RESUMO Objetivo Comparar a geometria da cavidade nasal de crianças e adolescentes com fissura labiopalatina e deficiência maxilar por meio de dois métodos: a tomografia computadorizada de feixe cônico, considerada padrão-ouro, e a rinometria acústica. Método Foram avaliados, de maneira transversal, os exames de tomografia computadorizada de feixe cônico e de rinometria acústica, previamente obtidos para fins de planejamento ortodôntico, de 17 crianças e adolescentes com fissura labiopalatina e atresia maxilar. Por meio do programa Dolphin Imaging 11.8, a cavidade nasal das imagens tomográficas foi reconstruída por dois avaliadores e foram obtidos os volumes internos nasais. Por meio da rinometria, os volumes nasais foram aferidos para as regiões V1 e V2. Os valores de cada exame foram, então, comparados, a um nível de significância de 5%. Resultados A análise estatística mostrou alta reprodutibilidade intra e interavaliadores na análise da tomografia computadorizada de feixe cônico. Os volumes internos nasais médios (± desvio-padrão), utilizando a rinometria acústica e a tomografia computadorizada de feixe cônico corresponderam a 6,6 ± 1,9 cm3 e 8,1 ± 1,5 cm3, respectivamente. A diferença entre os exames foi de 17,7%, considerada estatisticamente significante (p = 0,006). Conclusão Os volumes nasais aferidos pelos dois métodos são diferentes, ou seja, apresentam discrepâncias nas medidas. A técnica considerada padrão-ouro identificou volumes maiores na cavidade nasal. A determinação de qual exame reflete a realidade clínica constitui passo futuro importante.

The increasing use of cone beam computed tomography (CBCT) has led to a growing demand for DICOM software that enables the assessment and measurement of craniofacial structures. This study aimed to compare the airway volume and the minimum axial area in patients with cleft lip and palate using five different imaging software programs: Dolphin3D, InVivo Dental, ITK Snap, InVesalius, and NemoFAB. Initially, 100 CBCT scans were selected by an examiner, and their corresponding DICOM files were collected. The oropharyngeal segments were delineated following the manufacturer’s guidelines, using two different segmentation techniques: interactive and fixed threshold. The results were analyzed using the Friedman test and Wilcoxon post hoc test, with a 5% significance level for all statistical tests. The findings for both the minimum axial area and total volume revealed that the median values across the software groups were higher than expected, and significant differences were observed when comparing the groups (p < 0.001). All five software programs showed notable differences in their outputs. Specifically, a statistically significant difference in volume was found across all groups, except between InVivo and ITK-Snap. It is recommended that pre- and post-treatment comparisons be performed using the same software for consistency.

Objectives: Characterize the upper airways (UAW) in individuals with syndromic craniosynostosis (SCS) using computed tomography scans and correlate with the airflow dynamics and craniofacial pattern. Design: Observational, cross-sectional study. Setting: Tertiary craniofacial center. Individuals: Twenty-nine individuals were included, divided in 2 groups: CON (n = 19; 21.2 ± 3.7 y), individuals with no craniofacial anomalies and no UAW morphological alterations, and SCS (n = 10; 22.1 ± 5.1 y) individuals with SCS prior to maxillomandibular surgery. Interventions: Volume (V, cm ³ ) and minimal cross-sectional area (mCSA, mm ² ) was calculated (Mimics, Belgium). Computational fluid dynamics (ANSYS, EUA) was performed and flow (F, L/min), pressure (P, Pa), and resistance (R, Pa/[L/min]) were calculated. Cephalometric analysis (SNA[ ^o ]), ANB[ ^o ], Ba-S-N[ ^o ]) was also assessed (Dolphin Imaging, USA). Main Outcome: The morphophysiology of the UAW in SCS individuals was severely impaired compared with the CON group. Results: The SCS group exhibited significant volumetric reduction in the total UAW (−29%), nasal cavity (−21%), and pharynx (−37%) compared with the CON group. The mCSA was 57% smaller in the SCS group. CFD simulations demonstrated decreased flow (−9%), increased pressure (136%), and resistance (156%) in the SCS group. UAW resistance presented a strong positive correlation with mCSA (CON: r = 0.77 / SCS: r = 0.88). Cephalometric findings revealed significant differences between CON and SCS, with the SCS group exhibiting values outside the normal range. Conclusion: The UAW of individuals with SCS was anatomically and functionally impaired, suggesting a significant risk for obstructive sleep apnea.