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AJNR Awards, New Junior Editors, and more. Read the latest AJNR updates

Research ArticlePediatric Neuroimaging

Infant Midnasal Stenosis: Reliability of Nasal Metrics

M.E. Graham, K.M. Loveridge, S.H. Pollard, K.R. Moore and J.R. Skirko
American Journal of Neuroradiology March 2019, 40 (3) 562-567; DOI: https://doi.org/10.3174/ajnr.A5980
M.E. Graham
aFrom the Department of Otolaryngology-Head and Neck Surgery, and Schulich School of Medicine and Dentistry (M.E.G.), Western University, London, Ontario, Canada
bLondon Health Sciences Center (M.E.G.), London, Ontario, Canada
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K.M. Loveridge
cDivision of Pediatric Otolaryngology–Head and Neck Surgery (K.M.L., S.H.P., J.R.S.), University of Utah and Primary Children's Hospital, Salt Lake City, Utah
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S.H. Pollard
cDivision of Pediatric Otolaryngology–Head and Neck Surgery (K.M.L., S.H.P., J.R.S.), University of Utah and Primary Children's Hospital, Salt Lake City, Utah
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K.R. Moore
dDepartment of Medical Imaging (K.R.M.), Primary Children's Hospital, Salt Lake City, Utah.
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J.R. Skirko
cDivision of Pediatric Otolaryngology–Head and Neck Surgery (K.M.L., S.H.P., J.R.S.), University of Utah and Primary Children's Hospital, Salt Lake City, Utah
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Article Figures & Data

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  • Fig 1.
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    Fig 1.

    Measurement landmarks. Axial scans (A) were measured from bony lateral nasal wall to bony lateral nasal wall at the level of the pyriform aperture (PA), the choana, and at points 50% and 75% posteriorly between these two landmarks. An additional measurement on axial scan was obtained between the medial pterygoid plates. On coronal views, measurements were obtained from bony lateral nasal wall to bony lateral nasal wall at the pyriform aperture (not shown), just posterior to the lacrimal duct (B), and at the last molar (C).

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    Fig 2.

    Mean nasal measurements. Measurements are given in millimeters. Asterisks indicate statistical significance (P < .001).

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    Fig 3.

    Trends seen in the nasal cavity of pyriform aperture stenosis (A), syndromic craniosynostosis (B), and bilateral choanal atresia (C). Note the more global narrowing in patients with PAS and SC versus a more posterior narrowing in patients with BCA. Although the pyriform aperture in patients with BCA appears narrower than that in controls (Fig 1A) visually, this difference is not statistically significant.

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    Fig 4.

    3D reconstructions of maxillofacial CT scans highlighting the pyriform aperture, in particular in patients with PAS (A), Apert syndrome (B), and PRS (C).

Tables

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  • Inter- and intrarater reliability

    Intrarater ReliabilityInterrater Reliability
    ICCSE95% CIICCSE95% CI
    Coronal
        PA0.970.010.960.990.970.010.950.99
        LD0.940.020.890.980.940.020.900.98
        LM0.880.040.790.960.950.020.920.98
    Axial
        PA0.970.010.950.990.960.010.940.99
        50%0.900.040.830.970.930.030.880.99
        75%0.870.050.780.960.930.030.860.99
        CA0.760.080.600.910.770.090.590.96
        Pty0.860.050.760.950.450.210.040.86
    • Note:—SE indicates standard error; CA, choana; Pty, pterygoid plate; PA, pyriform aperture.

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American Journal of Neuroradiology: 40 (3)
American Journal of Neuroradiology
Vol. 40, Issue 3
1 Mar 2019
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Cite this article
M.E. Graham, K.M. Loveridge, S.H. Pollard, K.R. Moore, J.R. Skirko
Infant Midnasal Stenosis: Reliability of Nasal Metrics
American Journal of Neuroradiology Mar 2019, 40 (3) 562-567; DOI: 10.3174/ajnr.A5980

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Infant Midnasal Stenosis: Reliability of Nasal Metrics
M.E. Graham, K.M. Loveridge, S.H. Pollard, K.R. Moore, J.R. Skirko
American Journal of Neuroradiology Mar 2019, 40 (3) 562-567; DOI: 10.3174/ajnr.A5980
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