Thibault Coppens

Development of the nasal cavity during infancy: A restrospective CT imaging study

Dany Jaffuel, Nicolas Combes, Nicolas Molinari, Philippe Berdagué and Samir Jaber Pulmonary Disorders and Respiratory Sleep Disorders Unit, Polyclinic Saint-Privat, Boujan sur Libron, France. Cardiology Unit, Clinic Pasteur, Toulouse, France. Dept of Medical Information, Montpellier University Hospital, Montpellier, France. Cardiology Unit, Hospital Center, Béziers, France. Intensive Care Unit, Anaesthesia and Critical Care Dept B, Saint-Eloi Teaching Hospital, INSERM U1046, Montpellier 1 University, Montpellier, France.Body: Rationale: Upper airway and nasal airflow resistance are significant in infancy, due to the fact that infants are nasal breathers in early life, and that obstructive nasal diseases are frequent at this age. Nasal flow resistance is closely determined by anatomy, which rapidly changes with growth. The goal of this study was to assess standardized measurements of the nasal cavity dimensions in the first 2 years of life. Methods: 34 head CT scans of infants aged 4.13±4.08 months (range: 0.07 to 19.4, 17 male, 17 female) available in the Amiens University Hospital Dept. of Radiology database were retrospectively analyzed. Infants with craniofacial deformities were excluded. Images were 3D reconstructed, axially oriented and the nasal cavity was segmented by density thresholding from nares to vocal cords. Surface areas of the piriform and choanal apertures were automatically computed in the coronal plane, in standardized positions based on bony reference points. Results:Piriform surface area measured (mean±SD): 54.3±13.8 mm2 (range: 29.1 - 83.9), and was significantly correlated to age (R=0.59, p<0.001), and height (R=0.57, p<0.001). Choanal aperture surface area: 81.3±28.1 mm2 (range: 38.0 – 164.7), and was significantly correlated to age (R=0.74, p<10-6), and height (R=0.71, p<10-5). Conclusions: These data suggest that the nasal cavity anterior and posterior apertures grow rapidly during the first 2 years of life, and that their dimensions are closely correlated to age and height. Further investigation will focus on how the anatomic growth of the nasal cavity in early life affects airflow resistance.

Atélectasie du poumon droit : intérêt du Cough-Assist® ?

Resume Suite a une intubation prolongee, la capacite de toux peut etre alteree. Une toux efficace est indispensable a l’evacuation des secretions bronchiques. En cas de deficit de toux, l’encombrement peut entrainer des atelectasies sur bouchon muqueux. Nous avons observe l’efficacite du Cough-Assist® dans la levee d’une atelectasie du poumon droit. Il semble que cette technique soit interessante, tant par sa facilite d’application, aussi bien pour le patient que pour le therapeute, que par son efficacite. Niveau de preuve : non adapte