The Importance of Nasal Resistance in Obstructive Sleep Apnea Syndrome: A Study with Positional Rhinomanometry

2001 ◽  
Vol 5 (1) ◽  
pp. 3-11 ◽  
Author(s):  
Andrea De Vito ◽  
Stefano Berrettini ◽  
Anna Carabelli ◽  
Stefano Sellari-Franceschini ◽  
Enrica Bonanni ◽  
...  
2014 ◽  
Vol 116 (1) ◽  
pp. 104-112 ◽  
Author(s):  
David M. Wootton ◽  
Haiyan Luo ◽  
Steven C. Persak ◽  
Sanghun Sin ◽  
Joseph M. McDonough ◽  
...  

Computational fluid dynamics (CFD) analysis may quantify the severity of anatomical airway restriction in obstructive sleep apnea syndrome (OSAS) better than anatomical measurements alone. However, optimal CFD model endpoints to characterize or assess OSAS have not been determined. To model upper airway fluid dynamics using CFD and investigate the strength of correlation between various CFD endpoints, anatomical endpoints, and OSAS severity, in obese children with OSAS and controls. CFD models derived from magnetic resonance images were solved at subject-specific peak tidal inspiratory flow; pressure at the choanae was set by nasal resistance. Model endpoints included airway wall minimum pressure (Pmin), flow resistance in the pharynx (Rpharynx), and pressure drop from choanae to a minimum cross section where tonsils and adenoids constrict the pharynx ( dP TAmax). Significance of endpoints was analyzed using paired comparisons ( t-test or Wilcoxon signed rank test) and Spearman correlation. Fifteen subject pairs were analyzed. Rpharynx and dP TAmax were higher in OSAS than control and most significantly correlated to obstructive apnea-hypopnea index (oAHI), r = 0.48 and r = 0.49, respectively ( P < 0.01). Airway minimum cross-sectional correlation to oAHI was weaker ( r = −0.39); Pmin was not significantly correlated. CFD model endpoints based on pressure drops in the pharynx were more closely associated with the presence and severity of OSAS than pressures including nasal resistance, or anatomical endpoints. This study supports the usefulness of CFD to characterize anatomical restriction of the pharynx and as an additional tool to evaluate subjects with OSAS.


2001 ◽  
Vol 05 (01) ◽  
pp. 003-012 ◽  
Author(s):  
Andrea De Vito ◽  
Stefano Berrettini ◽  
Anna Carabelli ◽  
Stefano Sellari-Franceschini ◽  
Enrica Bonanni ◽  
...  

2014 ◽  
Vol 124 (11) ◽  
pp. 2640-2644 ◽  
Author(s):  
Sanghun Sin ◽  
David M. Wootton ◽  
Joseph M. McDonough ◽  
Kiran Nandalike ◽  
Raanan Arens

2014 ◽  
Vol 155 (18) ◽  
pp. 703-707 ◽  
Author(s):  
Pálma Benedek ◽  
Gabriella Kiss ◽  
Eszter Csábi ◽  
Gábor Katona

Introduction: Treatment of pediatric obstructive sleep apnea syndrome is surgical. The incidence of postoperative respiratory complications in this population is 5–25%. Aim: The aim of the authors was to present the preoperative evaluation and monitoring procedure elaborated in Heim Pál Children Hospital, Budapest. Method: 142 patients were involved in the study. Patient history was obtained and physical examination was performed in all cases. Thereafter, polysomnography was carried out, the severity of the obstructive sleep apnea syndrome was determined, and the patients underwent tonsilloadenotomy. Results: 45 patients with mild, 50 patients with moderate and 47 patients with severe obstructive sleep apnea syndrome were diagnosed. There was no complication in patients with mild disease, while complications were observed in 6 patients in the moderate group and 24 patients in the severe group (desaturation, apnea, stridor, stop breathing) (p<0.000). In patients with severe obstructive sleep apnea syndrome, no significant difference was noted in preoperative apnoea-hypapnea index (p = 0.23) and in nadir oxygen saturation values (p = 0.73) between patients with and without complication. Conclusions: Patients with severe obstructive sleep apnea syndrome should be treated in hospital where pediatric intensive care unit is available. Orv. Hetil., 2014, 155(18), 703–707.


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