Analysis of Upper Airway Flow Dynamics in Robin Sequence Infants Using 4-D Computed Tomography and Computational Fluid Dynamics.
4D-CT
CFD
Respiratory flow
Upper airway obstruction
Journal
Annals of biomedical engineering
ISSN: 1573-9686
Titre abrégé: Ann Biomed Eng
Pays: United States
ID NLM: 0361512
Informations de publication
Date de publication:
Feb 2023
Feb 2023
Historique:
received:
01
04
2022
accepted:
20
07
2022
pubmed:
12
8
2022
medline:
25
1
2023
entrez:
11
8
2022
Statut:
ppublish
Résumé
Robin Sequence (RS) is a potentially fatal craniofacial condition characterized by undersized jaw, posteriorly displaced tongue, and resultant upper airway obstruction (UAO). Accurate assessment of UAO severity is crucial for management and diagnosis of RS, yet current evaluation modalities have significant limitations and no quantitative measures of airway resistance exist. In this study, we combine 4-dimensional computed tomography and computational fluid dynamics (CFD) to assess, for the first time, UAO severity using fluid dynamic metrics in RS patients. Dramatic intrapopulation differences are found, with the ratio between most and least severe patients in breathing resistance, energy loss, and peak velocity equal to 40:1, 20:1, and 6:1, respectively. Analysis of local airflow dynamics characterized patients as presenting with primary obstructions either at the location of the tongue base, or at the larynx, with tongue base obstructions resulting in a more energetic stenotic jet and greater breathing resistance. Finally, CFD-derived flow metrics are found to correlate with the level of clinical respiratory support. Our results highlight the large intrapopulation variability, both in quantitative metrics of UAO severity (resistance, energy loss, velocity) and in the location and intensity of stenotic jets for RS patients. These results suggest that computed airflow metrics may significantly improve our understanding of UAO and its management in RS.
Identifiants
pubmed: 35951208
doi: 10.1007/s10439-022-03036-6
pii: 10.1007/s10439-022-03036-6
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
363-376Subventions
Organisme : NIDCD NIH HHS
ID : 5T32DC000018-38
Pays : United States
Organisme : NIDCD NIH HHS
ID : 5T32DC000018-38
Pays : United States
Informations de copyright
© 2022. The Author(s) under exclusive licence to Biomedical Engineering Society.
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