Upper Airway Measurements During Inspiration and Expiration in Infants

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Abstract
Accurate measurements of the upper airway of the infant are important but are difficult to obtain reliably because of the normal variation that occurs during respiration. X-ray films of the lateral upper airway were obtained during inspiration and expiration in healthy infants, by using as a timing device a respiration monitor which was wired to the x-ray machine and was attached to the abdominal wall of the infant. Cephalometric measurements were made of 44 "normal" full-term neonates and 29 infants at 6 weeks of age. Despite significant differences in head circumference between the sexes, only the nasion to sella length was significantly longer in the boys (P < .01). The lateral upper airway measurements were independent of weight, head circumference, and sex in neonates and infants at 6 weeks of age but were significantly smaller during inspiration than expiration (P < .01). The measurements progressively increased from the middle to the posterior airway space at both ages. The middle airway space behind the caudal end of the hard palate was smaller during inspiration at 6 weeks of age compared to the neonate (P < .01). During expiration, the posterior airway space was larger at 6 weeks compared to the neonate (P < .01). The method described in this report enables reliable roentgenographic measurements to be made of the upper airway of the infant; normal values for the changes during inspiration and expiration are provided. This may assist in the evaluation of infants with suspected upper airway obstruction.