Abstract
BackgroundThe effect of rapid maxillary expansion (RME) on the upper airway (UA) has been studied earlier but without a consistent conclusion. This study aims to evaluate the outcome of RME on the UA function in terms of aerodynamic characteristics by applying a computational fluid dynamics (CFD) simulation.MethodsThis retrospective cohort study consists of seventeen cases with two consecutive CBCT scans obtained before (T0) and after (T1) RME. Patients were divided into two groups with respect to patency of the nasopharyngeal airway as expressed in the adenoidal nasopharyngeal ratio (AN): group 1 was comprised of patients with an AN ratio < 0.6 and group 2 encompassing those with an AN ratio ≥ 0.6. CFD simulation at inspiration and expiration were performed based on the three-dimensional (3D) models of the UA segmented from the CBCT images. The aerodynamic characteristics in terms of pressure drop (ΔP), maximum midsagittal velocity (Vms), and maximum wall shear stress (Pws) were compared by paired t-test and Wilcoxon test according to the normality test at T0 and T1.ResultsThe aerodynamic characteristics in UA revealed no statistically significant difference after RME. The maximum Vms (m/s) decreased from 2.79 to 2.28 at expiration after RME (P = 0.057).ConclusionThe aerodynamic characteristics were not significantly changed after RME. Further CFD studies with more cases are warranted.
Highlights
The effect of rapid maxillary expansion (RME) on the upper airway (UA) has been studied earlier but without a consistent conclusion
De Backer et al [18] introduced computational fluid dynamics (CFD) as a diagnostic tool to observe the outcome of mandibular advancement devices when treating sleep-related breathing disorders and found that CFD models precisely capture UA’s aerodynamic characteristics
We aim to evaluate the effect of RME on airflow within the UA by investigating the aerodynamic characteristics that result from applying CFD simulation
Summary
The effect of rapid maxillary expansion (RME) on the upper airway (UA) has been studied earlier but without a consistent conclusion. This study aims to evaluate the outcome of RME on the UA function in terms of aero‐ dynamic characteristics by applying a computational fluid dynamics (CFD) simulation. AH may cause several health issues including mouth breathing, snoring, asthma, speech problems, and obstructive sleep apnoea [2, 3]. Laboratorybased PSG is considered the gold standard for diagnosing obstructive sleep apnoea, as it provides quantitative parameters to evaluate respiratory function such as the apnoea–hypopnea index [17]. It has limited availability and is relatively expensive and time consuming, which could be inconvenient for children and their families. The CFD results show a higher correlation with clinical symptoms than volumetric measurements on CT images
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