Figure 4e. MR imaging findings related to placement of nasal trumpet to establish patent airway. (a) Sagittal off-midline T1-weighted SE image (400/minimal, 22-cm field of view, 4-mm section thickness with 1-mm gap, 256 x 192 matrix, two signals acquired) shows nasal trumpet (arrows) bypassing enlarged adenoids and glossoptosis in a 15-year old patient. Nasal trumpet passes inferior to level of the tongue. (b–e) Sagittal gradient-echo cine images (80° flip angle, 8200/3600, 12-mm section thickness, 128 images acquired) in 9-year-old girl with obstructive sleep apnea despite previous adenoidectomy show changes in dynamic motion of the airway. (b, c) Images obtained at two points during respiratory cycle with nasal trumpet (not visible) show difference in diameter of hypopharynx (arrows) to be minimal. (d, e) Images obtained at two points during respiratory cycle without nasal trumpet in place show marked differences in diameter of hypopharynx (arrows), with intermittent collapse.