Upper airway reconstruction using long-range optical coherence tomography: Effects of airway curvature on airflow resistance.
adenotonsillectomy
computational fluid dynamics
long-range optical coherence tomography
obstructive sleep apnea
pediatric airway
Journal
Lasers in surgery and medicine
ISSN: 1096-9101
Titre abrégé: Lasers Surg Med
Pays: United States
ID NLM: 8007168
Informations de publication
Date de publication:
02 2019
02 2019
Historique:
accepted:
04
07
2018
pubmed:
28
7
2018
medline:
25
1
2020
entrez:
28
7
2018
Statut:
ppublish
Résumé
Adenotonsillectomy (AT) is commonly used to treat upper airway obstruction in children, but selection of patients who will benefit most from AT is challenging. The need for diagnostic evaluation tools without sedation, radiation, or high costs has motivated the development of long-range optical coherence tomography (LR-OCT), providing real-time cross-sectional airway imaging during endoscopy. Since the endoscope channel location is not tracked in conventional LR-OCT, airway curvature must be estimated and may affect predicted airway resistance. The study objective was to assess effects of three realistic airway curvatures on predicted airway resistance using computational fluid dynamics (CFD) in LR-OCT reconstructions of the upper airways of pediatric patients, before and after AT. Eight subjects (five males, three females, aged 4-9 years) were imaged using LR-OCT before and after AT during sedated endoscopy. Three-dimensional (3D) airway reconstructions included three airway curvatures. Steady-state, inspiratory airflow simulations were conducted under laminar conditions, along with turbulent simulations for one subject using the k-ω turbulence model. Airway resistance (pressure drop/flow) was compared using two-tailed Wilcoxon signed rank tests. Regardless of the airway curvatures, CFD findings corroborate a surgical end-goal with computed post-operative airway resistance significantly less than pre-operative (P < 0.01). The individual resistances did not vary significantly for different airway curvatures (P > 0.25). Resistances computed using turbulent simulations differed from laminar results by less than ∼5%. The results suggest that reconstruction of the upper airways from LR-OCT imaging data may not need to account for airway curvature to be predictive of surgical effects on airway resistance. Lasers Surg. Med. 51:150-160, 2019. © 2018 Wiley Periodicals, Inc.
Identifiants
pubmed: 30051633
doi: 10.1002/lsm.23005
pmc: PMC6424583
mid: NIHMS986722
doi:
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Langues
eng
Sous-ensembles de citation
IM
Pagination
150-160Subventions
Organisme : NIBIB NIH HHS
ID : P41 EB015890
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL105215
Pays : United States
Organisme : NHLBI NIH HHS
ID : R01 HL122154
Pays : United States
Informations de copyright
© 2018 Wiley Periodicals, Inc.
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