Skip to main content
Erschienen in:

16.06.2021 | Original Article

Postoperative functional evaluation of obstructive sleep apnea syndrome by computational fluid dynamics

verfasst von: Tsutomu Nomura, Tomomi Horikoshi, Yuka Kitano, Masato Yamada, Kenji Kondo, Shigeru Kikuchi

Erschienen in: Indian Journal of Otolaryngology and Head & Neck Surgery | Sonderheft 3/2022

Einloggen, um Zugang zu erhalten

Abstract

The aim of this study is to evaluate the efficacy of uvulopalatopharyngoplasty and the corresponding postoperative airflow. Eleven patients diagnosed with obstructive sleep apnea syndrome who complained of snoring and apnea were enrolled in this study. Computational fluid dynamics (CFD) was implemented. CFD could be accomplished in nine cases. Airflow analysis was not possible in cases with a high respiratory event index (REI) score. Before surgery, stenosis was identified in the oropharynx and epiglottic area. And the airflow velocity and pressure were found to have significantly decreased in the oropharynx postoperatively, while in the epiglottic area, those data had increased postoperatively in some cases. The velocity and pressure of the oropharynx are related to REI score. From the CFD analysis, airflow analysis is important for evaluating the apnea state. It is suggested that the postoperative function can now be predicted preoperatively.
Literatur
1.
Zurück zum Zitat Jennum P, Riha RL (2009) Epidemiology of sleep apnoea/hypopnoea syndrome and sleep-disordered breathing. Eur Respir J 33:907–914CrossRef Jennum P, Riha RL (2009) Epidemiology of sleep apnoea/hypopnoea syndrome and sleep-disordered breathing. Eur Respir J 33:907–914CrossRef
2.
Zurück zum Zitat Pracharktam N, Nelson S, Hans MG et al (1996) Cephalometric assessment in obstructive sleep apnea. Am J Orthod Dentofac Orthop 109:410–419CrossRef Pracharktam N, Nelson S, Hans MG et al (1996) Cephalometric assessment in obstructive sleep apnea. Am J Orthod Dentofac Orthop 109:410–419CrossRef
3.
Zurück zum Zitat Kim SJ, Kim YS, Park JH et al (2012) Cephalometric predictors of therapeutic response to multilevel surgery in patients with obstructive sleep apnea. J Oral Maxillofac Surg 70:1404–1412CrossRef Kim SJ, Kim YS, Park JH et al (2012) Cephalometric predictors of therapeutic response to multilevel surgery in patients with obstructive sleep apnea. J Oral Maxillofac Surg 70:1404–1412CrossRef
4.
Zurück zum Zitat Susarla SM, Abramson ZR, Dodson TB et al (2010) Cephalometric measurement of upper airway length correlates with the presence and severity of obstructive sleep apnea. J Oral Maxillofac Surg 68:2846–2855CrossRef Susarla SM, Abramson ZR, Dodson TB et al (2010) Cephalometric measurement of upper airway length correlates with the presence and severity of obstructive sleep apnea. J Oral Maxillofac Surg 68:2846–2855CrossRef
5.
Zurück zum Zitat Sonsuwan N, Suchachaisri S, Chaloeykitti L (2011) The relationships between cephalometric parameters and severity of obstructive sleep apnea. Auris Nasus Larynx 38:83–87CrossRef Sonsuwan N, Suchachaisri S, Chaloeykitti L (2011) The relationships between cephalometric parameters and severity of obstructive sleep apnea. Auris Nasus Larynx 38:83–87CrossRef
6.
Zurück zum Zitat deBerry-Borowiecki B, Kukwa A, Blanks RH (1988) Cephalometric analysis for diagnosis and treatment of obstructive sleep apnea. Laryngoscope 98:226–234CrossRef deBerry-Borowiecki B, Kukwa A, Blanks RH (1988) Cephalometric analysis for diagnosis and treatment of obstructive sleep apnea. Laryngoscope 98:226–234CrossRef
7.
Zurück zum Zitat Nomura T, Takeuchi S, Takanami T et al (2016) Evaluation of the role of palatal tonsil hypertrophy in sleep apnea patients: -cephalometric analysis. Open J Stomatol 6:164–169CrossRef Nomura T, Takeuchi S, Takanami T et al (2016) Evaluation of the role of palatal tonsil hypertrophy in sleep apnea patients: -cephalometric analysis. Open J Stomatol 6:164–169CrossRef
8.
Zurück zum Zitat De Backer JW, Vanderveken OM, Vos WG et al (2007) Functional imaging using computational fluid dynamics to predict treatment success of mandibular advancement devices in sleep-disordered breathing. J Biomech 40:3708–3714CrossRef De Backer JW, Vanderveken OM, Vos WG et al (2007) Functional imaging using computational fluid dynamics to predict treatment success of mandibular advancement devices in sleep-disordered breathing. J Biomech 40:3708–3714CrossRef
9.
Zurück zum Zitat Patini R, Arrica M, Di Stasio E, Gallenzi P, Cordaro M (2016) The use of magnetic resonance imaging in the evaluation of upper airway structures in paediatric obstructive sleep apnoea syndrome: a systematic review and meta-analysis. Dentomaxillofac Radiol 45:20160136CrossRef Patini R, Arrica M, Di Stasio E, Gallenzi P, Cordaro M (2016) The use of magnetic resonance imaging in the evaluation of upper airway structures in paediatric obstructive sleep apnoea syndrome: a systematic review and meta-analysis. Dentomaxillofac Radiol 45:20160136CrossRef
10.
Zurück zum Zitat Nomura T, Ushio M, Kondo K et al (2015) Effects of nasal septum perforation repair surgery on three-dimensional airflow -an evaluation using computational fluid dynamics. Eur Arch Otorhinolaryngol 272:3327–3333CrossRef Nomura T, Ushio M, Kondo K et al (2015) Effects of nasal septum perforation repair surgery on three-dimensional airflow -an evaluation using computational fluid dynamics. Eur Arch Otorhinolaryngol 272:3327–3333CrossRef
11.
Zurück zum Zitat Mihaescu M, Murugappan S, Gutmark E et al (2008) Computational modeling of upper airway before and after adenotonsillectomy for obstructive sleep apnea. Laryngoscope 118:360–362CrossRef Mihaescu M, Murugappan S, Gutmark E et al (2008) Computational modeling of upper airway before and after adenotonsillectomy for obstructive sleep apnea. Laryngoscope 118:360–362CrossRef
12.
Zurück zum Zitat Luo H, Sin S, McDonough JM et al (2014) Computational fluid dynamics endpoints for assessment of adenotonsillectomy outcome in obese children with obstructive sleep apnea syndrome. J Biomech 18(47):2498–2503CrossRef Luo H, Sin S, McDonough JM et al (2014) Computational fluid dynamics endpoints for assessment of adenotonsillectomy outcome in obese children with obstructive sleep apnea syndrome. J Biomech 18(47):2498–2503CrossRef
14.
Zurück zum Zitat Nomura T, Nishijima H, Kondo K, Kikuchi S (2017) Functional Evaluation of Sleep Apnea Patients Using Computational Fluid Dynamics Nippon Jibiinkoka Gakkai Kaiho (Tokyo) 120:1073–1078 Nomura T, Nishijima H, Kondo K, Kikuchi S (2017) Functional Evaluation of Sleep Apnea Patients Using Computational Fluid Dynamics Nippon Jibiinkoka Gakkai Kaiho (Tokyo) 120:1073–1078
15.
Zurück zum Zitat Zhu L, Liu H, Fu Z, Yin J (2019) Computational fluid dynamics analysis of H-uvulopalatopharyngoplasty in obstructive sleep apnea syndrome. Am J Otolaryngol 40:197–204CrossRef Zhu L, Liu H, Fu Z, Yin J (2019) Computational fluid dynamics analysis of H-uvulopalatopharyngoplasty in obstructive sleep apnea syndrome. Am J Otolaryngol 40:197–204CrossRef
16.
Zurück zum Zitat Patil SP, Ayappa IA, Caples SM, Kimoff RJ, Patel SR, Harrod CG (2019) Treatment of adult obstructive sleep apnea with positive airway pressure: an american academy of sleep medicine clinical practice guideline. J Clin Sleep Med 15:335–343CrossRef Patil SP, Ayappa IA, Caples SM, Kimoff RJ, Patel SR, Harrod CG (2019) Treatment of adult obstructive sleep apnea with positive airway pressure: an american academy of sleep medicine clinical practice guideline. J Clin Sleep Med 15:335–343CrossRef
17.
Zurück zum Zitat Braga A, Carboni LH, Lago T, Kupper DS, Eckeli A, Valera FC (2013) Is uvulopalatopharyngoplasty still an option for the treatment of obstructive sleep apnea. Eur Arch Otorhinolaryngol 270: 549–54. Braga A, Carboni LH, Lago T, Kupper DS, Eckeli A, Valera FC (2013) Is uvulopalatopharyngoplasty still an option for the treatment of obstructive sleep apnea. Eur Arch Otorhinolaryngol 270: 549–54.
19.
Zurück zum Zitat Friedman M, Ibrahim H, Bass L (2002) Clinical staging for sleep-disordered breathing. Otolaryngol Head Neck Surg 127:13–21CrossRef Friedman M, Ibrahim H, Bass L (2002) Clinical staging for sleep-disordered breathing. Otolaryngol Head Neck Surg 127:13–21CrossRef
20.
Zurück zum Zitat Fujita S, Conway W, Zorick F, Roth T (1981) Surgical correction of anatomic abnormalities in obstructive sleep apnea syndrome: uvulopalatopharyngoplasty. Otolaryngol Head Neck Surg 89:923–934CrossRef Fujita S, Conway W, Zorick F, Roth T (1981) Surgical correction of anatomic abnormalities in obstructive sleep apnea syndrome: uvulopalatopharyngoplasty. Otolaryngol Head Neck Surg 89:923–934CrossRef
21.
Zurück zum Zitat Sher AE, Schechtman KB, Piccirillo JF (1996) The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome. Sleep 19:156–177CrossRef Sher AE, Schechtman KB, Piccirillo JF (1996) The efficacy of surgical modifications of the upper airway in adults with obstructive sleep apnea syndrome. Sleep 19:156–177CrossRef
22.
Zurück zum Zitat Ohisa N, Ogawa H, Irokawa T, Kurosawa H (2013) Gender differences in the aggravation of sleep disorder breathing in obstructive sleep apnea-hypopnea syndrome (OSAHS). Jpn J Med Technol 62:666–672 Ohisa N, Ogawa H, Irokawa T, Kurosawa H (2013) Gender differences in the aggravation of sleep disorder breathing in obstructive sleep apnea-hypopnea syndrome (OSAHS). Jpn J Med Technol 62:666–672
23.
Zurück zum Zitat Chen NH, Li KK, Li SY, Wong CR, Chuang ML, Hwang CC, Wu YK (2002) Airway assessment by volumetric computed tomography in snorers and subjects with obstructive sleep apnea in a Far-East Asian population (Chinese). Laryngoscope 112:721–726CrossRef Chen NH, Li KK, Li SY, Wong CR, Chuang ML, Hwang CC, Wu YK (2002) Airway assessment by volumetric computed tomography in snorers and subjects with obstructive sleep apnea in a Far-East Asian population (Chinese). Laryngoscope 112:721–726CrossRef
24.
Zurück zum Zitat Yoichi Nishimura, Naoko Fujii,Takahisa Yamamot, Mahmood A. Hamed, Misato Nishimura,Takuro Kojima, Noboru Iwata, Kenji Suzuki, Seiichi Nakata (2016) Volumes of Velopharyngeal and Glossopharyngeal Airway Were Not Changed after Uvulopalatopharyngoplasty: Report of Three Cases. Case Reports in Otolaryngology. Doi:https://doi.org/10.1155/2016/9378428 Yoichi Nishimura, Naoko Fujii,Takahisa Yamamot, Mahmood A. Hamed, Misato Nishimura,Takuro Kojima, Noboru Iwata, Kenji Suzuki, Seiichi Nakata (2016) Volumes of Velopharyngeal and Glossopharyngeal Airway Were Not Changed after Uvulopalatopharyngoplasty: Report of Three Cases. Case Reports in Otolaryngology. Doi:https://​doi.​org/​10.​1155/​2016/​9378428
25.
Zurück zum Zitat Tan J, Huang J, Yang J et al (2013) Numerical simulation for the upper airway flow characteristics of Chinese patients with OSAHS using CFD models. Eur Arch Otorhinolaryngol 270:1035–1043CrossRef Tan J, Huang J, Yang J et al (2013) Numerical simulation for the upper airway flow characteristics of Chinese patients with OSAHS using CFD models. Eur Arch Otorhinolaryngol 270:1035–1043CrossRef
26.
Zurück zum Zitat Liu Y, Mitchell J, Chen Y, Yim W, Chu W, Wang RC (2018) Study of the upper airway of obstructive sleep apnea patient using fluid structure interaction. Respir Physiol Neurobiol 249:54–61CrossRef Liu Y, Mitchell J, Chen Y, Yim W, Chu W, Wang RC (2018) Study of the upper airway of obstructive sleep apnea patient using fluid structure interaction. Respir Physiol Neurobiol 249:54–61CrossRef
27.
Zurück zum Zitat Wootton DM, Luo H, Persak SC, Sin S, McDonough JM, Isasi CR, Arens R (2014) Computational fluid dynamics endpoints to characterize obstructive sleep apnea syndrome in children. J Appl Physiol 11:104–112CrossRef Wootton DM, Luo H, Persak SC, Sin S, McDonough JM, Isasi CR, Arens R (2014) Computational fluid dynamics endpoints to characterize obstructive sleep apnea syndrome in children. J Appl Physiol 11:104–112CrossRef
28.
Zurück zum Zitat Powell NB, Mihaescu M, Mylavarapu G, Weaver EM, Guilleminault C, Gutmark E (2011) Patterns in pharyngeal airflow associated with sleep-disordered breathing. Sleep Med 12:966–974CrossRef Powell NB, Mihaescu M, Mylavarapu G, Weaver EM, Guilleminault C, Gutmark E (2011) Patterns in pharyngeal airflow associated with sleep-disordered breathing. Sleep Med 12:966–974CrossRef
29.
Zurück zum Zitat Suga H, Iwasaki T, Mishima K, Nakano H, Ueyama Y, Yamasaki Y (2019) Evaluation of the effect of oral appliance treatment on upper-airway ventilation conditions in obstructive sleep apnea using computational fluid dynamics. Cranio 31:1–9 Suga H, Iwasaki T, Mishima K, Nakano H, Ueyama Y, Yamasaki Y (2019) Evaluation of the effect of oral appliance treatment on upper-airway ventilation conditions in obstructive sleep apnea using computational fluid dynamics. Cranio 31:1–9
30.
Zurück zum Zitat Yajima Y, Oshima M, Iwai T, Kitajima H, Omura S, Tohnai I (2017) Computational fluid dynamics study of the pharyngeal airway space before and after mandibular setback surgery in patients with mandibular prognathism. Int J Oral Maxillofac Surg 46:839–844CrossRef Yajima Y, Oshima M, Iwai T, Kitajima H, Omura S, Tohnai I (2017) Computational fluid dynamics study of the pharyngeal airway space before and after mandibular setback surgery in patients with mandibular prognathism. Int J Oral Maxillofac Surg 46:839–844CrossRef
Metadaten
Titel
Postoperative functional evaluation of obstructive sleep apnea syndrome by computational fluid dynamics
verfasst von
Tsutomu Nomura
Tomomi Horikoshi
Yuka Kitano
Masato Yamada
Kenji Kondo
Shigeru Kikuchi
Publikationsdatum
16.06.2021
Verlag
Springer India
Erschienen in
Indian Journal of Otolaryngology and Head & Neck Surgery / Ausgabe Sonderheft 3/2022
Print ISSN: 2231-3796
Elektronische ISSN: 0973-7707
DOI
https://doi.org/10.1007/s12070-021-02681-y

Neu im Fachgebiet HNO

Nur selten ernste Komplikationen bei endoskopischer Sinuschirurgie

Etwa 3% der Menschen mit einer endoskopischen Nasennebenhöhlenoperation entwickeln ausgeprägtes Nasenbluten. Andere Komplikationen, wie Verletzungen des Nervus opticus oder eine Meningitis, treten nur äußerst selten auf, legt eine Registeranalyse nahe.

Sicheres Protokoll zur Entfernung von Fremdkörpern im Gehörgang

Ein erfahrener HNO-Arzt und Pädiater stellt ein Protokoll vor, mit dem Fremdkörper bei Kindern und Jugendlichen aus dem äußeren Gehörgang erfolgreich entfernt werden können. Im Mittelpunkt stehen dabei die sichere Fixierung des Kindes sowie der Einsatz eines Operationsmikroskops.

Ärztinnen überholen Ärzte bei Praxisgründungen

Bei Praxisgründungen haben inzwischen die Frauen deutlich die Nase vorn: Seit zehn Jahren wagen laut apoBank mehr Ärztinnen als Ärzte den Schritt in die Selbstständigkeit. In puncto Finanzierung sind sie aber vorsichtiger als die männlichen Kollegen.

Ambulante Behandlung darf länger dauern als stationäre

Ambulante Behandlungen haben Vorrang vor stationären - auch wenn diese läner dauern. Das hat das Bundessozialgericht klargestellt. Konkret ging es um Liposuktionen der Ober- und Unterschenkel.

Update HNO

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert – ganz bequem per eMail.