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Abstract：
Accurate and reproducible measurements of the pediatric airway are critical for diagnostic evaluation and management of subglottic and tracheal stenosis. The endoluminal functional lumen imaging probe (EndoFLIP) is a catheter-based imaging probe which utilizes impedance planimetry to calculate luminal parameters, including cross-sectional area and compliance. Herein, we demonstrate the feasibility of this system for multidimensional evaluation of the pediatric airway.
3D-printed pediatric laryngotracheal models were created based on computed tomography scans, then artificially deformed to simulate both circumferential and posterior subglottic stenosis. Two observers made six measurements of the minimum cross-sectional area (MCSA) and length of stenosis of each model with EndoFLIP. Agreement between observer measurements and model dimensions was evaluated using Lin\'s concordance correlation coefficient; inter-observer reliability was assessed using intraclass correlation.
Four models were created: two without pathology (MCSA: 132.4, 44.3 mm2 ) and two with subglottic stenosis (MCSA: 28.7, 59.7 mm2 , stenotic length 27.8, 24.4 mm). Observer measurements of MCSA and length of stenosis demonstrated high concordance with the models (r = 0.99, 0.95, p < 0.001) with a mean error of 4.5% and 18.2% respectively. There was a low coefficient of variation (0.6%-2.8%) for measurements, indicating high precision. Interrater reliability was high for both MCSA and stenotic length (ICC: 0.99, 0.98).
The EndoFLIP system allows for accurate and reproducible measurements of cross-sectional area and stenotic length in pediatric airway models. This method may provide further advantages in the evaluation of airway distensibility, as well as measurements of asymmetric airway pathology.
NA Laryngoscope, 134:108-112, 2024.
3D-printed pediatric laryngotracheal models were created based on computed tomography scans, then artificially deformed to simulate both circumferential and posterior subglottic stenosis. Two observers made six measurements of the minimum cross-sectional area (MCSA) and length of stenosis of each model with EndoFLIP. Agreement between observer measurements and model dimensions was evaluated using Lin\'s concordance correlation coefficient; inter-observer reliability was assessed using intraclass correlation.
Four models were created: two without pathology (MCSA: 132.4, 44.3 mm2 ) and two with subglottic stenosis (MCSA: 28.7, 59.7 mm2 , stenotic length 27.8, 24.4 mm). Observer measurements of MCSA and length of stenosis demonstrated high concordance with the models (r = 0.99, 0.95, p < 0.001) with a mean error of 4.5% and 18.2% respectively. There was a low coefficient of variation (0.6%-2.8%) for measurements, indicating high precision. Interrater reliability was high for both MCSA and stenotic length (ICC: 0.99, 0.98).
The EndoFLIP system allows for accurate and reproducible measurements of cross-sectional area and stenotic length in pediatric airway models. This method may provide further advantages in the evaluation of airway distensibility, as well as measurements of asymmetric airway pathology.
NA Laryngoscope, 134:108-112, 2024.
摘要：
目的：小儿气道的准确和可重复测量对于声门下和气管狭窄的诊断评估和治疗至关重要。腔内功能性管腔成像探头（EndoFLIP）是一种基于导管的成像探头，利用阻抗平面法计算管腔参数，包括横截面积和合规性。在这里，我们证明了该系统用于儿科气道多维评估的可行性.
方法：基于计算机断层扫描创建3D打印的小儿喉气管模型，然后人工变形以模拟环状和后部声门下狭窄。两名观察者使用EndoFLIP对每个模型的最小横截面积（MCSA）和狭窄长度进行了六次测量。使用Lin的一致性相关系数评估观察者测量值与模型尺寸之间的一致性；使用组内相关性评估观察者间的可靠性。
结果：创建了四个模型：两个无病理（MCSA：132.4，44.3mm2）和两个声门下狭窄（MCSA：28.7，59.7mm2，狭窄长度27.8，24.4毫米）。MCSA和狭窄长度的观察者测量显示与模型高度一致（r=0.99，0.95，p<0.001），平均误差分别为4.5％和18.2％。测量的变异系数低(0.6%-2.8%)，指示精度高。MCSA和狭窄长度（ICC：0.99，0.98）的评分者间可靠性很高。
结论：EndoFLIP系统可以准确且可重复地测量小儿气道模型的横截面积和狭窄长度。该方法可以在评估气道扩张性方面提供进一步的优势。以及不对称气道病理的测量。
方法：N/A喉镜，2023年。
方法：基于计算机断层扫描创建3D打印的小儿喉气管模型，然后人工变形以模拟环状和后部声门下狭窄。两名观察者使用EndoFLIP对每个模型的最小横截面积（MCSA）和狭窄长度进行了六次测量。使用Lin的一致性相关系数评估观察者测量值与模型尺寸之间的一致性；使用组内相关性评估观察者间的可靠性。
结果：创建了四个模型：两个无病理（MCSA：132.4，44.3mm2）和两个声门下狭窄（MCSA：28.7，59.7mm2，狭窄长度27.8，24.4毫米）。MCSA和狭窄长度的观察者测量显示与模型高度一致（r=0.99，0.95，p<0.001），平均误差分别为4.5％和18.2％。测量的变异系数低(0.6%-2.8%)，指示精度高。MCSA和狭窄长度（ICC：0.99，0.98）的评分者间可靠性很高。
结论：EndoFLIP系统可以准确且可重复地测量小儿气道模型的横截面积和狭窄长度。该方法可以在评估气道扩张性方面提供进一步的优势。以及不对称气道病理的测量。
方法：N/A喉镜，2023年。
