3D morphometric analysis of the epiglottis using CBCT: age and gender differences.

Abstract

Background: This study aimed to perform a comprehensive morphometric analysis of the epiglottis using cone-beam computed tomography (CBCT) images, including the determination of epiglottis dimensions, the investigation of shape variations, and the assessment of their relationship with gender and age.

Methods: A retrospective analysis was conducted on high-quality CBCT images from 100 patients, obtained using the NewTom 5G system. In CBCT images, epiglottis thicknesses (right, midline, left) and horizontal angle at three levels (suprahyoid, hyoid, infrahyoid) were measured in axial sections, while the length and vertical angle of epiglottis were measured in midsagittal view. Epiglottis shapes were identified through 3D visualization.

Results: The midline epiglottis thicknesses were 4.68 mm at the suprahyoid level, 5.51 mm at the hyoid level, and 6.80 mm at the infrahyoid levels. Epiglottis thicknesses and length were statistically significantly greater in males. Of the 100 patients, 51 had a normal curvature, 41 had a flat epiglottis, and 8 had an omega epiglottis. The omega-shaped epiglottis was significantly longer compared to both the flat and normal curvature types (p = 0.011). There was a positive correlation between age and epiglottis thicknesses at the suprahyoid level and horizontal angles at three levels.

Conclusions: This study visualizes epiglottis morphology and uncovers significant morphometric differences. Males exhibit greater epiglottis thickness and length compared to females, while the omega-shaped epiglottis is notably longer than other types. These findings underscore the need for further investigation into the clinical relevance of these morphometric differences, particularly in improving airway management and refining approaches to swallowing function.