Sufficient nasal airway size is crucial for normal nasal breathing pattern. With emerging evidence of how an altered breathing pattern affects craniofacial development and causes sleep-related breathing problems, the structure of the upper airway is of growing interest to researchers ( Santander, Sievers & Moser, 2016 Ucar & Uysal, 2012), among which nasal airway is a common site for obstruction ( Mohan et al., 2018). AS and MIMICS presented accurate volume calculations, while INVIVO 5 significantly overestimated the mockup of the nasal airway volume.ConclusionWith the aid of a 3D printing technique, the new algorithm AS was found to be a clinically reliable and accurate tool for the segmentation and reconstruction of the nasal airway space. The accuracy was reported as a percentage of the gold standard.ResultsThe intra-examiner reproducibility was high, and the inter-examiner reproducibility was clinically acceptable. AS, along with the software programs MIMICS 19.0 and INVIVO 5, was applied to calculate the inner volume of the models from the CBCT scan of the phantom. The water-equivalent method was used to calculate the inner volume as the gold standard, and the models were then embedded into a dry human skull as a phantom and subjected to CBCT. For accuracy testing, the CBCT data for pairs of nasal cavities were 3D printed to form hollow shell models. The intra- and inter-examiner reproducibility of the nasal airway volume was evaluated using paired t-tests and intraclass correlation coefficients. This study reports the reproducibility and accuracy of an algorithm, airway segmentor (AS), designed for nasal airway space analysis using a 3D printed anthropomorphic nasal airway model.MethodsTo test reproducibility, two examiners independently used AS to edit and segment 10 nasal airway CBCT scans. Previous work has shown that software programs can vary in accuracy and reproducibility outcomes of these measurements. A gold standard for these measures also is lacking. Processing cone beam computed tomography (CBCT) scans of this region is complicated, however, by the intricate anatomy of the sinuses compared to the simpler nasopharynx. BackgroundThree-dimensional (3D) modeling of the nasal airway space is becoming increasingly important for assessment in breathing disorders.

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