Overview of Recent Advances in Surgical Treatments for OSA

Urban, Matthew J.; Husain, Inna; LoSavio, Phillip

doi:10.1007/s40675-020-00186-8

Cited by 4 publications

(1 citation statement)

References 88 publications

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“…Despite groundbreaking scientific progress and increasing interest within the otorhinolaryngology community [ 183 ], CFD technology is still considered immature. This is evident from the fact that recent reviews of diagnostic tools in rhinology [ 46 ] and of recent advances in surgical treatments for obstructive sleep apnea [ 184 ] did not even mention CFD. A specific concern raised by Vicory et al [ 185 ] is the labor-intensive nature of manual segmentation in CFD-based virtual surgery, which adds complexity and time requirements to the process.…”

Section: Part Ii—overview Of Published Literature On In Vitro and In ...mentioning

confidence: 99%

Computational Rhinology: Unraveling Discrepancies between In Silico and In Vivo Nasal Airflow Assessments for Enhanced Clinical Decision Support

Johnsen

2024

Bioengineering

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Computational rhinology is a specialized branch of biomechanics leveraging engineering techniques for mathematical modelling and simulation to complement the medical field of rhinology. Computational rhinology has already contributed significantly to advancing our understanding of the nasal function, including airflow patterns, mucosal cooling, particle deposition, and drug delivery, and is foreseen as a crucial element in, e.g., the development of virtual surgery as a clinical, patient-specific decision support tool. The current paper delves into the field of computational rhinology from a nasal airflow perspective, highlighting the use of computational fluid dynamics to enhance diagnostics and treatment of breathing disorders. This paper consists of three distinct parts—an introduction to and review of the field of computational rhinology, a review of the published literature on in vitro and in silico studies of nasal airflow, and the presentation and analysis of previously unpublished high-fidelity CFD simulation data of in silico rhinomanometry. While the two first parts of this paper summarize the current status and challenges in the application of computational tools in rhinology, the last part addresses the gross disagreement commonly observed when comparing in silico and in vivo rhinomanometry results. It is concluded that this discrepancy cannot readily be explained by CFD model deficiencies caused by poor choice of turbulence model, insufficient spatial or temporal resolution, or neglecting transient effects. Hence, alternative explanations such as nasal cavity compliance or drag effects due to nasal hair should be investigated.

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Section: Part Ii—overview Of Published Literature On In Vitro and In ...mentioning

confidence: 99%

Computational Rhinology: Unraveling Discrepancies between In Silico and In Vivo Nasal Airflow Assessments for Enhanced Clinical Decision Support

Johnsen

2024

Bioengineering

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The Prevalence of Central Sleep Apnea in New Referrals to a Sleep Surgery Clinic

Rodin,

Harkins,

Kent

et al. 2024

Otolaryngol.--head neck surg.

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ObjectiveSurgical treatment of non‐obstructive sleep apnea (OSA) pathology poses the risk of inappropriate surgical indications. Herein, we sought to determine the prevalence of non‐OSA respiratory disorders, specifically central sleep apnea (CSA), in new referrals to a Sleep Surgery Clinic.Study DesignProspective observational review.SettingTertiary care academic medical center.MethodsIn a sleep surgery clinic cohort, the presence of clinically significant CSA was defined as having >25% of the total apnea‐hypopnea index (AHI) being central and/or mixed events. Demographics, comorbid disorders, patient‐reported outcome measurements, and sleep study results were compared among patients using linear or logistic regression analysis, unadjusted and adjusted for age, sex, and body mass index (BMI).ResultsOn average, the cohort (n = 295) was male (74%), middle‐aged (mean [±SD] 54.2 ± 13.9 years), and overweight (BMI 30.3 ± 5.4), with severe sleep apnea (AHI 30.6 ± 22.6 events/h). Twenty‐nine patients (9.8%) were found to have clinically significant CSA yet only 10% of these cases carried a diagnosis of CSA upon presentation. The remainder were identified by reviewing the pre‐visit sleep study tables (35%), raw data (17%), and tables and raw data of a repeat post‐visit study (38%). Patients with CSA were older and had evidence of more cardiac comorbidities.ConclusionThe prevalence of CSA in new referrals to a Sleep Surgery Clinic was nearly 1 in 10 despite only 1% (3 of 295) with a known diagnosis upon presentation. Sleep surgeons must remain vigilant for patients with occult CSA, especially in older patients with a history of significant cardiovascular disease.

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An Evaluation of Obstructive Sleep Apnea Patient’s Quality of life Following Continuous Positive Airway Pressure and Uvulopalatopharyngoplasty

Najafi,

Ala,

Amali

et al. 2023

Indian J Otolaryngol Head Neck Surg

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Overview of Recent Advances in Surgical Treatments for OSA

Cited by 4 publications

References 88 publications

Computational Rhinology: Unraveling Discrepancies between In Silico and In Vivo Nasal Airflow Assessments for Enhanced Clinical Decision Support

Computational Rhinology: Unraveling Discrepancies between In Silico and In Vivo Nasal Airflow Assessments for Enhanced Clinical Decision Support

The Prevalence of Central Sleep Apnea in New Referrals to a Sleep Surgery Clinic

An Evaluation of Obstructive Sleep Apnea Patient’s Quality of life Following Continuous Positive Airway Pressure and Uvulopalatopharyngoplasty

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