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Degraeve M, Beij T, Lammens I, Vagenende T, De Meyer M, Aps J, Jacquet W. A systematic review on 4D images of the upper airway in patients with OSA. Sleep Breath 2024; 28:597-606. [PMID: 38127191 DOI: 10.1007/s11325-023-02948-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 10/19/2023] [Accepted: 10/30/2023] [Indexed: 12/23/2023]
Abstract
AIM-BACKGROUND In the treatment of obstructive sleep apnoea (OSA), oral appliances are now being recognized as a valuable alternative to continuous positive airway pressure (CPAP). Various static imaging techniques of the upper airways allow for assessment of bone and soft tissue structures. However, static images do not capture dynamic airway characteristics. The aim of this paper was to review 4D imaging techniques in patients with OSA. METHODS PubMed/MEDLINE, Web of Science and Embase were systematically searched for studies published before June 2022. The review was compliant with the PRISMA guidelines. The quality of each eligible study was critically evaluated by all four authors independently. Four unique articles with qualitative analyses were retrieved. All included studies had a clear objective/aim, an appropriate endpoint and sufficiently described eligibility criteria. RESULTS With dynamic imaging (4D) evaluation of the upper airway, the incidence of upper airway collapsibility due to use of a mandibular advancement device (MAD) was reduced, extraluminal tissue pressure was decreased and the space in the upper airway was increased, notably in the retropalatal and retroglossal areas of the airway. These findings suggest that MADs may be effective for OSA regardless of whether or not the obstruction site is in the velopharynx or oropharynx. However, further investigation of dynamic changes in the upper airway is required to explain the efficacy of OSA treatment and the underlying mechanisms.
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Affiliation(s)
- Michiel Degraeve
- Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium.
- Department of Oral and Maxillofacial Surgery, University Hospitals Ghent, Ghent, Belgium.
| | - Tessa Beij
- Department of Oral and Maxillofacial Surgery, RadboudUMC, Nijmegen, The Netherlands
| | - Inés Lammens
- Faculty of Medicine and Health Sciences, Ghent University Hospital, Ghent, Belgium
| | - Tim Vagenende
- Department of Oral and Maxillofacial Surgery, Jan Palfijn General Hospital, Ghent, Belgium
| | - Miche De Meyer
- Department of Adult Educational Sciences EDWE-LOCI, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Dentistry, Radboud University Medical Center and Radboud Institute for Health Sciences, Nijmegen, the Netherlands
- Department of Oral Health Sciences ORHE, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
| | - Johan Aps
- Department of Dentistry, Groningen University Medical Center, Groningen, the Netherlands
- OpiniDent BV, Marke, Belgium
| | - Wolfgang Jacquet
- Department of Adult Educational Sciences EDWE-LOCI, Faculty of Psychology and Educational Sciences, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Oral Health Sciences ORHE, Faculty of Medicine and Pharmacy, Vrije Universiteit Brussel, Brussels, Belgium
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Wen XL, Wu BZ, Li Y, Yi B, Peng X. Analysis of the aerodynamic characteristics of the upper airway in obstructive sleep apnea patients. J Dent Sci 2024; 19:329-337. [PMID: 38303889 PMCID: PMC10829548 DOI: 10.1016/j.jds.2023.03.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/15/2023] [Indexed: 02/03/2024] Open
Abstract
Background/purpose This study was designed to explore upper airway aerodynamic characteristics in individuals diagnosed with obstructive sleep apnea (OSA) and to evaluate correlations between these characteristics and other anatomical upper airway findings in these patients. Materials and methods This was a retrospective study of 40 OSA patients (22 male, 18 female) who were stratified into groups with mild, moderate, and severe disease based upon overnight polysomnographic (PSG) recording results. Newtom5G cone-beam CT scans (CBCT) were conducted for all patients, and the resultant images were used to reconstruct three-dimensional images of the upper airways which were used to calculate aerodynamic characteristics. Differences in these characteristics between groups were evaluated with one-way ANOVAs, while relationships between anatomical and aerodynamic characteristics were assessed through Pearson correlation analyses. Results The aerodynamic of the upper airway has typical characteristic in severe group. There was a significant negative correlation in severe group between resistance during inspiration (Rin) and volume (V) (r = -0.693, P = 0.013), minimum axial area (MMA) (r = -0.685, P = 0.014), and lateral dimension (LAT) (r = -0.724, P = 0.008), resistance during expiration (Rex) and LAT (r = -0.923, P < 0.001). Conclusion This study showed that airway resistance during inspiration and expiration are most closely associated with upper airway collapse in OSA patients, with repetitive collapse occurring during both of these breathing processes. LAT may be an important anatomical factor associated with OSA pathogenesis and treatment.
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Affiliation(s)
- Xing-Long Wen
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Bin-Zhang Wu
- First Clinical Division, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Yang Li
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Biao Yi
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
| | - Xin Peng
- Department of Oral and Maxillofacial Surgery, Peking University School and Hospital of Stomatology & National Center for Stomatology & National Clinical Research Center for Oral Diseases & National Engineering Research Center of Oral Biomaterials and Digital Medical Devices, Beijing, PR China
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Wang X, Jia L, Xu X, Guo J. The relationship between aerodynamic characteristics of the upper airway and severity of obstructive sleep apnea in adults. Cranio 2023:1-8. [PMID: 37980603 DOI: 10.1080/08869634.2023.2278958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
OBJECTIVE To investigate the relationship between aerodynamic characteristics of the upper airway and severity of obstructive sleep apnea (OSA) in adults. METHODS Ninety-seven adult OSA patients underwent polysomnography and cone beam computed tomography (CBCT). The anatomical and aerodynamic characteristics were measured based on CBCT images and computational fluid dynamics modelling of the upper airway. RESULTS After controlling for patients' gender, age, and body mass index (BMI), the maximum velocity during inspiration (In-Vmax) led to the largest increase in the explanatory power of apnea-hypopnea index (AHI) variation. The In-Vmax was closely correlated with the minimum axial area, and their relationship was represented by an inversely proportional fitted curve. CONCLUSIONS The In-Vmax was the most relevant to OSA severity, and it could be used to assist in recognizing severe OSA patients and as a primary variable to evaluate treatment outcomes of OSA. The In-Vmax was closely related to the most constricted area of the upper airway.
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Affiliation(s)
- Xiaoya Wang
- Department of Stomatology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, China
| | - Lu Jia
- Department of Orthodontics, Jinan Stomatological Hospital, Jinan, China
| | - Xin Xu
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
| | - Jing Guo
- Engineering Laboratory for Biomaterials and Tissue Regeneration, Ningbo Stomatology Hospital, Zhejiang, China
- Savaid Stomatology School, Hangzhou Medical College, Hangzhou, Zhejiang, China
- Savaid medical institute for stomatology and ENT, Ningbo, China
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Research Center of Dental Materials and Oral Tissue Regeneration & Shandong Provincial Clinical Research Center for Oral Diseases, Jinan, China
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Jin S, Han H, Huang Z, Xiang Y, Du M, Hua F, Guan X, Liu J, Chen F, He H. Automatic three-dimensional nasal and pharyngeal airway subregions identification via Vision Transformer. J Dent 2023; 136:104595. [PMID: 37343616 DOI: 10.1016/j.jdent.2023.104595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/06/2023] [Accepted: 06/19/2023] [Indexed: 06/23/2023] Open
Abstract
OBJECTIVES Upper airway assessment requires a fully-automated segmentation system for complete or sub-regional identification. This study aimed to develop a novel Deep Learning (DL) model for accurate segmentation of the upper airway and achieve entire and subregional identification. METHODS Fifty cone-beam computed tomography (CBCT) scans, including 24,502 slices, were labelled as the ground truth by one orthodontist and two otorhinolaryngologists. A novel model, a lightweight multitask network based on the Swin Transformer and U-Net, was built for automatic segmentation of the entire upper airway and subregions. Segmentation performance was evaluated using Precision, Recall, Dice similarity coefficient (DSC) and Intersection over union (IoU). The clinical implications of the precision errors were quantitatively analysed, and comparisons between the AI model and Dolphin software were conducted. RESULTS Our model achieved good performance with a precision of 85.88-94.25%, recall of 93.74-98.44%, DSC of 90.95-96.29%, IoU of 83.68-92.85% in the overall and subregions of three-dimensional (3D) upper airway, and a precision of 91.22-97.51%, recall of 90.70-97.62%, DSC of 90.92-97.55%, and IoU of 83.41-95.29% in the subregions of two-dimensional (2D) crosssections. Discrepancies in volume and area caused by precision errors did not affect clinical outcomes. Both our AI model and the Dolphin software provided clinically acceptable consistency for pharyngeal airway assessments. CONCLUSION The novel DL model not only achieved segmentation of the entire upper airway, including the nasal cavity and subregion identification, but also performed exceptionally well, making it well suited for 3D upper airway assessment from the nasal cavity to the hypopharynx, especially for intricate structures. CLINICAL SIGNIFICANCE This system provides insights into the aetiology, risk, severity, treatment effect, and prognosis of dentoskeletal deformities and obstructive sleep apnea. It achieves rapid assessment of the entire upper airway and its subregions, making airway management-an integral part of orthodontic treatment, orthognathic surgery, and ENT surgery-easier.
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Affiliation(s)
- Suhan Jin
- Department of Orthodontics, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University,Wuhan, China; Department of Orthodontics, Affiliated Stomatological Hospital of Zunyi Medical University, Zunyi, China
| | - Haojie Han
- College of Computer Science and Technology, Nanjing University of Aeronautics and Astronautics, MIIT Key Laboratory of Pattern Analysis and Machine Intelligence, Nanjing, China
| | - Zhiqun Huang
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Yuandi Xiang
- Department of Otolaryngology-Head and Neck Surgery, Renmin Hospital of Wuhan University, Wuhan, China
| | - Mingyuan Du
- Department of Orthodontics, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University,Wuhan, China
| | - Fang Hua
- Department of Orthodontics, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University,Wuhan, China
| | - Xiaoyan Guan
- Department of Orthodontics, Affiliated Stomatological Hospital of Zunyi Medical University, Zunyi, China
| | - Jianguo Liu
- School of Stomatology, Zunyi Medical University, Zunyi, China; Special Key Laboratory of Oral Diseases Research, Higher Education Institution, Zunyi, China
| | - Fang Chen
- College of Computer Science and Technology, Nanjing University of Aeronautics and Astronautics, MIIT Key Laboratory of Pattern Analysis and Machine Intelligence, Nanjing, China.
| | - Hong He
- Department of Orthodontics, Hubei-MOST KLOS & KLOBM, School & Hospital of Stomatology, Wuhan University,Wuhan, China.
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Tang H, Cui X, Li H, Zheng F, Chen Y, Jiang J. Effects of vertical control on anatomic and aerodynamic characteristics of the oropharyngeal airway during premolar extraction treatment of Class II hyperdivergent nonsevere crowding malocclusion. Am J Orthod Dentofacial Orthop 2023:S0889-5406(23)00256-1. [PMID: 37245126 DOI: 10.1016/j.ajodo.2023.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 05/01/2023] [Accepted: 05/01/2023] [Indexed: 05/29/2023]
Abstract
INTRODUCTION This study aimed to analyze the effects of premolar extraction treatment with vertical control on changes in the anatomy and aerodynamics of the oropharynx in Class II hyperdivergent malocclusion with nonsevere crowding. METHODS Thirty-nine patients with Class II hyperdivergent malocclusion were enrolled consecutively. All the participants underwent 4 premolar extractions. The high-pull J-hook and mini-implants were used to provide vertical control. Cone-beam computed tomography was performed before and after treatment. The participants were divided into a decreased lower vertical facial height group (n = 23) and an increased lower vertical facial height group (n = 16) on the basis of superimposition. The aerodynamic characteristics, including airway resistance (inspiration, Rin; expiration, Rex) and maximum velocity (inspiration, Vmaxin; expiration, Vmaxex) at inspiration and expiration, were calculated using computational fluid dynamics. Anatomic characteristics, including volume and cross-sectional area (CSAmin), were measured using the Dolphin Imaging software (Dolphin Imaging and Management Solutions, Chatsworth, Calif). RESULTS After treatment, the median volume and CSAmin increased by 2357 mm3 and 43 mm2, respectively, and median Rin and Vmaxex decreased by 0.15 Pa/L/min and 0.24 m×s-1, respectively, in decreased lower vertical facial height group. In contrast, the median CSAmin decreased by 9.5 mm2 in the increased lower vertical facial height group. All the changes were statistically significant (all P <0.05). Significant differences in volume, CSAmin, Rin, and Vmaxex were observed between the 2 groups. CONCLUSIONS Vertical control might improve the anatomic and aerodynamic characteristics of the oropharyngeal airway during premolar extraction treatment of Class II hyperdivergent malocclusion with nonsevere crowding.
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Affiliation(s)
- Hongyi Tang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Xinyu Cui
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Huazhi Li
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Fu Zheng
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Youchao Chen
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China
| | - Jiuhui Jiang
- Department of Orthodontics, Peking University School and Hospital of Stomatology, Beijing, China.
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Gurgel ML, Junior CC, Cevidanes LHS, de Barros Silva PG, Carvalho FSR, Kurita LM, Cunha TCA, Dal Fabbro C, Costa FWG. Methodological parameters for upper airway assessment by cone-beam computed tomography in adults with obstructive sleep apnea: a systematic review of the literature and meta-analysis. Sleep Breath 2023; 27:1-30. [PMID: 35190957 PMCID: PMC9392812 DOI: 10.1007/s11325-022-02582-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 01/28/2022] [Accepted: 02/03/2022] [Indexed: 01/11/2023]
Abstract
BACKGROUND A reliable method for analyzing the upper airway (UA) remains a challenge. This study aimed to report the methods for UA assessment using cone-beam computed tomography (CBCT) in adults with obstructive sleep apnea (OSA). METHODS We performed a systematic review (PROSPERO #CRD42021237490 and PRISMA checklist) that applied a search strategy to seven databases and grey literature. RESULTS In 29 studies with moderate-to-high risk of bias, investigators mostly reported the body position during CBCT (upright or supine) and hard tissue references, diverging in UA delimitation and terminologies. The meta-analysis showed two subgroups (upright and supine), and no statistical differences were identified (p = 0.18) considering the UA area. The volume in the OSA group was smaller than that in the control group (p < 0.003 and Cohen's d = - 0.81) in the upright position. Patients with OSA showed smaller anteroposterior dimensions than the control group and were not affected by the position during image acquisition (p = 0.02; Cohen's d = - 0.52). The lateral measurements were also lower in the OSA group (supine) (p = 0.002; Cohen's d = - 0.6). CONCLUSIONS Patients with OSA showed smaller UA measurements in the upright (volume) and supine (lateral dimension) positions. The anteroposterior dimension was also reduced in patients with OSA compared to the control group, regardless of the position during CBCT acquisition.
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Affiliation(s)
- Marcela Lima Gurgel
- Department of Dental Clinic, School of Dentistry, Federal University of Ceará, 1273 Monsenhor Furtado St, Fortaleza, CE, Brazil
| | - Cauby Chaves Junior
- Department of Dental Clinic, School of Dentistry, Federal University of Ceará, 1273 Monsenhor Furtado St, Fortaleza, CE, Brazil.
| | | | | | | | - Lúcio Mitsuo Kurita
- Department of Dental Clinic, School of Dentistry, Federal University of Ceará, 1273 Monsenhor Furtado St, Fortaleza, CE, Brazil
| | | | - Cibele Dal Fabbro
- Faculty of Dental Medicine, Center for Advance Research in Sleep Medicine & Stomatology, Universite de Montreal & CIUSSS Nord Ile de Montreal, CHUM, Montreal, QC, Canada
| | - Fabio Wildson Gurgel Costa
- Department of Dental Clinic, School of Dentistry, Federal University of Ceará, 1273 Monsenhor Furtado St, Fortaleza, CE, Brazil
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Chen Y, Feng X, Shi X, Cai W, Li B, Zhao Y. Evaluation of computational fluid dynamics models for predicting pediatric upper airway airflow characteristics. Med Biol Eng Comput 2023; 61:259-270. [PMID: 36369608 DOI: 10.1007/s11517-022-02715-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 11/03/2022] [Indexed: 11/13/2022]
Abstract
Computational fluid dynamics (CFD) has the potential for use as a clinical tool to predict the aerodynamics and respiratory function in the upper airway (UA) of children; however, careful selection of validated computational models is necessary. This study constructed a 3D model of the pediatric UA based on cone beam computed tomography (CBCT) imaging. The pediatric UA was 3D printed for pressure and velocity experiments, which were used as reference standards to validate the CFD simulation models. Static wall pressure and velocity distribution inside of the UA under inhale airflow rates from 0 to 266.67 mL/s were studied by CFD simulations based on the large eddy simulation (LES) model and four Reynolds-averaged Navier-Stokes (RANS) models. Our results showed that the LES performed best for pressure prediction; however, it was much more time-consuming than the four RANS models. Among the RANS models, the Low Reynolds number (LRN) SST k-ω model had the best overall performance at a series of airflow rates. Central flow velocity determined by particle image velocimetry was 3.617 m/s, while velocities predicted by the LES, LRN SST k-ω, and k-ω models were 3.681, 3.532, and 3.439 m/s, respectively. All models predicted jet flow in the oropharynx. These results suggest that the above CFD models have acceptable accuracy for predicting pediatric UA aerodynamics and that the LRN SST k-ω model has the most potential for clinical application in pediatric respiratory studies.
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Affiliation(s)
- Yicheng Chen
- School of Energy Science and Engineering, Harbin Institute of Technology, Harbin, China
| | - Xin Feng
- Department of Clinical Dentistry, Section for Oral and Maxillofacial Radiology, University of Bergen, Bergen, Norway.,Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Xieqi Shi
- Department of Clinical Dentistry, Section for Oral and Maxillofacial Radiology, University of Bergen, Bergen, Norway.,Department of Oral Maxillofacial Radiology, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Weihua Cai
- School of Energy Science and Engineering, Harbin Institute of Technology, Harbin, China. .,School of Energy and Power Engineering, Northeast Electric Power University, Jilin City, China.
| | - Biao Li
- School of Energy Science and Engineering, Harbin Institute of Technology, Harbin, China.
| | - Yijun Zhao
- School of Energy Science and Engineering, Harbin Institute of Technology, Harbin, China
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de Bataille C, Bernard D, Dumoncel J, Vaysse F, Cussat-Blanc S, Telmon N, Maret D, Monsarrat P. Machine Learning Analysis of the Anatomical Parameters of the Upper Airway Morphology: A Retrospective Study from Cone-Beam CT Examinations in a French Population. J Clin Med 2022; 12:84. [PMID: 36614885 PMCID: PMC9820916 DOI: 10.3390/jcm12010084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Revised: 12/12/2022] [Accepted: 12/12/2022] [Indexed: 12/24/2022] Open
Abstract
The objective of this study is to assess, using cone-beam CT (CBCT) examinations, the correlation between hard and soft anatomical parameters and their impact on the characteristics of the upper airway using symbolic regression as a machine learning strategy. Methods: On each CBCT, the upper airway was segmented, and 24 anatomical landmarks were positioned to obtain six angles and 19 distances. Some anatomical landmarks were related to soft tissues and others were related to hard tissues. To explore which variables were the most influential to explain the morphology of the upper airway, principal component and symbolic regression analyses were conducted. Results: In total, 60 CBCT were analyzed from subjects with a mean age of 39.5 ± 13.5 years. The intra-observer reproducibility for each variable was between good and excellent. The horizontal soft palate measure mostly contributed to the reduction of the airway volume and minimal section area with a variable importance of around 50%. The tongue and the position of the hyoid bone were also linked to the upper airway morphology. For hard anatomical structures, the anteroposterior position of the mandible and the maxilla had some influence. Conclusions: Although the volume of the airway is not accessible on all CBCT scans performed by dental practitioners, this study demonstrates that a small number of anatomical elements may be markers of the reduction of the upper airway with, potentially, an increased risk of obstructive sleep apnea. This could help the dentist refer the patient to a suitable physician.
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Affiliation(s)
- Caroline de Bataille
- Laboratoire Centre d’Anthropobiologie et de Génomique de Toulouse, Université Paul Sabatier, 31073 Toulouse, France
- School of Dental Medicine and CHU de Toulouse—Toulouse Institute of Oral Medicine and Science, 31062 Toulouse, France
| | - David Bernard
- Institute of Research in Informatics (IRIT) of Toulouse, CNRS—UMR5505, 31062 Toulouse, France
- RESTORE Research Center, Department of Oral Medicine, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, Toulouse University Hospital (CHU), Batiment INCERE, 4bis Avenue Hubert Curien, 31100 Toulouse, France
| | - Jean Dumoncel
- Laboratoire Centre d’Anthropobiologie et de Génomique de Toulouse, Université Paul Sabatier, 31073 Toulouse, France
| | - Frédéric Vaysse
- Laboratoire Centre d’Anthropobiologie et de Génomique de Toulouse, Université Paul Sabatier, 31073 Toulouse, France
- School of Dental Medicine and CHU de Toulouse—Toulouse Institute of Oral Medicine and Science, 31062 Toulouse, France
| | - Sylvain Cussat-Blanc
- Institute of Research in Informatics (IRIT) of Toulouse, CNRS—UMR5505, 31062 Toulouse, France
- Artificial and Natural Intelligence Toulouse Institute ANITI, 31013 Toulouse, France
| | - Norbert Telmon
- Laboratoire Centre d’Anthropobiologie et de Génomique de Toulouse, Université Paul Sabatier, 31073 Toulouse, France
- Service de Médecine Légale, Centre Hospitalier Universitaire Rangueil, Avenue du Professeur Jean Poulhès, CEDEX 9, 31059 Toulouse, France
| | - Delphine Maret
- Laboratoire Centre d’Anthropobiologie et de Génomique de Toulouse, Université Paul Sabatier, 31073 Toulouse, France
- School of Dental Medicine and CHU de Toulouse—Toulouse Institute of Oral Medicine and Science, 31062 Toulouse, France
| | - Paul Monsarrat
- School of Dental Medicine and CHU de Toulouse—Toulouse Institute of Oral Medicine and Science, 31062 Toulouse, France
- RESTORE Research Center, Department of Oral Medicine, Université de Toulouse, INSERM, CNRS, EFS, ENVT, Université P. Sabatier, Toulouse University Hospital (CHU), Batiment INCERE, 4bis Avenue Hubert Curien, 31100 Toulouse, France
- Artificial and Natural Intelligence Toulouse Institute ANITI, 31013 Toulouse, France
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Chen H, Elham E, Li Y, Ge S, Schmittbuhl M, Lavigne G, van der Stelt PF, Huynh N. Comparison of anatomic and aerodynamic characteristics of the upper airway among edentulous mild, moderate, and severe obstructive sleep apnea in older adults. J Clin Sleep Med 2022; 18:759-768. [PMID: 34636319 PMCID: PMC8883080 DOI: 10.5664/jcsm.9716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
STUDY OBJECTIVES First, to compare the upper airway's anatomic and aerodynamic characteristics of the edentulous older adults who experience mild, moderate, and severe obstructive sleep apnea (OSA). Second, to examine the correlation between the severity of OSA and the anatomic and aerodynamic characteristic(s) of the upper airway in these edentulous individuals. METHODS NewTom5G cone beam computed tomography scans of 58 edentulous individuals with mild, moderate, and severe OSA were included in this analysis. 1) Computational models of the upper airway were reconstructed based on cone beam computed tomography images and the anatomical and aerodynamic characteristics of the upper airway were examined by an observer blind to OSA severity. 2) Pearson correlation analysis was used to determine the correlation between apnea-hypopnea index and the anatomic and aerodynamic characteristics of the upper airway. RESULTS Compared with edentulous patients with mild and moderate OSA, those with severe OSA have a more hourglass-shaped upper airway. The severity of OSA, namely, apnea-hypopnea index, was significantly correlated with the length, shape, and minimum cross-sectional area of the upper airway. During inspiration, the mean velocity of the airflow within the upper airway of the edentulous patients with severe OSA was higher than that of patients with mild and moderate OSA. During both inspiration and expiration, apnea-hypopnea index was found to be significantly correlated with maximum velocity (P = .05) and airway resistance (P = .024, 0.038). CONCLUSIONS The edentulous patients with severe OSA have a more hourglass-shaped upper airway. The findings also suggest that, during inspiration, the airflow travels faster in edentulous patients with severe OSA than in those with mild or moderate OSA. CLINICAL TRIAL REGISTRATION Registry: ClinicalTrials.gov; Name: The Effect of Nocturnal Wear of Dentures on Sleep and Oral Health Related Quality of Life; URL: https://clinicaltrials.gov/ct2/show/NCT01868295; Identifier: NCT01868295. CITATION Chen H, Elham E, Li Y, et al. Comparison of anatomic and aerodynamic characteristics of the upper airway among edentulous mild, moderate, and severe obstructive sleep apnea in older adults. J Clin Sleep Med. 2022;18(3):759-768.
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Affiliation(s)
- Hui Chen
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University and Shandong Key Laboratory of Oral Tissue Regeneration and Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Shandong, China,Faculty of Dental Medicine, University of Montreal, Montreal, Quebec, Canada,Address correspondence to: Hui Chen, PhD, No. 44-1 Wenhua Road West, 250012, Jinan, Shandong, China; ; and Shaohua Ge, PhD, No. 44-1 Wenhua Road West, 250012, Jinan, Shandong, China;
| | - Emami Elham
- Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Yingguang Li
- Kunshan Industrial Technology Research Institute Co., Ltd., Kunshan, China
| | - Shaohua Ge
- Department of Periodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University and Shandong Key Laboratory of Oral Tissue Regeneration and Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Shandong, China,Address correspondence to: Hui Chen, PhD, No. 44-1 Wenhua Road West, 250012, Jinan, Shandong, China; ; and Shaohua Ge, PhD, No. 44-1 Wenhua Road West, 250012, Jinan, Shandong, China;
| | | | - Gilles Lavigne
- Faculty of Dental Medicine, University of Montreal, Montreal, Quebec, Canada
| | | | - Nelly Huynh
- Faculty of Dental Medicine, University of Montreal, Montreal, Quebec, Canada
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10
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Feng X, Chen Y, Cai W, Lie SA, Hellén-Halme K, Shi XQ. Aerodynamic characteristics in upper airways among orthodontic patients and its association with adenoid nasopharyngeal ratios in lateral cephalograms. BMC Med Imaging 2021; 21:127. [PMID: 34425762 PMCID: PMC8381502 DOI: 10.1186/s12880-021-00659-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 08/15/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adenoid hypertrophy among orthodontic patients may be detected in lateral cephalograms. The study investigates the aerodynamic characteristics within the upper airway (UA) by means of computational fluid dynamics (CFD) simulation. Furthermore, airflow features are compared between subgroups according to the adenoidal nasopharyngeal (AN) ratios. METHODS This retrospective study included thirty-five patients aged 9-15 years having both lateral cephalogram and cone beam computed tomography (CBCT) imaging that covered the UA region. The cases were divided into two subgroups according to the AN ratios measured on the lateral cephalograms: Group 1 with an AN ratio < 0.6 and Group 2 with an AN ratio ≥ 0.6. Based on the CBCT images, segmented UA models were created and the aerodynamic characteristics at inspiration and expiration were simulated by the CFD method for the two groups. The studied aerodynamic parameters were pressure drop (ΔP), maximum midsagittal velocity (Vms), maximum wall shear stress (Pws), and minimum wall static pressure (Pw). RESULTS The maximum Vms exhibits nearly 30% increases in Group 2 at both inspiration (p = 0.013) and expiration (p = 0.045) compared to Group 1. For the other aerodynamic parameters such as ΔP, the maximum Pws, and minimum Pw, no significant difference is found between the two groups. CONCLUSIONS The maximum Vms seems to be the most sensitive aerodynamic parameter for the groups of cases. An AN ratio of more than 0.6 measured on a lateral cephalogram may associate with a noticeably increased maximum Vms, which could assist clinicians in estimating the airflow features in the UA.
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Affiliation(s)
- Xin Feng
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway
| | - Yicheng Chen
- School of Energy Science and Engineering, Harbin Institute of Technology, Xi Da Zhi Street, Nangang, Harbin, 150001, People's Republic of China
| | - Weihua Cai
- School of Energy and Power Engineering, Northeast Electric Power University, Changchun Road 169, Changchun, 132012, People's Republic of China
| | - Stein Atle Lie
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway
| | - Kristina Hellén-Halme
- Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, 205 06, Malmö, Sweden
| | - Xie-Qi Shi
- Department of Clinical Dentistry, Faculty of Medicine, University of Bergen, Årstadveien 19, 5009, Bergen, Norway. .,Department of Oral and Maxillofacial Radiology, Faculty of Odontology, Malmö University, 205 06, Malmö, Sweden.
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11
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Wang X, Chen H, Jia L, Xu X, Guo J. The relationship between three-dimensional craniofacial and upper airway anatomical variables and severity of obstructive sleep apnoea in adults. Eur J Orthod 2021; 44:78-85. [PMID: 34268561 DOI: 10.1093/ejo/cjab014] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate the relationship between three-dimensional craniofacial and upper airway anatomical variables and severity of obstructive sleep apnoea (OSA) using cone beam computed tomography (CBCT). METHODS This was a prospective observational study, consisted of 95 adult OSA whose polysomnography and CBCT were available. Three-dimensional craniofacial and upper airway anatomical analysis were performed using 12 CBCT variables, including sagittal and vertical jaw relationships, maxillary width, the volume, length and minimum axial area of upper airway. The severity of OSA was evaluated through the apnea-hypopnea index (AHI). A hierarchical regression was performed to analyze the relationship between OSA severity and craniofacial and upper airway anatomical variables after controlling patients' demographic characteristics (gender, age, and BMI). RESULTS After controlling patients' gender, age, and BMI, individual CBCT variables including MAA, V-RPA, L-RPA and Go-Me were related to AHI. The final hierarchical regression model with demographic variables in Step 1 and CBCT variables (MAA, L-RPA and Go-Me) in Step 2 indicated that CBCT variables added additional explanatory power for AHI (ΔF(3,88) = 5.176, P = 0.002). Among these variables, L-RPA and Go-Me were statistically significant (P < 0.05). LIMITATION The OSA severity was expressed by AHI alone. CONCLUSIONS Three-dimensional craniofacial and upper airway morphology played an essential role in OSA severity. The most relevant anatomical characteristic with OSA severity were the length of retropalatal airway and mandibular body, which could be used to recognize severe OSA patients and as estimators for selecting the most appropriate treatment modality for OSA patients.
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Affiliation(s)
- Xiaoya Wang
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China.,Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Hui Chen
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Lu Jia
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Xin Xu
- Department of Implantology, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
| | - Jing Guo
- Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China
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12
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Maret D, Vergnes JN, Peters OA, Peters C, Nasr K, Monsarrat P. Recent Advances in Cone-beam CT in Oral Medicine. Curr Med Imaging 2021; 16:553-564. [PMID: 32484089 DOI: 10.2174/1573405615666190114152003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2018] [Revised: 12/09/2018] [Accepted: 12/19/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND The cone-beam computed tomography (CBCT) technology has continuously evolved since its appearance in oral medicine in the early 2000s. OBJECTIVES To present recent advances in CBCT in oral medicine: i) selection of recent and consensual evidence-based sources, ii) structured summary of the information based on an iterative framework and iii) compliance with ethical, public health and patient-centered concerns. MAIN FINDINGS We will focus on technological advances, such as sensors and reconstruction algorithms used to improve the constant quality of the image and dosimetry. CBCT examination is now performed in almost all disciplines of oral medicine: currently, the main clinical disciplines that use CBCT acquisitions are endodontics and oral surgery, with clearly defined indications. Periodontology and ear, nose and throat medicine are more recent fields of application. For a given application and indication, the smallest possible field of view must be used. One of the major challenges in contemporary healthcare is ensuring that technological developments do not take precedence over admitted standards of care. The entire volume should be reviewed in full, with a systematic approach. All findings are noted in the patient's record and explained to the patient, including incidental findings. This presupposes the person reviewing the images is sufficiently trained to interpret such images, inform the patient and organize the clinical pathway, with referrals to other medical or oral medicine specialties as needed. CONCLUSION A close collaboration between dentists, medical physicists, radiologists, radiographers and engineers is critical for all aspects of CBCT technology.
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Affiliation(s)
- Delphine Maret
- Oral Rehabilitation Department, Dental Faculty, Paul Sabatier University, Toulouse University Hospital (CHU de Toulouse), Toulouse, France.,AMIS Laboratory - Laboratoire Anthropologie Moléculaire et Imagerie de Synthèse, Université de Toulouse, UMR 5288 CNRS, UPS, Toulouse, France
| | - Jean-Noel Vergnes
- Epidemiology and Public Health Department, Dental Faculty, Paul Sabatier University, Toulouse University Hospital (CHU de Toulouse), Toulouse, France.,Division of Oral Health and Society, Faculty of Dentistry, McGill University, Montreal, Quebec, Canada
| | - Ove A Peters
- Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California, United States.,School of Dentistry, University of Queensland, Brisbane, Queensland, Australia
| | - Christine Peters
- Department of Endodontics, Arthur A. Dugoni School of Dentistry, University of the Pacific, San Francisco, California, United States
| | - Karim Nasr
- Oral Rehabilitation Department, Dental Faculty, Paul Sabatier University, Toulouse University Hospital (CHU de Toulouse), Toulouse, France
| | - Paul Monsarrat
- Oral Rehabilitation Department, Dental Faculty, Paul Sabatier University, Toulouse University Hospital (CHU de Toulouse), Toulouse, France.,STROMALab, Université de Toulouse, CNRS ERL 5311, EFS, ENVT, Inserm U1031, UPS, Toulouse, France
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13
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Arnold M, Burgmann S, Bonitz L, Pugachev A, Janoske U. Experimental study on the influence of model variations on the airway occlusion of an obstructive sleep apnea patient. J Biomech 2021; 123:110529. [PMID: 34062349 DOI: 10.1016/j.jbiomech.2021.110529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 05/07/2021] [Accepted: 05/10/2021] [Indexed: 10/21/2022]
Abstract
This study deals with the analysis of model parameters to mimic the airway collapse of an obstructive sleep apnea patient during nasal breathing. Different material properties and geometry variations of a patient-specific airway model are analyzed in detail. The patient-specific airway geometry is obtained from MRI data. A completely rigid model is compared to two partly elastic variations with different elasticities. Furthermore, the influence of the nasal cavities and the treatment effect of a mandibular protrusion are studied. Rigid model parts are 3D-printed and elastic parts cast from silicone. The models are analyzed under the impact of a transient airflow which is realized through a computer controlled piston pump. The results suggest, that, for moderate deformations, the elasticity of the soft tissue replicate influences rather the level of the pressure drop inside the airway than the shape of the pressure curve. The same suggestion can be made for the influence of the nasal cavities. Often, the spatial location of the minimum pressure is taken as the collapse site of the airway geometry. This study demonstrates, that the spatial locations of the minimum pressure and the maximum deformation do not match. This reveals the importance of a coupled approach of soft tissue and airflow analysis in the search of the collapse site and therefore the best treatment option. A treatment effect of the mandibular protrusion can be anticipated with an accurate patient-specific airway model.
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Affiliation(s)
- M Arnold
- University of Wuppertal, School of Mechanical Engineering and Safety Engineering, Germany.
| | - S Burgmann
- University of Wuppertal, School of Mechanical Engineering and Safety Engineering, Germany
| | - L Bonitz
- Dortmund General Hospital, Germany
| | | | - U Janoske
- University of Wuppertal, School of Mechanical Engineering and Safety Engineering, Germany
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14
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The effect of rapid maxillary expansion on the upper airway's aerodynamic characteristics. BMC Oral Health 2021; 21:123. [PMID: 33731068 PMCID: PMC7968163 DOI: 10.1186/s12903-021-01488-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Accepted: 03/04/2021] [Indexed: 12/20/2022] Open
Abstract
Background The effect of rapid maxillary expansion (RME) on the upper airway (UA) has been studied earlier but without a consistent conclusion. This study aims to evaluate the outcome of RME on the UA function in terms of aerodynamic characteristics by applying a computational fluid dynamics (CFD) simulation. Methods This retrospective cohort study consists of seventeen cases with two consecutive CBCT scans obtained before (T0) and after (T1) RME. Patients were divided into two groups with respect to patency of the nasopharyngeal airway as expressed in the adenoidal nasopharyngeal ratio (AN): group 1 was comprised of patients with an AN ratio < 0.6 and group 2 encompassing those with an AN ratio ≥ 0.6. CFD simulation at inspiration and expiration were performed based on the three-dimensional (3D) models of the UA segmented from the CBCT images. The aerodynamic characteristics in terms of pressure drop (ΔP), maximum midsagittal velocity (Vms), and maximum wall shear stress (Pws) were compared by paired t-test and Wilcoxon test according to the normality test at T0 and T1. Results The aerodynamic characteristics in UA revealed no statistically significant difference after RME. The maximum Vms (m/s) decreased from 2.79 to 2.28 at expiration after RME (P = 0.057). Conclusion The aerodynamic characteristics were not significantly changed after RME. Further CFD studies with more cases are warranted.
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15
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Tang H, Liu P, Xu Q, Hou Y, Guo J. A comparative analysis of aerodynamic and anatomic characteristics of upper airway before and after mini-implant-assisted rapid maxillary expansion. Am J Orthod Dentofacial Orthop 2021; 159:e301-e310. [PMID: 33541787 DOI: 10.1016/j.ajodo.2020.12.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 11/01/2020] [Accepted: 12/01/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION The objective of this research was to observe changes in aerodynamics and anatomic characteristics of the upper airway after mini-implants assisted rapid maxillary expansion and to evaluate the correlation between the 2 changes of the upper airway in young adults. METHODS Thirty consecutive patients (mean age, 23.82 ± 3.90 years; median, 24.5 years; 9 males, 21 females) were involved. Cone-beam computed tomography was taken before activation and over 3 months. Three-dimensional models of the upper airway were reconstructed on the basis of cone-beam computed tomography. The anatomic characteristics of the upper airway, including volume, area, transverse, and sagittal diameter, were measured. The aerodynamic characteristics of the upper airway were calculated on the basis of 3-dimensional models using computational fluid dynamics. The correlation between the changes in aerodynamics and anatomic characteristics of the upper airway was explored. RESULTS The enlargements of the volume of the total pharynx, nasopharynx, and oropharynx were found (9.99%, 20.7%, and 8.84%, respectively). The minimum cross-sectional area increased significantly (13.6%). The airway resistance (R) and maximum velocity (Vmax) decreased significantly in both the inspiration and expiration phase (inspiration: R, -26.8%, Vmax, -15.7%; expiration: R, -24.7%, Vmax, -16.5%). The minimum wall shear stress reduced significantly only in the inspiration phase (-26.3%). The correlations between decreased R and increased volume and minimum cross-sectional area were observed. CONCLUSIONS Mini-implants assisted rapid maxillary expansion is an effective device for improving anatomic characteristics represented by the total volume of the upper airway and minimum cross-sectional area, which contributed to the respiratory function depending on the favorable changes of aerodynamic characteristics including resistance, velocity, and minimum wall shear stress.
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Affiliation(s)
- Hongyi Tang
- Department of Orthodontics, School and Hospital of Stomatology, Shandong University, Shandong Key Laboratory of Oral Tissue Regeneration, and Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Panpan Liu
- Department of Orthodontics, School and Hospital of Stomatology, Shandong University, Shandong Key Laboratory of Oral Tissue Regeneration, and Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Qiuping Xu
- Department of Orthodontics, School and Hospital of Stomatology, Shandong University, Shandong Key Laboratory of Oral Tissue Regeneration, and Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Yingyue Hou
- Department of Orthodontics, School and Hospital of Stomatology, Shandong University, Shandong Key Laboratory of Oral Tissue Regeneration, and Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China
| | - Jing Guo
- Department of Orthodontics, School and Hospital of Stomatology, Shandong University, Shandong Key Laboratory of Oral Tissue Regeneration, and Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, Shandong, China.
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16
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Pugachev A, Arnold M, Burgmann S, Janoske U, Bicsák Á, Abel D, Linssen J, Bonitz L. Application of patient-specific simulation workflow for obstructive sleep apnea diagnosis and treatment with a mandibular advancement device. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2020; 36:e3350. [PMID: 32412654 DOI: 10.1002/cnm.3350] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2019] [Revised: 04/21/2020] [Accepted: 05/09/2020] [Indexed: 06/11/2023]
Abstract
A computational fluid dynamics simulation workflow was developed to analyze the upper airway of patients with obstructive sleep apnea, which is a potentially serious sleep-related breathing disorder. A single characteristic parameter was introduced to assess the severity of sleep apnea on the basis of the numerical results. Additionally, a fluid-structure interaction simulation was applied to study in detail the behavior of compliant pharyngeal walls. An experimental setup was designed to validate the patient-specific upper airway modeling. The suitability of the characteristic parameter was demonstrated in a retrospective analysis of radiological and clinical data of 58 patients as well as a prospective analysis of 22 patients. The simulation workflow was successfully used as part of an ongoing clinical investigation to predict the outcome of the obstructive sleep apnea treatment with a mandibular advancement device. The simulation results provided essential information about the critical region in the pharynx for the selection of an appropriate treatment and readily demonstrated the effect of mandibular protrusion on the air flow in the upper airway.
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Affiliation(s)
| | - Marleen Arnold
- Chair of Fluid Mechanics, University of Wuppertal, Wuppertal, Germany
| | | | - Uwe Janoske
- Chair of Fluid Mechanics, University of Wuppertal, Wuppertal, Germany
| | - Ákos Bicsák
- Department of Oral and Maxillofacial Surgery, Dortmund General Hospital, Dortmund, Germany
| | - Dietmar Abel
- Department of Oral and Maxillofacial Surgery, Dortmund General Hospital, Dortmund, Germany
| | - Johannes Linssen
- Department of Oral and Maxillofacial Surgery, Dortmund General Hospital, Dortmund, Germany
| | - Lars Bonitz
- Department of Oral and Maxillofacial Surgery, Dortmund General Hospital, Dortmund, Germany
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17
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Modified Genioplasty Combined With Orthognathic Surgeries for the Treatment of Chin Defect Accompanying Micrognathia and Airway Stenosis. J Craniofac Surg 2019; 30:2486-2489. [DOI: 10.1097/scs.0000000000005859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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18
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Chen H, Aarab G, Lobbezoo F, De Lange J, Van der Stelt P, Darendeliler MA, Cistulli PA, Sutherland K, Dalci O. Differences in three-dimensional craniofacial anatomy between responders and non-responders to mandibular advancement splint treatment in obstructive sleep apnoea patients. Eur J Orthod 2019; 41:308-315. [DOI: 10.1093/ejo/cjy085] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- Hui Chen
- Department of Oral and Maxillofacial Radiology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
- Department of Orthodontics, School of Stomatology, Shandong University and Key Laboratory of Oral Biomedicine of Shandong, Jinan, China
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Ghizlane Aarab
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Frank Lobbezoo
- Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - Jan De Lange
- Department of Oral and Maxillofacial Surgery, Academic Medical Center (AMC), University of Amsterdam, Amsterdam, The Netherlands
| | - Paul Van der Stelt
- Department of Oral and Maxillofacial Radiology, Academic Centre for Dentistry Amsterdam, University of Amsterdam and Vrije Universiteit, Amsterdam, The Netherlands
| | - M Ali Darendeliler
- Discipline of Orthodontics, Faculty of Dentistry, University of Sydney, Sydney Dental Hospital, Sydney Local Health District, New South Wales, Australia
| | - Peter A Cistulli
- Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, and Charles Perkins Centre, School of Medicine, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Kate Sutherland
- Department of Respiratory and Sleep Medicine, Royal North Shore Hospital, and Charles Perkins Centre, School of Medicine, Faculty of Medicine and Health, University of Sydney, Sydney, Australia
| | - Oyku Dalci
- Discipline of Orthodontics, Faculty of Dentistry, University of Sydney, Sydney Dental Hospital, Sydney Local Health District, New South Wales, Australia
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