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Computational fluid dynamics simulation of the upper airway of obstructive sleep apnea syndrome by Muller maneuver

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Summary

This study aimed to use computer simulation to describe the fluid dynamic characteristics in patients with obstructive sleep apnea syndrome (OSAS) and to evaluate the difference between during quiet respiration and the Muller maneuver (MM). Seven patients with OSAS were involved to perform computed tomographic (CT) scanning during quiet respiration and the MM. CT data in DICOM format were transformed into an anatomically three-dimensional computational fluid dynamics (CFD) model of the upper airway. The velocity magnitude, relative pressure, and flow distribution were obtained. Numerical simulation of airflow was performed to discuss how the MM affected airflow in the upper airway. To measure the discrepancy, the SPSS19.0 software package was utilized for statistic analysis. The results showed that the shape of the upper airway became narrower, and the pressure decreased during the MM. The minimal cross-sectional area (MCSA) of velopharynx was significantly decreased (P<0.05) and the airflow velocity in MCSAs of velopharynx and glossopharynx significantly accelerated (P<0.05) during the MM. This study demonstrated the possibility of CFD model combined with the MM for understanding pharyngeal aerodynamics in the pathophysiology of OSAS.

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References

  1. Malhotra A, White DP. Obstructive sleep apnea. Lancet, 2002,360(9328):237–245

    Article  PubMed  Google Scholar 

  2. Caballero P, Alvarez-Sala R, Garcia-Rio F, et al. CT in the evaluation of the upper airway in healthy subjects and in patients with obstructive sleep apnea syndrome. Chest, 1998,113(1):111–116

    Article  CAS  PubMed  Google Scholar 

  3. Fogel RB, Malhotra A, White DP. Sleep. 2: pathophysiology of obstructive sleep apnoea/hypopnoea syndrome. Thorax, 2004,59(2):159–163

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  4. Xiao Y, Chen X, Shi HS, et al. Evaluation of airway obstruction at soft palate level in male patients with obstructive sleep apnea/hypopnea syndrome: dynamic 3-Dimensional CT imaging of upper airway. J Huazhong Univ Sci Technol, 2011,31(3):413–418

    Article  Google Scholar 

  5. Mylavarapu G, Murugappan S, Mihaescu M, et al. Validation of computational fluid dynamics methodology used for human upper airway flow simulations. J Biomech, 2009,42(10):1553–1559

    Article  PubMed  Google Scholar 

  6. Sung SJ, Jeong SJ, Yu YS, et al. Customized three-dimensional computational fluid dynamics simulation of the upper airway of obstructive sleep apnea. Angle Orthod, 2006,76(5):791–799

    PubMed  Google Scholar 

  7. Yu CC, Hsiao HD, Lee LC, et al. Computational fluid dynamic study on obstructive sleep apnea syndrome treated with maxillomandibular advancement. J Craniofac Surg, 2009,20(2):426–430

    Article  PubMed  Google Scholar 

  8. Ito Y, Cheng GC, Shih AM, et al. Patient-specific geometry modeling and mesh generation for simulating obstructive sleep apnea syndrome cases by maxillomandibular advancement. Math Comput Simul, 2011,81(9):1876–1891

    Article  PubMed Central  PubMed  Google Scholar 

  9. Moyin Z, Tracie B, Peter C, et al. Computational fluid dynamics for the assessment of upper airway response to oral appliance treatment in obstructive sleep apnea. J Biomech, 2013,46(1):142–150

    Article  Google Scholar 

  10. Terris DJ, Hanasono MM, Liu YC. Reliability of the Muller maneuver and its association with sleep-disordered breathing. Laryngoscope, 2000,110(11): 1819–1823

    Article  CAS  PubMed  Google Scholar 

  11. Tan J, Han D, Wang J, et al. Numerical simulation of normal nasal cavity airflow in Chinese adult: a computational flow dynamics model. Eur Arch Otorhinolaryngol, 2012,269(3):881–889

    Article  PubMed  Google Scholar 

  12. Qian Y, Qian H, Wu Y, et al. Numeric simulation of the upper airway structure and airflow dynamic characteristics after unilateral complete maxillary resection. Int J Prosthodont, 2013,26(3):268–271

    Article  CAS  PubMed  Google Scholar 

  13. Mohsenin V. Effects of gender on upper airway collapsibility and severity of obstructive sleep apnea. Sleep Med, 2003,4(6):523–529

    Article  PubMed  Google Scholar 

  14. Liao YF, Huang CS, Chuang ML. The utility of cephalometry with the Muller Maneuver in evaluating the upper airway and its surrounding structures in Chinese patients with sleep-disordered breathing. Laryngoscope, 2003,113(4):614–619

    Article  PubMed  Google Scholar 

  15. Borowiecki BD, Sassin JF. Surgical treatment of sleep apnea. Arch Otolaryngol, 1983,109 (8):508–512

    Article  CAS  PubMed  Google Scholar 

  16. Sher AE, Thorpy MJ, Shprintzen RJ, et al. Predictive value of Muller maneuver in selection of patients for uvulopalatopharyngoplasty. Laryngoscope, 1985,95(12):1483–1487

    Article  CAS  PubMed  Google Scholar 

  17. Li S, Shi H, Dong X, et al. Quantitative evaluation of the upper airway by CT scan with the Muller maneuver. Lin Chuang Er Bi Yan Hou Ke Za Zhi (Chinese), 2005,19(3):104–107

    CAS  Google Scholar 

  18. Yan ZQ, Sun JJ, Chen X, et al. Real-time CT of upper airway in patients with obstructive sleep apnea hypopnea syndrome. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi (Chinese), 2013,48(4):284–288

    Google Scholar 

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Authors and Affiliations

  1. Department of Oral & Cranio-maxillofacial Science, Shanghai Ninth People’s Hospital, College of Stomatology, Shanghai Jiao Tong University School of Medicine, Top Priority Clinical Medical Center of Shanghai Municipal Commission of Health and Family Planning, Shanghai Key Laboratory of Stomatology, Shanghai, 200011, China

    Ping Nie  (聂萍), Yan-mei Tang  (唐艳梅), Xiao-ling Wang  (王晓玲), Xiao-chen Xue  (薛晓晨) & Min Zhu  (朱敏)

  2. Department of Stomatology, Pudong New District Oculopathy Odontopathy Dispensary, Shanghai, 201300, China

    Xiao-long Xu  (徐晓珑)

  3. School of Aeronautics and Astronautics, Shanghai Jiao Tong University, Shanghai, 200240, China

    Ya-dong Wu  (吴亚东)

Authors
  1. Ping Nie  (聂萍)
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  2. Xiao-long Xu  (徐晓珑)
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  3. Yan-mei Tang  (唐艳梅)
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  4. Xiao-ling Wang  (王晓玲)
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  5. Xiao-chen Xue  (薛晓晨)
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  6. Ya-dong Wu  (吴亚东)
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  7. Min Zhu  (朱敏)
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Corresponding author

Correspondence to Min Zhu  (朱敏).

Additional information

The authors contributed equally to this work.

This study was supported by grants from Shanghai College Young Teacher Training Program (No. shjdy029) and Youth Projects of Shanghai Municipality Health and Family Planning Commission (No. 20144Y0124).

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Nie, P., Xu, Xl., Tang, Ym. et al. Computational fluid dynamics simulation of the upper airway of obstructive sleep apnea syndrome by Muller maneuver. J. Huazhong Univ. Sci. Technol. [Med. Sci.] 35, 464–468 (2015). https://doi.org/10.1007/s11596-015-1454-x

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  • DOI: https://doi.org/10.1007/s11596-015-1454-x

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