Editor’s intro: A radiology report for your CBCT scans by BeamReaders can be a primary tool in assessment of multiple factors that contribute to airway issues. Read Dr. Zubad Newaz’s article about how this service can help to educate your patients, engage other treatment providers, and increase your confidence in your treatment planning.
Your BeamReaders radiology report will help you identify all anatomic features located between the external nasal valve and trachea that are contributing to an increase in airway resistance. This includes assessing the airway dimensions, the skeletal framework that bounds the airway, facial growth patterns and identifying airway encroachments.
Cone Beam CT has a role in the anatomic assessment of the airway and the structures that support the airway. BeamReaders’ team of Oral and Maxillofacial Radiologists focus on key anatomical areas and functional interrelationships when evaluating a CBCT scan for an airway focused radiology report. The following is a brief outline of the factors involved in accessing the influencers on a patient’s airway resistance.
Airway analysis in a CBCT involves mapping and measurement of the airway, including determining the most constricted area [MCA], volume and linear distances. The MCA can be an indication of the level of risk of SRBD and identified as a site of increased resistance. The airway analysis results can be influenced by the head, spine and tongue posture. This underlies the importance of having a defined patient setup protocol (for best practices see our short video)
The airway is framed by the skull base, cervical spine, jaws, nasal cavity and hyoid bone. The tongue, soft palate, turbinates, epiglottis and airway lumen have to fit within the skeletal framework. Contraction of the skeletal framework diminishes the potential space for the airway lumen.
Facial Growth Pattern:
Normal facial growth is characterized by a counterclockwise rotation of the mandible thus projecting menton and the skeletal attachments for the genioglossus and geniohyoid muscles anteriorly. A dolichofacial growth pattern rotates the mandible and menton in a clockwise direction. A clockwise rotation of the mandible allows the hyoid bone to descend and tongue to posterinferiorly reposition. A dolichofacial growth pattern is often associated with reduced condylar size and growth anomalies which can influence the airway.
The most common airway encroachments include hyperplasia of the lymphoid tissues; adenoids, lingual tonsils and lateral pharyngeal tonsils. Tongue, turbinate and soft palate sizes are assessed. The airway spaces are screened for benign and malignant neoplastic formations. The nasal fossae and paranasal sinuses are evaluated for inflammatory changes. The encroachment on the airway by any of these can significantly alter airway resistance.
A BeamReaders radiology report evaluates all of these anatomical areas and combines the various anatomic situations into a cohesive diagnostic impression. Allowing a BeamReaders radiologist virtually onto your team reduces liability, improves understanding of all the factors involved, and provides a great communication tool with the patient and others involved in the patient’s care.
The use of CBCT in your dental sleep practice should go far beyond just determining the MCA. A BeamReaders radiology report can be one of your primary tools to help in the assessment of the multiple factors that can contribute to airway resistance. The report provides a great platform to easily educate your patient, engage other treatment providers, increase your confidence in your treatment planning, and reduce liability associated with the large volume scan. These benefits will invariably help improve outcomes and efficiency, helping to grow the reputation and productivity of any dental sleep practice.
BeamReaders is a team of more than 50 Oral and Maxillofacial Radiologists working to help you succeed in your dental sleep practice. Submit your first case for free today by registering at www.BeamReaders.com and using the registration code: BRSLEEP
A radiology report is an important aspect of a detailed reading of your CBCT. Find out more about other technologies and their benefits to the dental practice by reading Glennine Varga’s article here.