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Primary site identification in children with obstructive sleep apnea by computational fluid dynamics analysis of the

Ayaka Yanagisawa-Minami1, Takeshi Sugiyama2,3, Tomonori Iwasaki1

  • 1Department of Pediatric Dentistry, Kagoshima University Graduate School of Medical and Dental Sciences, Sakuragaoka, Kagoshima, Kagoshima, Japan.

Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine
|January 30, 2020
PubMed

Insights

Computational fluid dynamics (CFD) analysis accurately identifies the primary site of obstructive sleep apnea (OSA) in children. This method helps determine OSA severity and guides effective treatment strategies by pinpointing the exact airway obstruction location.

Area of Science:

  • Pediatric Respiratory Medicine
  • Biomedical Engineering
  • Medical Imaging Analysis

Background:

  • Obstructive sleep apnea (OSA) is a common pediatric respiratory disorder.
  • Accurate identification of the primary site of upper airway obstruction is crucial for effective OSA treatment.
  • Current methods may not precisely locate the main site of obstruction.

Purpose of the Study:

  • To establish computational fluid dynamics (CFD) analysis for assessing OSA severity in children.
  • To identify the primary site of upper airway obstruction in pediatric OSA patients using CFD.
  • To correlate CFD findings with clinical OSA severity.

Main Methods:

  • Three-dimensional airway models were created from CT scans of 20 children (mean age 6 years) divided into OSA and control groups.
  • CFD analysis was employed to evaluate pharyngeal airway morphology, pressure, and airflow velocity.
  • Apnea-hypopnea index was used to classify participants and assess OSA severity.

Main Results:

  • Significant correlations were found between maximum upper airway velocity and OSA severity (rs = .741, P < .001).
  • Negative pressure in the upper airway also correlated significantly with OSA severity (rs = -.653, P = .002).
  • A velocity exceeding 12 m/s was identified as an indicator for the primary site of OSA.

Conclusions:

  • CFD analysis is a valuable tool for evaluating pediatric OSA severity and pinpointing the primary site of obstruction.
  • The primary site of OSA may differ from the site of airway collapse, highlighting the need for precise localization.
  • CFD analysis can guide targeted interventions for improved treatment outcomes in pediatric OSA.
Abstract

Keywords:
airway negative pressureairway velocitychildrencomputed fluid dynamicsobstruction siteobstructive sleep apneaprimary site

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