ASSESSMENT OF OROPHARYNGEAL DISTANCE IN CHILDREN USING MAGNETIC-RESONANCE-IMAGING

Rational determination of oral airway size in children must account fo r the oropharyngeal length. We used magnetic resonance imaging (MRI) t o measure the distance from the teeth/gums to the prevertebral pharyng eal space and created algorithms to predict this distance based on age , weight, and gender. After institutional review board approval, we re viewed 200 MRI head scans of children 0-17 yr old. Patient information , including midline distance from teeth/gums to prevertebral space (L1 ) and distance along a perpendicular line from L1 to the epiglottis ti p (L2), was recorded. Two groups (Group 1 (n = 100) training group, Gr oup 2 (n = 100) validation group) were then randomly selected from thi s sample. Predictive models created using Group 1 were tested using Gr oup 2 as the sample group. Oropharyngeal distance was related to age, weight, and gender. A prediction equation using all data was estimated to determine the final model: predicted L1 = 5.51 + 0.25 (age [years] ) -0.01 (age(2)) + 0.02(weight [kg]) + 0.12 (male). We report equation s to predict the oropharyngeal distance based on age, weight, and gend er in children. The oral airway size will be 1-2 an longer than these measurements to position the tooth/lip guard outside the lip. Variabil ity in the distance to the epiglottis must be considered when selectin g proper oral airway size for any child. This information will provide the foundation for a more rational determination of the proper oral a irway size for infants and children. Implications: Age, weight, and ge nder can be used to predict the length of the oropharynx in children a s determined by midline sagittal magnetic resonance image of the airwa y. Prediction of this length will lead to a more rational determinatio n of proper oral airway size for infants and children and, potentially , more effective airway management.