Biomechanics of the soft-palate in sleep apnea patients with polycystic ovarian syndrome

JOURNAL OF BIOMECHANICS

卷:76

Article

Subramaniam, Dhananjay Radhakrishnan¹  Arens, Raanan²  Wagshul, Mark E.³  Sin, Sanghun²  Wootton, David M.⁴  Gutmark, Ephraim J.^1,5 

[1] Univ Cincinnati, Dept Aerosp Engn & Engn Mech, CEAS, Cincinnati, OH 45221 USA

[2] Childrens Hosp Montefiore, Albert Einstein Coll Med, Div Resp & Sleep Med, Bronx, NY USA

[3] Albert Einstein Coll Med, Montefiore Med Ctr, Gross Magnet Resonance Res Ctr, Bronx, NY 10467 USA

[4] Cooper Union Adv Sci & Art, Dept Mech Engn, New York, NY 10003 USA

[5] UC Dept Otolaryngol Head & Neck Surg, Cincinnati, OH USA

关键词: Sleep apnea;    Biomechanical properties;    Pharyngeal airflow;    Fluid-structure interaction;    Virtual surgery;   

DOI  :  10.1016/j.jbiomech.2018.05.013

来源: Elsevier

【 摘 要 】

Highly compliant tissue supporting the pharynx and low muscle tone enhance the possibility of upper airway occlusion in children with obstructive sleep apnea (OSA). The present study describes subject-specific computational modeling of flow-induced velopharyngeal narrowing in a female child with polycystic ovarian syndrome (PCOS) with OSA and a non-OSA control. Anatomically accurate three-dimensional geometries of the upper airway and soft-palate were reconstructed for both subjects using magnetic resonance (MR) images. A fluid-structure interaction (FSI) shape registration analysis was performed using subject-specific values of flow rate to iteratively compute the biomechanical properties of the soft-palate. The optimized shear modulus for the control was 38 percent higher than the corresponding value for the OSA patient. The proposed computational FSI model was then employed for planning surgical treatment for the apneic subject. A virtual surgery comprising of a combined adenoidectomy, palatoplasty and genioglossus advancement was performed to estimate the resulting post-operative patterns of airflow and tissue displacement. Maximum flow velocity and velopharyngeal resistance decreased by 80 percent and 66 percent respectively following surgery. Post-operative flow-induced forces on the anterior and posterior faces of the soft-palate were equilibrated and the resulting magnitude of tissue displacement was 63 percent lower compared to the pre-operative case. Results from this pilot study indicate that FSI computational modeling can be employed to characterize the mechanical properties of pharyngeal tissue and evaluate the effectiveness of various upper airway surgeries prior to their application. (C) 2018 Elsevier Ltd. All rights reserved.

【 授权许可】

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