Hui Chen1,2, Yingguang Li3, Johan Hc Reiber3, Jan de Lange4, Shengxian Tu5, Paul van der Stelt1, Frank Lobbezoo2, Ghizlane Aarab2. 1. 1 Department of Oral Radiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam , Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam , Amsterdam , The Netherlands. 2. 2 Department of Oral Kinesiology, Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam , Academic Centre for Dentistry Amsterdam (ACTA), University of Amsterdam and Vrije Universiteit Amsterdam , Amsterdam , The Netherlands. 3. 3 Division of Image Processing, Department of Radiology, Leiden University Medical Centre , Leiden University Medical Centre , Leiden , The Netherlands. 4. 4 Department of Oral and Maxillofacial Surgery, Academic Centre for Dentistry Amsterdam (ACTA) and Academic Medical Centre (AMC), University of Amsterdam and Vrije Universiteit Amsterdam , Academic Centre for Dentistry Amsterdam (ACTA) and Academic Medical Centre (AMC), University of Amsterdam and Vrije Universiteit Amsterdam , Amsterdam , The Netherlands. 5. 5 Biomedical Instrument Institute, School of Biomedical Engineering, Shanghai Jiao Tong University , Shanghai , China.
Abstract
OBJECTIVES: To determine the most relevant aerodynamic characteristic of the oropharynx related to the collapse of the upper airway in obstructive sleep apnea (OSA) patients; and to determine the correlation between the most relevant aerodynamic characteristic(s) of the oropharynx and anatomical characteristics of the oropharynx in OSA patients. METHODS: 31 mild to moderate OSA patients (mean ± SD age = 43.5 ± 9.7 years) and 13 control subjects (mean ± SD age = 48.5 ± 16.2 years) were included in this prospective study. The diagnosis of OSA patients was based on an overnight polysomnographic recording. To exclude the presence of OSA in the control subjects, they were asked to fill out a validated questionnaire to determine the risk of OSA. NewTom5G cone beam CT (CBCT) scans were obtained from both OSA patients and control subjects. Computational models of the oropharynx were reconstructed based on CBCT images. The aerodynamic characteristics of the oropharynx were calculated based on these computational models. Pearson correlation analysis was used to analyse the correlation between the most relevant aerodynamic characteristic(s) and anatomical characteristics of the oropharynx in OSA patients. RESULTS: Compared with controls, the airway resistance during expiration (Rex) of the OSA patients was significantly higher (p = 0.04). There was a significant negative correlation between Rex and the minimum cross-sectional area (CSAmin) of the oropharynx (r = -0.41, p = 0.02), and between Rex and the volume of the oropharynx (r = -0.48, p = 0.01) in OSA patients. After excluding an outlier, there is only significant correlation between Rex and the CSAmin of the oropharynx (r = -0.45, p = 0.01). CONCLUSIONS: Within the limitations of this study, we concluded that the most relevant aerodynamic characteristic of the oropharynx in the collapse of the upper airway in OSA patients is Rex. Therefore, the repetitive collapse of the upper airway in OSA patients may be explained by a high Rex, which is related to the CSAmin of the oropharynx.
OBJECTIVES: To determine the most relevant aerodynamic characteristic of the oropharynx related to the collapse of the upper airway in obstructive sleep apnea (OSA) patients; and to determine the correlation between the most relevant aerodynamic characteristic(s) of the oropharynx and anatomical characteristics of the oropharynx in OSA patients. METHODS: 31 mild to moderate OSA patients (mean ± SD age = 43.5 ± 9.7 years) and 13 control subjects (mean ± SD age = 48.5 ± 16.2 years) were included in this prospective study. The diagnosis of OSA patients was based on an overnight polysomnographic recording. To exclude the presence of OSA in the control subjects, they were asked to fill out a validated questionnaire to determine the risk of OSA. NewTom5G cone beam CT (CBCT) scans were obtained from both OSA patients and control subjects. Computational models of the oropharynx were reconstructed based on CBCT images. The aerodynamic characteristics of the oropharynx were calculated based on these computational models. Pearson correlation analysis was used to analyse the correlation between the most relevant aerodynamic characteristic(s) and anatomical characteristics of the oropharynx in OSA patients. RESULTS: Compared with controls, the airway resistance during expiration (Rex) of the OSA patients was significantly higher (p = 0.04). There was a significant negative correlation between Rex and the minimum cross-sectional area (CSAmin) of the oropharynx (r = -0.41, p = 0.02), and between Rex and the volume of the oropharynx (r = -0.48, p = 0.01) in OSA patients. After excluding an outlier, there is only significant correlation between Rex and the CSAmin of the oropharynx (r = -0.45, p = 0.01). CONCLUSIONS: Within the limitations of this study, we concluded that the most relevant aerodynamic characteristic of the oropharynx in the collapse of the upper airway in OSA patients is Rex. Therefore, the repetitive collapse of the upper airway in OSA patients may be explained by a high Rex, which is related to the CSAmin of the oropharynx.
Authors: Cedric Van Holsbeke; Jan De Backer; Wim Vos; Pascal Verdonck; Peter Van Ransbeeck; Tom Claessens; Marc Braem; Olivier Vanderveken; Wilfried De Backer Journal: J Biomech Date: 2011-02-03 Impact factor: 2.712
Authors: Haiyan Luo; Sanghun Sin; Joseph M McDonough; Carmen R Isasi; Raanan Arens; David M Wootton Journal: J Biomech Date: 2014-03-24 Impact factor: 2.712
Authors: Shengxian Tu; Emanuele Barbato; Zsolt Köszegi; Junqing Yang; Zhonghua Sun; Niels R Holm; Balázs Tar; Yingguang Li; Dan Rusinaru; William Wijns; Johan H C Reiber Journal: JACC Cardiovasc Interv Date: 2014-07 Impact factor: 11.195
Authors: Gary C Cheng; Roy P Koomullil; Yasushi Ito; Alan M Shih; Somsak Sittitavornwong; Peter D Waite Journal: Math Comput Simul Date: 2014-12-01 Impact factor: 2.463
Authors: Hui Chen; Ghizlane Aarab; Maurits H T de Ruiter; Jan de Lange; Frank Lobbezoo; Paul F van der Stelt Journal: Sleep Med Date: 2016-04-05 Impact factor: 3.492
Authors: Somsak Sittitavornwong; Peter D Waite; Alan M Shih; Gary C Cheng; Roy Koomullil; Yasushi Ito; Joel K Cure; Susan M Harding; Mark Litaker Journal: J Oral Maxillofac Surg Date: 2013-05-01 Impact factor: 1.895