Clinical otolaryngology : official journal of ENT-UK ; official journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery · 2023
Computational fluid dynamics study in children with obstructive sleep apnea.
СтатьяПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Hsu Wei-Chung, Kang Kun-Tai, Chen Yunn-Jy, Weng Wen-Chin, Lee Pei-Lin, Hsiao Hung-Ta
Аннотация
OBJECTIVES: This study aims to identify characteristics in image-based computational fluid dynamics (CFD) in children with obstructive sleep apnea (OSA).
DESIGN: Diagnostic study.
SETTING: Hospital-based cohort.
PARTICIPANTS: Children with symptoms suggestive of OSA were recruited and underwent polysomnography.
MAIN OUTCOME MEASURES: Three-dimensional models of computational fluid dynamics were derived from cone-beam computed tomography.
RESULTS: A total of 68 children participated in the study (44 boys; mean age: 7.8 years), including 34 participants having moderate-to-severe OSA (apnea-hypopnea index [AHI] greater than 5 events/h), and 34 age, gender, and body mass index percentile matched participants having primary snoring (AHI less than 1). Children with moderate-to-severe OSA had a significantly higher total airway pressure (166.3 vs. 39.1 Pa, p = .009), total airway resistance (9851 vs. 2060 Newton-metre, p = .004) and velocity at a minimal cross-sectional area (65.7 vs. 8.8 metre per second, p = .017) than those with primary snoring. The optimal cut-off points for moderate-to-severe OSA were 46.2 Pa in the total airway pressure (area under the curve [AUC] = 73.2%), 2373 Newton-metre in the total airway resistance (AUC = 72.5%) and 12.6 metres per second in the velocity at a minimal cross-sectional area (AUC = 70.5%). The conditional logistic regression model revealed that total airway pressure, total airway resistance and velocity at minimal cross-sectional area were significantly associated with an increased risk of moderate-to-severe OSA.
CONCLUSIONS: This study demonstrates that CFD could be a useful tool for evaluating upper airway patency in children with OSA.
DESIGN: Diagnostic study.
SETTING: Hospital-based cohort.
PARTICIPANTS: Children with symptoms suggestive of OSA were recruited and underwent polysomnography.
MAIN OUTCOME MEASURES: Three-dimensional models of computational fluid dynamics were derived from cone-beam computed tomography.
RESULTS: A total of 68 children participated in the study (44 boys; mean age: 7.8 years), including 34 participants having moderate-to-severe OSA (apnea-hypopnea index [AHI] greater than 5 events/h), and 34 age, gender, and body mass index percentile matched participants having primary snoring (AHI less than 1). Children with moderate-to-severe OSA had a significantly higher total airway pressure (166.3 vs. 39.1 Pa, p = .009), total airway resistance (9851 vs. 2060 Newton-metre, p = .004) and velocity at a minimal cross-sectional area (65.7 vs. 8.8 metre per second, p = .017) than those with primary snoring. The optimal cut-off points for moderate-to-severe OSA were 46.2 Pa in the total airway pressure (area under the curve [AUC] = 73.2%), 2373 Newton-metre in the total airway resistance (AUC = 72.5%) and 12.6 metres per second in the velocity at a minimal cross-sectional area (AUC = 70.5%). The conditional logistic regression model revealed that total airway pressure, total airway resistance and velocity at minimal cross-sectional area were significantly associated with an increased risk of moderate-to-severe OSA.
CONCLUSIONS: This study demonstrates that CFD could be a useful tool for evaluating upper airway patency in children with OSA.