ArticleLaryngoscope investigative otolaryngology2018
Simulation of the upper airways in patients with obstructive sleep apnea and nasal obstruction: A novel finite element method.
Article in Laryngoscope investigative otolaryngology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 18 citations in OpenAlex.
- CT and finite element analysis of mandibular advancement device mechanics in a participant with obstructive sleep apnea: a proof-of-concept study.BMC oral health · 2026Article
- Computational Rhinology: Unraveling Discrepancies between In Silico and In Vivo Nasal Airflow Assessments for Enhanced Clinical Decision Support.Bioengineering (Basel, Switzerland) · 2024Review
- Critical to Know Pcrit: A Review on Pharyngeal Critical Closing Pressure in Obstructive Sleep Apnea.Frontiers in neurology · 2022Review
- Airflow limitation in a collapsible model of the human pharynx: physical mechanisms studied with fluid-structure interaction simulations and experiments.Physiological reports · 2019Article
- Biomechanics of the soft-palate in sleep apnea patients with polycystic ovarian syndrome.Journal of biomechanics · 2018Article
Corrections and comments
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Authors and funding
4 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo evaluate the biomechanical properties of the soft palate and velopharynx in patients with obstructive sleep apnea (OSA) and nasal obstruction. STUDY
designProspective experimental study. MATERIALS AND
methodsTwo finite element (FE) models of the soft palate were created in six patients undergoing nasal surgery, one homogeneous model based on CT images, and one layered model based on soft tissue composition. The influence of anatomy on displacement caused by a gravitational load and closing pressure were evaluated in both models. The strains in the transverse and longitudinal direction were obtained for each patient.
resultsThe individual anatomy influences both its structural stiffness and its gravitational displacement. The soft palate width was the sole anatomical parameter correlated to the critical closing pressure, but the maximal displacement due to gravity may have a relationship to closing pressure of possibly an exponential order. The airway occlusion occurred mainly at the lateral attachments of the soft palate. The total transverse strain showed a strong correlation with maximal closing pressure. There was no relationship between the critical closing pressure and the preoperative AHI levels, or the change in AHI after surgery.
conclusionHyperelastic FE models both in the homogeneous and layered model represent a novel method of evaluating soft tissue biomechanics of the upper airway. The obstruction occurs mainly at the level of the lateral attachments to the pharyngeal wall, and the width of the soft palate is an indicator of the degree of critical closing pressure. A less negative closing pressure corresponds to small total transverse strain. The effect of nasal surgery on OSA is most likely not explained by change in soft palate biomechanics. LEVEL OF EVIDENCE: NA.
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