A preoperative predictive study of advantages of airway changes after maxillomandibular advancement surgery using computational fluid dynamics analysis.

Morio Tonogi,Shuichi Nishikubo,Shouhei Ogisawa,Giannicola Iannella,Masaaki Suzuki,Takako Sato,Kanako Yamagata,Hiroaki Azaki,Tadashi Tanuma,Akio Himejima,Keiji Shinozuka

doi:10.1371/journal.pone.0255973

Abstract

The purpose of this study was to develop a simulation approach for predicting maxillomandibular advancement-induced airway changes using computational fluid dynamics. Eight patients with jaw deformities who underwent maxillomandibular advancement and genioglossus advancement surgery were included in this study. Computed tomography scans and rhinomanometric readings were performed both preoperatively and postoperatively. Computational fluid dynamics models were created, and airflow simulations were performed using computational fluid dynamics software; the preferable number of computational mesh points was at least 10 million cells. The results for the right and left nares, including simulation and postoperative measurements, were qualitatively consistent, and surgery reduced airflow pressure loss. Geometry prediction simulation results were qualitatively consistent with the postoperative stereolithography data and postoperative simulation results. Simulations were performed with either the right or left naris blocked, and the predicted values were similar to those found clinically. In addition, geometry prediction simulation results were qualitatively consistent with the postoperative stereolithography data and postoperative simulation results. These findings suggest that geometry prediction simulation facilitates the preoperative prediction of the postoperative structural outcome.

Highlights

Obstructive sleep apnea (OSA) is a highly prevalent disorder that affects 4% of the global population; it induces a frequent partial or total obstruction of the upper airway during sleep, thereby decreasing oxygen saturation and disrupting sleep [1]
Our previous study evaluated maxillomandibular advancement (MMA)-associated airway changes using computational fluid dynamics (CFD) and rhinomanometry to simulate fluid dynamics in inhalation, and we found that simulated projections were comparable to actual measurements [19]
A geometry prediction simulation methodology was developed based on our previous work

Summary

Introduction

Obstructive sleep apnea (OSA) is a highly prevalent disorder that affects 4% of the global population; it induces a frequent partial or total obstruction of the upper airway during sleep, thereby decreasing oxygen saturation and disrupting sleep [1]. In patients with diabetes and cardiovascular disorders, untreated OSA is associated with severe complications, including. Predicting advantages of postoperative airway changes after maxillomandibular advancement surgery

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Conclusion