Hypopnea Syndrome （OSAHS）, three-dimensional models of upper airway cavity and soft palate are reconstructed by the method of surface rendering. Numerical simulation is performed for airflow in the upper airway and displacement of soft palate by fluid-structure interaction analysis. The reconstructed threedimensional models precisely preserve the original configuration of upper airways and soft palate. The results of the pressure and velocity distributions in the airflow field are quantitatively determined, and the displacement of soft palate is presented. Pressure gradients of airway are lower for the healthy person and the airflow distribution is quite uniform in the case of free breathing. However, the OSAHS patient remarkably escalates both the pressure and velocity in the upper airway, and causes higher displacement of the soft palate. The present study is useful in revealing pathogenesis and quantitative mutual relationship between configuration and function of the upper airway as well as in diagnosingdiseases related to anatomical structure and function of the upper airway.
文摘This study examined the dynamic characteristics of upper airway collapse at soft palate level in patients with obstructive sleep apnea/hypopnea syndrome（OSAHS） by using dynamic 3-Dimensional（3-D） CT imaging.A total of 41 male patients who presented with 2 of the following symptoms,i.e.,daytime sleepiness and fatigue,frequent snoring,and apnea with witness,were diagnosed as having OSAHS.They underwent full-night polysomnography and then dynamic 3-D CT imaging of the upper airway during quiet breathing and in Muller＇s maneuver.The soft palate length（SPL）,the minimal cross-sectional area of the retropalatal region（mXSA-RP）,and the vertical distance from the hard palate to the upper posterior part of the hyoid（hhL） were compared between the two breathing states.These parameters,together with hard palate length（HPL）,were also compared between mild/moderate and severe OSAHS groups.Association of these parameters with the severity of OSAHS [as reflected by apnea hypopnea index（AHI） and the lowest saturation of blood oxygen（LSaO2）] was examined.The results showed that 31 patients had severe OSAHS,and 10 mild/moderate OSAHS.All the patients had airway obstruction at soft palate level.mXSA-RP was significantly decreased and SPL remarkably increased during Muller＇s maneuver as compared with the quiet breathing state.There were no significant differences in these airway parameters（except the position of the hyoid bone） between severe and mild/moderate OSAHS groups.And no significant correlation between these airway parameters and the severity of OSAHS was found.The position of hyoid was lower in the severe OSAHS group than in the mild/moderate OSAHS group.The patients in group with body mass index（BMI）≥26 had higher collapse ratio of mXSA-RP,greater neck circumference and smaller mXSA-RP in the Muller＇s maneuver than those in group with BMI26（P0.05 for all）.It was concluded that dynamic 3-D CT imaging could dynamically show the upper airway changes at soft palate level in OSAHS patients.All the OSAHS patients had airway obstruction of various degrees at soft palate level.But no correlation was observed between the airway change at soft palate level and the severity of OSAHS.The patients in group with BMI≥26 were more likely to develop airway obstruction at soft palate level than those with BMI26.
基金supported by the National Natural Science Foundation of China (10472025 10672036+1 种基金 10872043)Natural Science Foundation of Liaoning Province, China (20032109).
文摘A computational fluid dynamics （CFD） approach is used to study the respiratory airflow dynamics within a human upper airway. The airway model which consists of the airway from nasal cavity, pharynx, larynx and trachea to triple bifurcation is built based on the CT images of a healthy volunteer and the Weibel model. The flow character- istics of the whole upper airway are quantitatively described at any time level of respiratory cycle. Simulation results of respiratory flow show good agreement with the clinical mea- sures, experimental and computational results in the litera- ture. The air mainly passes through the floor of the nasal cavity in the common, middle and inferior nasal meatus. The higher airway resistance and wall shear stresses are distrib- uted on the posterior nasal valve. Although the airways of pharynx, larynx and bronchi experience low shear stresses, it is notable that relatively high shear stresses are distrib- uted on the wall of epiglottis and bronchial bifurcations. Besides, two-dimensional fluid-structure interaction models of normal and abnormal airways are built to discuss the flow-induced deformation in various anatomy models. The result shows that the wall deformation in normal airway is relatively small.
基金supported by grants from Shanghai College Young Teacher Training Program(No.shjdy029)Youth Projects of Shanghai Municipality Health and Family Planning Commission(No.20144Y0124)
文摘This study aimed to use computer simulation to describe the fluid dynamic characteristics in patients with obstructive sleep apnea syndrome（OSAS） and to evaluate the difference between during quiet respiration and the Muller maneuver（MM）. Seven patients with OSAS were involved to perform computed tomographic（CT） scanning during quiet respiration and the MM. CT data in DICOM format were transformed into an anatomically three-dimensional computational fluid dynamics（CFD） model of the upper airway. The velocity magnitude, relative pressure, and flow distribution were obtained. Numerical simulation of airflow was performed to discuss how the MM affected airflow in the upper airway. To measure the discrepancy, the SPSS19.0 software package was utilized for statistic analysis. The results showed that the shape of the upper airway became narrower, and the pressure decreased during the MM. The minimal cross-sectional area（MCSA） of velopharynx was significantly decreased（P〈0.05） and the airflow velocity in MCSAs of velopharynx and glossopharynx significantly accelerated（P〈0.05） during the MM. This study demonstrated the possibility of CFD model combined with the MM for understanding pharyngeal aerodynamics in the pathophysiology of OSAS.
基金This work is supported by the Fundamental Research Grant Scheme provided by the Ministry of Higher Education(Ref.No.FRGS/1/2020/TK0/UNIMAP/03/26)and University of Malaya Grant(Ref.No.GPF020A-2019)The authors extend their appreciation to the Deanship of Scientific Research at King Khalid University for funding this work through the General Research Project GRP/281/42.
文摘Background:Obstructive sleep apnea is a sleeping disorder that has troubled a sizeable population.There is an active area of research on obstructive sleep apnea that intends to better understand airflow behaviors and therefore treat patients more effectively.This paper aims to investigate the airflow characteristics of the upper airway in an obstructive sleep apnea(OSA)patient under light and heavy breathing conditions by using Turbulent Kinetic Energy(TKE),an accurate method in expressing the flow concentration mechanisms of sleeping disorders.It is important to visualize the concentration of flow in the upper airway in order to identify the severity level of the obstruction during sleep.Methods:Computational fluid dynamic(CFD)analysis was used as a solution tool to evaluate the airflow during light and heavy breathing conditions.A medical imaging technique was used to extract the 3D model from the CT scan images.Additionally,mesh generation and simulation were carried out via CFD software to evaluate the light and heavy breathing characteristics related to obstructive sleep apnea.Steady state Reynold’s averaged Navier-Stoke(RANS)with the k-ωshear stress transport(SST)turbulence model was utilized.The airflow characteristics were quantified using parameters such as pressure distribution,skin friction coefficient,velocity profile,Reynolds number,turbulent Reynolds number and turbulence kinetic energy.Results:Contour plots at different planes were used to visualize the airflow distribution as it passed through different cross-sectional areas of the airway.The results revealed that the presence of a smaller cross-sectional area of the airway caused an increase in airflow parameters,especially during heavy breathing.Furthermore,turbulent airflow conditions along the airway were noticed during heavy breathing.The severity of OSA could be measured by the turbulent kinetic energy which is able to show the behavior and concentration of mean flow.This study is expected to provide crucial and important results by visualizing the concentration of airflow mechanisms and characteristics of a patient’s airway during light and heavy breathing. These findings enable TKE to be used as a new tool for characterizing theseverity of obstructive sleep apnea in the upper airways of patients.
文摘Purpose: To measure the upper airway changes associated with maxillary distraction osteogenesis in cleft lip and palate patients in the immediate post operative period and 12 months later. Materials and Methods: Seven patients with repaired cleft lip and palate (CLP) presented with severe maxillary hypoplasia. They were examined initially at T1 predistraction phase. Records taken included radiographs (orthopantograms OPG, lateral cephalometric, posteroanterior). Cephalometric analysis was done to evaluate the upper airway. Mean age is 17 years and the reverse overjet > 6 mm. They underwent maxillary Le Fort I distraction using external rigid distracters (RED). Cephalometric analysis to evaluate the upper airway was repeated at the end of the consolidation phase T2 and twelve months after distractor removal T3. Results: The range of maxillary advancement was between 8 - 15 mm (mean 9 mm). The anteroposterior distance of the superior velopharynx (PPS) and middle velopharynx (SPPS) increased at T2. A small amount of reduction in these values was recorded at T3. The inferior velopharynx (MPS) and the oropharynx (IPS, EPS) showed minimum increase in anteroposterior distance in only two patients at T2 and no change at T3. Conclusion: All seven patients showed clinical improvement in the upper airway and an increase in the upper airway values on lateral cephalometric radiographs.
文摘The wide availability, low radiation dose and short acquisition time of Cone-Beam CT (CBCT) scans make them an attractive source of data for compiling databases of anatomical structures. However CBCT has higher noise and lower contrast than helical slice CT, which makes segmentation more challenging and the optimal methods are not yet known. This paper evaluates several methods of segmenting airway geometries (nares, nasal cavities and pharynx) from typical dental quality head and neck CBCT data. The nasal cavity has narrow and intricate passages and is separated from the paranasal sinuses by thin walls, making it is susceptible to either over- or under-segmentation. The upper airway was split into two: the nasal cavity and the pharyngeal region (nasopharynx to larynx). Each part was segmented using global thresholding, multi-step level-set, and region competition methods (the latter using thresholding, clustering and classification initialisation and edge attraction techniques). The segmented 3D surfaces were evaluated against a reference manual segmentation using distance-, overlap- and volume-based metrics. Global thresholding, multi-step level-set, and region competition all gave satisfactory results for the lower part of the airway (nasopharynx to larynx). Edge attraction failed completely. A semi-automatic region-growing segmentation with multi-thresholding (or classification) initialization offered the best quality segmentation. With some minimal manual editing, it resulted in an accurate upper airway model, as judged by the similarity and volumetric indices, while being the least time consuming of the semi-automatic methods, and relying the least on the operator’s expertise.
文摘Upper airway cough syndrome refers to a clinical syndrome with chronic cough as the main manifestation caused by the reverse flow of secretions from various upper airway diseases such as allergic rhinitis,rhino-sinusitis,adenoid hypertrophy and other parts of the nose and pharynx.Professor Yin Dan believes that the main disease of upper airway cough syndrome is due to cold fluid retained in lung,blood stasis endogenous,compound feeling of wind evil.The pathogenesis is external wind evil and the hidden pathogen together to cause the disease.In the treatment,the warm cold fluid retention is the core,accompanied by the activation of blood and wind,so that the wind evil can go away,the cold evil can be warmed,the phlegm can be removed,and the blood stasis can be dispersed,so as to achieve the purpose of treating the upper airway cough syndrome of the children’s cold fluid retention in lung.
文摘Tuberculosis is a potentially serious infectious disease. In otorhinolaryngology practice, lymph node infection is the most common site of predilection followed by the larynx. Laryngeal tuberculosis (LTB) typically presents with dysphagia, odynophagia and hoarseness. We reported a case of primary LTB presenting with acute upper airway obstruction and respiratory distress mimicking acute supraglottitis which requires emergency tracheostomy. Therefore, in acute upper airway obstruction, the appropriate initial investigation should be done to rule out TB to make sure early treatment can be given and it may prevent complications of disease to the patient. .
基金This research was funded by Defiance Brands Inc,Nashville,TN,USA.
文摘Racehorses in training are in situations of repeated stress that may have effects on hydration and health.It was hypothesized that daily consumption of a structured water(SW)product for 4 weeks will result in improved hydration,improved upper airway health and increased heart rate variability.Two groups of Thoroughbred racehorses matched for physiological,training and racing attributes were studied for 4 weeks.One group(n=17)received 10 L(about 15%)of their daily water as SW(followed by ad libitum filtered deep well water)and the control group(n=15)only filtered deep well water.Blood samples and bioelectrical impedance analysis(BIA)measures were obtained at baseline,2 and 4 weeks.Hydration was assessed using BIA.The upper airway was assessed by nasopharyngeal endoscopy at baseline and weekly within 60 minutes of breezing.On weekly breeze days heart rate was recorded at rest,during exercise and recovery and data were analysed for heart rate variability.Compared to controls,horses drinking SW showed increased hydration improved upper airway health post-breezing and increased heart rate variability.It is concluded that drinking 10 L daily of SW increased hydration and may have conferred some wellness benefits.
