Quantitative Measurement of Throat and Larynx After Endotracheal Intubation for Palatoplasty

INTRODUCTION: Quantitative morphometric measurements of living human upper airway remain challenging. This study aimed to introduce a special laser projection device that can facilitate computer-assisted, digitalized analysis and provide important information on airway mucosa change, before and after endotracheal intubation for palatoplasty. MATERIALS AND METHODS: The laryngeal images were captured before and after surgery. Image processing techniques were used to quantize the post-operative laryngeal variation, with its distinct color space and texture features. Meanwhile, the maximum length of the vocal fold, vocal width at the midpoint, maximum cross-sectional area of the glottic space, maximum cross-sectional area of the oropharyngeal inlet (CSAOI) and the depth of the retropalatal space were determined and calculated. These parameters were analyzed and compared before and after surgery. RESULTS: A total of 39 subjects were enrolled in this study. The color space and texture analysis all show trends toward higher measures in post-operative images than in pre-operative images, especially in the interarytenoid region. Furthermore, the glottic area showed a significant decrease of 31.2%, while the vocal width showed a significant increase after intubation. The post-operative retropalatal depth and CSAOI were significantly deeper and larger than the baseline, reaching their peak in the 4th week after the surgery, and then slightly reduced in the 12th week. CONCLUSION: For the first time we present a series of changes in upper airway after surgery, by using a laser module with quantitative measurement. Our equipment and processing can measure subtle mucosal changes that would allow a clinician to diagnose post-operative airway inflammation in a simpler and less invasive way. Here additional information collected by different imaging modalities would help to solve multiple current unmet needs in post-operative airway inflammation.