The effect of rapid maxillary expansion on pharyngeal airway pressure during inspiration evaluated using computational fluid dynamics
The effect of rapid maxillary expansion on pharyngeal airway pressure during inspiration evaluated using computational fluid dynamics
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DOI：
10.1016/j.ijporl.2014.05.004
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发表时间：
2014-08-01
影响因子：
1.5
通讯作者：
Yamasaki, Youichi
中科院分区：
文献类型：
--
作者：
Iwasaki, Tomonori;Takemoto, Yoshihiko;Yamasaki, Youichi
简介：最近的证据表明，快速上颌扩张（RME）是治疗上颌收缩儿童阻塞性睡眠呼吸暂停综合征（OSAS）的有效方法。尽管如此，RME 对吸气时咽部气道压力的影响尚不清楚。这项回顾性研究的目的是利用计算流体动力学评估 RME 在通气条件下引起的变化。 方法：25 名需要 RME 的受试者（14 名男孩，11 名女孩；平均年龄 9.7 岁）在 RME 之前和之后拍摄了锥形束计算机断层扫描 (CBCT) 图像。 CBCT 数据用于重建鼻和咽部气道的 3 维形状。使用计算流体动力学模拟气流压力的测量，以计算呼气期间的鼻阻力。该值用于评估吸气时咽部气道最大负压。结果：RME后鼻阻力为0.137 Pa/(cm(3)/s)，明显低于RME前0.496 Pa/(cm(3)/s)，并且RME后吸气时咽部气道最大负压(-48.66 Pa)比RME前(-124.96)小。 Pa).结论：吸气时咽部气道压力随着RME鼻阻力的降低而降低。这一机制可能有助于缓解儿童 OSAS。 (C) 2014 Elsevier Ireland Ltd. 保留所有权利。
Introduction: Recent evidence suggests that rapid maxillary expansion (RME) is an effective treatment of obstructive sleep apnea syndrome (OSAS) in children with maxillary constriction. Nonetheless, the effect of RME on pharyngeal airway pressure during inspiration is not clear. The purpose of this retrospective study was to evaluate changes induced by the RME in ventilation conditions using computational fluid dynamics.Methods: Twenty-five subjects (14 boys, 11 girls; mean age 9.7 years) who required RME had cone-beam computed tomography (CBCT) images taken before and after the RME. The CBCT data were used to reconstruct 3-dimensional shapes of nasal and pharyngeal airways. Measurement of airflow pressure was simulated using computational fluid dynamics for calculating nasal resistance during exhalation. This value was used to assess maximal negative pressure in the pharyngeal airway during inspiration.Results: Nasal resistance after RME, 0.137 Pa/(cm(3)/s), was significantly lower than that before RME, 0.496 Pa/(cm(3)/s), and the maximal negative pressure in the pharyngeal airway during inspiration was smaller after RME (-48.66 Pa) than before (-124.96 Pa).Conclusion: Pharyngeal airway pressure during inspiration is decreased with the reduction of nasal resistance by the RME. This mechanism may contribute to the alleviation of OSAS in children. (C) 2014 Elsevier Ireland Ltd. All rights reserved.