Comparison of endoscopic versus 3D CT derived airway measurements.

Objectives/Hypothesis To understand: 1) how endoscopic airway measurements compare to three-dimensional (3D) CT derived measurements; 2) where each technique is potentially useful; and 3) where each has limitations. Study Design Compare airway diameters and cross-sectional areas from endoscopic images and CT derived 3D reconstructions. Methods Videobronchoscopy was performed and recorded on an adult-sized commercially available airway mannequin. At various levels, cross-sectional areas were measured from still video frames using a referent placed via the biopsy port. A 3D reconstruction was generated from a high resolution CT of the mannequin; planar sections were cut at similar cross-sectional levels; and cross-sectional areas were obtained. Results At three levels of mechanically generated tracheal stricture, the differences between the endoscopic measurement and CT-derived cross-sectional area were 1%, 0%, and 7% (1.8, 0.8, and 14 mm2). At the vocal folds, the difference was 9% (7.8 mm2). The tip of the epiglottis and width of the epiglottis differed by 27% and 10% (18.73 mm2, 0.40mm). The airway measurements at the base of tongue, minimal cross-sectional area of the pharynx, and choana differed by 26%, 36%, and 30% (101.40 mm2, 36.67 mm2, 122.71 mm2). Conclusions Endoscopy is an effective tool for obtaining airway measurements compared with 3D reconstructions derived from CT. Concordance is best in geometrically simple areas where the entire cross-section measured is visible within one field of view (trachea, round; vocal folds, triangular) versus geometrically complex areas that encompass more than one field of view (i.e. pharynx, choana). Level of Evidence N/A. Laryngoscope, 123:2136–2141, 2013