Efficacy of Maxillomandibular Advancement Examined with Drug-Induced Sleep Endoscopy and Computational Fluid Dynamics Airflow Modeling

To use drug-induced sedation endoscopy (DISE) and computational fluid dynamics (CFD) modeling to study dynamic airway and airflow changes after maxillomandibular advancement (MMA), and how the changes correlate with surgical success based on polysomnography parameters. Retrospective cohort study. Un...

Full description

Saved in:
Bibliographic Details
Published in:Otolaryngology-head and neck surgery Vol. 154; no. 1; p. 189
Main Authors: Liu, Stanley Yung-Chuan, Huon, Leh-Kiong, Iwasaki, Tomonori, Yoon, Audrey, Riley, Robert, Powell, Nelson, Torre, Carlos, Capasso, Robson
Format: Journal Article
Language:English
Published: England 01.01.2016
Subjects:
Adolescent
Adult
Cohort Studies
Endoscopy
Female
Humans
Hydrodynamics
Male
Mandibular Advancement
Middle Aged
Models, Theoretical
Polysomnography
Retrospective Studies
Sleep - physiology
Treatment Outcome
Young Adult
obstructive sleep apnea
drug-induced sleep endoscopy
maxillomandibular advancement
computational fluid dynamics
lateral pharyngeal wall collapse
ISSN:1097-6817, 1097-6817
Online Access:Get more information
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:To use drug-induced sedation endoscopy (DISE) and computational fluid dynamics (CFD) modeling to study dynamic airway and airflow changes after maxillomandibular advancement (MMA), and how the changes correlate with surgical success based on polysomnography parameters. Retrospective cohort study. University medical center. DISE was rated with the VOTE (velum, oropharynx, tongue, epiglottis) classification, and CFD was used to model airflow velocity and negative pressure exerted on pharyngeal wall. Changes in VOTE score by site and CFD measurements were correlated with perioperative polysomnography outcomes of apnea-hypopnea index (AHI), apnea index (AI), oxygenation desaturation index (ODI), and lowest oxygen saturation. After MMA, 20 subjects (17 males, 3 females) with a mean age of 44 ± 12 years and body mass index of 27.4 ± 4.6 kg/m(2) showed mean decreases in AHI (53.6 ± 26.6 to 9.5 ± 7.4 events/h) and ODI (38.7 ± 30.3 to 8.1 ± 9.2 events/h; P < .001). Improvement in lateral pharyngeal wall collapse during DISE based on VOTE score correlated with the most decrease in AHI (60.0 ± 25.6 to 7.5 ± 3.4 events/h) and ODI (46.7 ± 29.8 to 5.3 ± 2 events/h; P = .002). CFD modeling showed significant positive Pearson correlations between reduction of retropalatal airflow velocity and AHI (r = 0.617, P = .04) and ODI (r = 0.773, P = .005). AHI and ODI improvement after MMA is best correlated with (1) decreased retropalatal airflow velocity modeled by CFD and (2) increased lateral pharyngeal wall stability based on VOTE scoring from DISE.
Bibliography:ObjectType-Article-1
SourceType-Scholarly Journals-1
ObjectType-Feature-2
content type line 23
ISSN:1097-6817
1097-6817
DOI:10.1177/0194599815611603