Evaluating philtrum-to-tragus distance as an external predictor of nasal passage dimensions: A computed tomography (CT) approach

Accurate quantification of nasopharyngeal temperature requires the placement of a flexible intranasal probe into the upper or mid-nasopharynx. Yet, without guidance from medical imaging, data shows that in practice less than half of nasopharyngeal temperature probes are optimally positioned. Still, previous studies have suggested that the distance between the philtrum (external nose) to tragus (external ear) provides a reliable predictor of internal nasal passage dimensions. However, previous attempts to verify the accuracy of this external proxy have returned equivocal results. Accordingly, this study employed measurements collected from CT scans of 11 living participants (4 female, 7 male) to assess associations between external philtrum-tragus length and internal lengths of the nasal cavity, nasopharynx, and total nasal passage (i.e., cavity + pharynx). Results show statistically significant correlations between philtrum-tragus length and internal measurements of nasal cavity (r=0.412, p=0.033) and total nasal passage (r=0.502, p=0.015) length. In contrast, no significant correlation was identified between philtrum-tragus length and nasopharynx length (r=0.110, p=0.320). Despite the small size of the study sample, these suggest that philtrum-tragus length can provide insights for estimating internal dimensions relating to the location of the end of nasal cavity (i.e., choanal aperture) and the posterior wall of nasopharynx. Thus, this external measurement may enhance the accuracy of intranasal probe placement, especially when medical imaging data (i.e., radiographs, CT, MRI) are not available for guidance. Accordingly, additional investigation into the applied utility of philtrum-tragus length with larger sample sizes appears warranted.