Volume 128, Issue 1 pp. 277-282
Sleep Medicine

Constructing a patient-specific computer model of the upper airway in sleep apnea patients

Sandeep S. Dhaliwal MD

Sandeep S. Dhaliwal MD

Department of Otolaryngology–Head and Neck Surgery, Western University, London, Ontario, Canada

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Seyyed M. Hesabgar MEng

Seyyed M. Hesabgar MEng

Department of Medical Biophysics, Western University, London, Ontario, Canada

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Seyyed M. H. Haddad MSc

Seyyed M. H. Haddad MSc

Department of Medical Biophysics, Western University, London, Ontario, Canada

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Hanif Ladak BASc, MEng, PhD

Hanif Ladak BASc, MEng, PhD

Department of Medical Biophysics, Western University, London, Ontario, Canada

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Abbas Samani BSc, MSc, PhD

Abbas Samani BSc, MSc, PhD

Department of Medical Biophysics, Western University, London, Ontario, Canada

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Brian W. Rotenberg MD, MPH, FRCSC

Corresponding Author

Brian W. Rotenberg MD, MPH, FRCSC

Department of Otolaryngology–Head and Neck Surgery, Western University, London, Ontario, Canada

Send correspondence to Brian Rotenberg, MD, MPH, FRCSC, St. Joseph's Hospital, Room B2-501, 268 Grosvenor Street, London, ON, N6A 4V2, Canada. E-mail: [email protected]Search for more papers by this author
First published: 23 August 2017
Citations: 4

Institution where work was performed: Western University in London, Ontario, Canada.

Presented at the Triological Society Combined Sections Meeting, New Orleans, Louisiana, U.S.A., January 20, 2017.

This study was funded by a Lawson Health Research Institute Internal Grant. The authors have no other funding, financial relationships, or conflicts of interest to disclose.

Abstract

Objective

The use of computer simulation to develop a high-fidelity model has been proposed as a novel and cost-effective alternative to help guide therapeutic intervention in sleep apnea surgery. We describe a computer model based on patient-specific anatomy of obstructive sleep apnea (OSA) subjects wherein the percentage and sites of upper airway collapse are compared to findings on drug-induced sleep endoscopy (DISE).

Study Design

Basic science computer model generation.

Methods

Three-dimensional finite element techniques were undertaken for model development in a pilot study of four OSA patients. Magnetic resonance imaging was used to capture patient anatomy and software employed to outline critical anatomical structures. A finite-element mesh was applied to the volume enclosed by each structure. Linear and hyperelastic soft-tissue properties for various subsites (tonsils, uvula, soft palate, and tongue base) were derived using an inverse finite-element technique from surgical specimens. Each model underwent computer simulation to determine the degree of displacement on various structures within the upper airway, and these findings were compared to DISE exams performed on the four study patients.

Results

Computer simulation predictions for percentage of airway collapse and site of maximal collapse show agreement with observed results seen on endoscopic visualization.

Conclusion

Modeling the upper airway in OSA patients is feasible and holds promise in aiding patient-specific surgical treatment.

Level of Evidence

NA. Laryngoscope, 128:277–282, 2018

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