Evaluation of the effect of oral appliance treatment on upper-airway ventilation conditions in obstructive sleep apnea using computational fluid dynamics
Evaluation of the effect of oral appliance treatment on upper-airway ventilation conditions in obstructive sleep apnea using computational fluid dynamics
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DOI：
10.1080/08869634.2019.1596554
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发表时间：
2019-04-02
影响因子：
1.6
通讯作者：
Yamasaki, Youichi
中科院分区：
文献类型：
--
作者：
Suga, Hokuto;Iwasaki, Tomonori;Yamasaki, Youichi
目的：目的：应用计算流体力学（CFD）技术评价口腔矫治器（oral appliance，OA）治疗对阻塞性睡眠呼吸暂停（obstructive sleep apnea，OSA）患者上气道通气状况的影响。利用CT数据重建鼻、咽气道的三维模型。结果：OA治疗后，呼吸暂停低通气指数（AHI）从23.1次/h提高到10.1次/h。在CFD分析中，气流速度在腭后和会厌尖水平降低，而气道压力在腭后、悬雍垂和会厌尖水平降低。OA治疗前OSA患者的AHI与会厌尖水平的气道压力相关。讨论：OA治疗改善了咽部气道的通气条件和AHI。气道压力和气流速度的CFD分析结果分别有助于确定OSA的严重程度和阻塞性病变部位。
Objective: To evaluate the effect of oral appliance (OA) treatment on upper-airway ventilation conditions in patients with obstructive sleep apnea (OSA) using computational fluid dynamics (CFD).Methods: Fifteen patients received OA treatment and underwent polysomnography (PSG) and computed tomography (CT). CT data were used to reconstruct three-dimensional models of nasal and pharyngeal airways. Airflow velocity and airway pressure measurements at inspiration were simulated using CFD.Results: The apnea-hypopnea index (AHI) improved from 23.1 to 10.1 events/h after OA treatment. On CFD analysis, airflow velocity decreased at the retropalatal and epiglottis-tip levels, while airway pressure decreased at the retropalatal, uvular- and epiglottis-tip levels. The AHI of patients with OSA before OA treatment was correlated with airway pressure at the epiglottis-tip level.Discussion: Treatment with OA improved the ventilation conditions of the pharyngeal airway and AHI. Results of CFD analysis of airway pressure and airflow velocity helped determine the severity and ventilatory impairment site of OSA, respectively.