Three-dimensional Assessment of Swallowing Organs Using Cone-Beam CT

Shape and Development of the Epiglottis

Abstract

Objectives: The epiglottis plays a main role in swallowing reflex action. Swallowing and respiration naturally cooperate, and the epiglottis automatically works as a cover of the trachea. The epiglottis controls swallowing and respiration, while asphyxia and aspiration may be produced by abnormal actions of the epiglottis. The aim of this article is to describe the three-dimensional shape and development of the epiglottis using cone-beam CT (CBCT).
Subjects and Methods: Hellmann dental age was used as a representative developmental index, and categorized into stages from IIC to IVA. Each stage had ten boys and ten girls. For a total of, fifty boys and fifty girls, one hundred children, (mean age: 10 y 6 m) were examined. They had individually normal occlusion, and had not under gone any orthodontic treatment. Their epiglottis did not touch their inner wall of the pharynx, and their epiglottic vallecula were open in the relaxed position. The width, depth, thickness and length of the epiglottis were measured using CBCT, and the development of the epiglottis was examined and analyzed.
Results: The width and length of the epiglottis significantly increased from stages IIC to IVA of Hellmann dental age, the depth, however, did not significantly change during these periods. The thickness of the epiglottis also moderately increased from IIC to IVA.
Conclusion: CBCT was a useful piece of equipment for analysis of the epiglottis. The development pattern of the epiglottis was examined during the period from the stage IIC to IVA of Hellmann dental age. The width and length of the epiglottis did significantly increased, while the depth of the epiglottis did not significantly change during these periods. The depth of the epiglottis might increase before IIC. These results indicate that the depth of the epiglottis developed ahead of the width and length.