Computational fluid dynamic analysis of the posterior airway space after maxillomandibular advancement for obstructive sleep apnea syndrome

Academic Article

Abstract

  • Purpose: This study evaluated the soft tissue change of the upper airway after maxillomandibular advancement (MMA) using computational fluid dynamics. Materials and Methods: Eight patients with obstructive sleep apnea syndrome who required MMA were recruited into this study. All participants underwent pre- and postoperative computed tomography and then MMA by a single oral and maxillofacial surgeon. Upper airway computed tomographic datasets for these 8 patients were created with high-fidelity 3-dimensional numerical models for computational fluid dynamics. The 3-dimensional models were simulated and analyzed to study how changes in airway anatomy affect the pressure effort required for normal breathing. Airway dimensions, skeletal changes, apnea-hypopnea index, and pressure effort of pre- and postoperative 3-dimensional models were compared and correlations were interpreted. Results: After MMA, laminar and turbulent air flows were significantly decreased at every level of the airway. The cross-sectional areas at the soft palate and tongue base were significantly increased. Conclusions: This study showed that MMA increased airway dimensions by increasing the distance from the occipital base to the pogonion. An increase of this distance showed a significant correlation with an improvement in the apnea-hypopnea index and a decreased pressure effort of the upper airway. Decreasing the pressure effort will decrease the breathing workload. This improves the condition of obstructive sleep apnea syndrome. © 2013 American Association of Oral and Maxillofacial Surgeons.
  • Digital Object Identifier (doi)

    Author List

  • Sittitavornwong S; Waite PD; Shih AM; Cheng GC; Koomullil R; Ito Y; Cure JK; Harding SM; Litaker M
  • Start Page

  • 1397
  • End Page

  • 1405
  • Volume

  • 71
  • Issue

  • 8