When static meets dynamic: Comparing cone-beam computed tomography and acoustic reflection for upper airway analysis

•Correlation between cone-beam computed tomography (CBCT) and acoustic reflection methods was high.•No differences were found between methods when measuring anterior nasal volume.•No differences were found between methods when measuring nasal minimal cross-sectional area.•Pharyngeal volume and minimal cross-sectional area measurements were also similar.•CBCT is an accurate method for the measuring some parts of the upper airway.

IntroductionUpper airway measurement can be important for the diagnosis of breathing disorders. Acoustic reflection (AR) is an accepted tool for studying the airway. Our objective was to investigate the differences between cone-beam computed tomography (CBCT) and AR in calculating airway volumes and areas.MethodsSubjects with prescribed CBCT images as part of their records were also asked to have AR performed. A total of 59 subjects (mean age, 15 ± 3.8 years) had their upper airway (5 areas) measured from CBCT images, acoustic rhinometry, and acoustic pharyngometry. Volumes and minimal cross-sectional areas were extracted and compared with software.ResultsIntraclass correlation on 20 randomly selected subjects, remeasured 2 weeks apart, showed high reliability (r >0.77). Means of total nasal volume were significantly different between the 2 methods (P = 0.035), but anterior nasal volume and minimal cross-sectional area showed no differences (P = 0.532 and P = 0.066, respectively). Pharyngeal volume showed significant differences (P = 0.01) with high correlation (r = 0.755), whereas pharyngeal minimal cross-sectional area showed no differences (P = 0.109). The pharyngeal volume difference may not be considered clinically significant, since it is 758 mm3 for measurements showing means of 11,000 ± 4000 mm3.ConclusionsCBCT is an accurate method for measuring anterior nasal volume, nasal minimal cross-sectional area, pharyngeal volume, and pharyngeal minimal cross-sectional area.