Upper Airway Areas, Volumes, and Linear Measurements Determined on Computed Tomography During Different Phases of Respiration Predict the Presence of Severe Obstructive Sleep Apnea

Chousangsuntorn, Khaisang; Bhongmakapat, Thongchai; Apirakkittikul, Navarat; Sungkarat, Witaya; Supakul, Nucharin; Laothamatas, Jiraporn

doi:10.1016/j.joms.2017.11.041

Cited by 10 publications

(3 citation statements)

References 28 publications

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“…It is possible that upper airway morphology may be different during sleep from that described in the present study; however, we captured the static upper airway morphology at the end of expiration, which has good predictive ability for OSA severity according to prior studies. 35,36 Furthermore, we tried to simulate the natural ageing process of upper airway morphology instead of locating the obstructive sites during sleep. Finally, we cannot definitively conclude that the pharyngeal calibre enlarges with ageing in OSA patients because of our cross-sectional design.…”

Section: Discussionmentioning

confidence: 99%

Upper airway morphological changes in obstructive sleep apnoea: effect of age on pharyngeal anatomy

Gao

et al. 2020

J. Laryngol. Otol.

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ObjectiveTo evaluate the upper airway morphology changes associated with ageing in adult Chinese patients with obstructive sleep apnoea.MethodsA total of 124 male patients diagnosed with obstructive sleep apnoea by overnight polysomnography, who underwent upper airway computed tomography, were enrolled. The linear dimensions, cross-sectional area and volume of the upper airway region and the surrounding bony frame were measured. The association between ageing and upper airway morphology was analysed.ResultsSoft palate length, minimum cross-sectional area of the retroglossal region, lateral dimensions at the minimum cross-sectional area of the retropalatal and retroglossal regions, nasopharyngeal volume, and average cross-sectional area of the nasopharyngeal region were found to significantly increase with ageing in all patients, while the upper airway shape flattened with ageing. The volume of the retropalatal region increased with ageing among the patients with a body mass index of less than 24 kg/m2. The volume of parapharyngeal fat pad increased with ageing among patients with a body mass index greater than 28 kg/m2.ConclusionA number of dimensional, cross-sectional and volumetric parameters of the pharynx increased with age, indicating that non-anatomical factors may play a more important role in the pathogenesis of obstructive sleep apnoea in aged patients.

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Section: Discussionmentioning

confidence: 99%

Upper airway morphological changes in obstructive sleep apnoea: effect of age on pharyngeal anatomy

Gao

et al. 2020

J. Laryngol. Otol.

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“…The dimensions of the simplified model follows typical linear measurements of URT via a computed tomography technique. 34 The nostrils have a diameter of ∼0.01 m, while the mouth exit is nearly rectangular with a 0.025 m width and a 0.01 m height. Such a geometry provides a reasonable representation to study the effects of various fluid-dynamics aspects to the human sneeze.…”

Section: Methodsmentioning

confidence: 99%

A study of fluid dynamics and human physiology factors driving droplet dispersion from a human sneeze

et al. 2020

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Recent studies have indicated that COVID-19 is an airborne disease, which has driven conservative social distancing and widescale usage of face coverings. Airborne virus transmission occurs through droplets formed during respiratory events (breathing, speaking, coughing, and sneezing) associated with the airflow through a network of nasal and buccal passages. The airflow interacts with saliva/mucus films where droplets are formed and dispersed, creating a route to transmit SARS-CoV-2. Here, we present a series of numerical simulations to investigate droplet dispersion from a sneeze while varying a series of human physiological factors that can be associated with illness, anatomy, stress condition, and sex of an individual. The model measures the transmission risk utilizing an approximated upper respiratory tract geometry for the following variations: (1) the effect of saliva properties and (2) the effect of geometric features within the buccal/nasal passages. These effects relate to natural human physiological responses to illness, stress, and sex of the host as well as features relating to poor dental health. The results find that the resulting exposure levels are highly dependent on the fluid dynamics that can vary depending on several human factors. For example, a sneeze without flow in the nasal passage (consistent with congestion) yields a 300% rise in the droplet content at 1.83 m (≈6 ft) and an increase over 60% on the spray distance 5 s after the sneeze. Alternatively, when the viscosity of the saliva is increased (consistent with the human response to illness), the number of droplets is both fewer and larger, which leads to an estimated 47% reduction in the transmission risk. These findings yield novel insight into variability in the exposure distance and indicate how physiological factors affect transmissibility rates. Such factors may partly relate to how the immune system of a human has evolved to prevent transmission or be an underlying factor driving superspreading events in the COVID-19 pandemic.

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“…The malocclusion is evaluated as divergences on the x-y-z planes of space which are coronal, sagittal, and axial [11], [12], [13], [14] .The legacy 2D lateral cephalographic x-ray, posterior-anterior cephalograms and panoramic radiographs enlightened the pathway to 3D imaging, overcoming low resolution, imaging errors and superimposition of structures allowing calculation of the cross-sectional areas of the airway [15], [16], [17]. Such parameters elevate the precision of treatment of patients with orthodontic malocclusions and assist specialists to perform with highest details in their treatment plan [18].…”

Section: Introductionmentioning

confidence: 99%

Change in the Constricted Airway in Patients after Clear Aligner Treatment: Retrospective Study

Fountoulaki¹,

Thurzo²

2022

Preprint

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This retrospective study evaluated changes in the pharyngeal portion of the upper airway in pa-tients with constricted and normal airway treated with clear aligners (Invisalign, Align). Additionally, the paper has assessed the change of tongue position in the oral cavity from lateral view. Evaluation was performed with specialized software (Invivo 6.0, Anatomage) on pre-treatment and posttreatment pairs of cone beam computed tomography imaging (CBCT) data. The level of airway constriction, volume, cross-section minimal area, and tongue profile were evaluated. Patients with malocclusion, with pair or initial and finishing CBCT and without sig-nificant weight change between the scans, treated with Invisalign clear aligners were distributed in two groups. Group A consisted of fifty-five patients with orthodontic malocclusion and con-stricted upper airway. Control group B consisted of thirty-one patients with orthodontic malocclusions without any airway constriction. In the group with airway constriction, there was a statistically significant increase in volume during therapy (p<0.001). The surface of the most con-stricted cross-section of airway did not change significantly after treatment in any of the groups. The airway constriction was most frequently localized at the level of 2nd cervical vertebra. The final tongue position was different from initial in 62.2% of all clear aligner treatments.

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Upper Airway Areas, Volumes, and Linear Measurements Determined on Computed Tomography During Different Phases of Respiration Predict the Presence of Severe Obstructive Sleep Apnea

Cited by 10 publications

References 28 publications

Upper airway morphological changes in obstructive sleep apnoea: effect of age on pharyngeal anatomy

Upper airway morphological changes in obstructive sleep apnoea: effect of age on pharyngeal anatomy

A study of fluid dynamics and human physiology factors driving droplet dispersion from a human sneeze

Change in the Constricted Airway in Patients after Clear Aligner Treatment: Retrospective Study

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