Application of patient‐specific simulation workflow for obstructive sleep apnea diagnosis and treatment with a mandibular advancement device. (16th June 2020)

• Record Type: Journal Article
• Authors: Pugachev, Alexander; Arnold, Marleen; Burgmann, Sebastian; Janoske, Uwe; Bicsák, Ákos; Abel, Dietmar; Linssen, Johannes; Bonitz, Lars
• Is Part Of: International journal for numerical methods in biomedical engineering. Volume 36:Number 8(2020)
• Page Start: n/a
• Page End: n/a
• Publication Date: 2020-06-16
• Subjects: computational fluid dynamics -- experimental validation -- fluid‐structure interaction -- human upper airway -- mandibular protruding device -- obstructive sleep apnea; Biomedical engineering -- Periodicals; Imaging systems in medicine -- Periodicals; Numerical analysis -- Periodicals; Engineering mathematics -- Periodicals; 610.28
• DOI: 10.1002/cnm.3350
• Languages: English
• ISSNs: 2040-7939

Abstract

Abstract: A computational fluid dynamics simulation workflow was developed to analyze the upper airway of patients with obstructive sleep apnea, which is a potentially serious sleep‐related breathing disorder. A single characteristic parameter was introduced to assess the severity of sleep apnea on the basis of the numerical results. Additionally, a fluid‐structure interaction simulation was applied to study in detail the behavior of compliant pharyngeal walls. An experimental setup was designed to validate the patient‐specific upper airway modeling. The suitability of the characteristic parameter was demonstrated in a retrospective analysis of radiological and clinical data of 58 patients as well as a prospective analysis of 22 patients. The simulation workflow was successfully used as part of an ongoing clinical investigation to predict the outcome of the obstructive sleep apnea treatment with a mandibular advancement device. The simulation results provided essential information about the critical region in the pharynx for the selection of an appropriate treatment and readily demonstrated the effect of mandibular protrusion on the air flow in the upper airway. Abstract : Theoretical instruments (OSA index and pharyngeal maps) are presented for quantification of the severity of sleep apnea, as well as for identification of the critical regions in the human pharynx. The results are derived from a large number of patient‐specific upper airway simulations and from experimental validation of the CFD and FSI models. The proposed integrated simulation‐based approach allows to reduce time to diagnosis, as well as to predict the outcome of MAD treatment.