Relationship Between Nostril, Nasal Valve and Minimal Cross-Sectional Area in Functional Upper Airway

Abstract

Purpose: To propose a three-dimensional cephalometric analysis of upper airway (UA) related to its functionality, defining normal reference values in healthy individuals and the relationship between nostril, nasal valve, and minimal cross-sectional area (MCS) in functional upper airway. Materials and Methods: The UAs of 20 Class I patients were analyzed with CBCT using Nemoceph 3D-OS and HOROS software, determining linear distances, volumes and cross-sectional areas, including MCS. Results: MCS was mostly located in the middle-upper oropharynx and high hypopharynx. MCS showed moderate correlation with the area of both nares (BNA) (r = 0.60, P = 0.004) and high correlation with the area of both internal nasal valves (BNV) (r = 0.66, P = 0.0016). BNA and BNV showed a moderate correlation (r = 0.445, P = 0.049). A total upper airway (TUA) and functional upper airway (FUA) volumes were established. TUA and FUA showed the strongest statistical correlation (r = 0.82, P = 0.00). A paired samples t test compared the measurement as absolute values of MCS with BNA (t = 0.781, P = 0.44), with BNV (t = -0.12, P = 0.90); and BNA with BNV (t = -0.76, P = 0.45), showed no significant differences. Conclusions: A functional cephalometric analysis of the UA with stable parameters in cervical spine and normal reference values has been proposed. BNA and BNV could be used as reference to establish the MCS compatible with respiratory health.