Abstract
OBJECTIVES: The objective of this study was to investigate the significance of segmental airway volume in developing a predictive model to guide the timing of postoperative extubation in patients with oral and maxillofacial space infections (OMSIs). METHODS: A retrospective cohort study was performed to analyse clinical data from 177 medical records, with a focus on key variables related to disease severity and treatment outcomes. The inclusion criteria of this study were as follows: adherence to the OMSI diagnostic criteria (local tissue inflammation characterized by erythema, oedema, hyperthermia and tenderness); compromised functions such as difficulties opening the mouth, swallowing, or breathing; the presence of purulent material confirmed by puncture or computed tomography (CT); and laboratory examinations indicating an underlying infection process. The data included age, sex, body mass index (BMI), blood test results, smoking history, history of alcohol abuse, the extent of mouth opening, the number of infected spaces, and the source of infection. DICOM files were imported into 3D Slicer for manual segmentation, followed by volume measurement of each segment. RESULTS: We observed statistically significant differences in age, neutrophil count, lymphocyte count, and C4 segment volume among patient subgroups stratified by extubation time. Regression analysis revealed that age and C4 segment volume were significantly correlated with extubation time. Additionally, the machine learning models yielded good evaluation metrics. CONCLUSION: Segmental airway volume shows promise as an indicator for predicting extubation time. Predictive models constructed using machine learning algorithms yield good predictive performance and may facilitate clinical decision-making.