ArticleThe Laryngoscope2021
Subglottic Stenosis Position Affects Work of Breathing.
Article in The Laryngoscope, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 20 citations in OpenAlex.
- Application of numerical simulation of upper airway flow field in pediatric obstructive sleep apnea with adenoid hypertrophy.Quantitative imaging in medicine and surgery · 2026Article
- Investigating Risk Factors for Laryngotracheal Reconstruction and Assessing Postoperative Management.Cureus · 2025Review
- The Effect of an Increasing Subglottal Stenosis Constriction That Extends From the Vocal Folds to the Inferior Border of the Cricoid Cartilage.Journal of biomechanical engineering · 2024Article
- Influence of catheter thickness on respiratory physiology during less invasive surfactant administration in extremely preterm infants.Frontiers in pediatrics · 2024Article
- Effect of cartilaginous rings in tracheal flow with stenosis.BMC biomedical engineering · 2023Article
- Predicting tracheal work of breathing in neonates based on radiological and pulmonary measurements.Journal of applied physiology (Bethesda, Md. : 1985) · 2022Article
- Imaging in neonatal respiratory disease.Paediatric respiratory reviews · 2022Review
- Monitoring Adult Subglottic Stenosis With Spirometry and Dyspnea Index: A Novel Approach.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2022Article
- Neonates With Tracheomalacia Generate Auto-Positive End-Expiratory Pressure via Glottis Closure.Chest · 2021Article
- Central airway issues in bronchopulmonary dysplasia.Pediatric pulmonology · 2021Article
- The effect of airway motion and breathing phase during imaging on CFD simulations of respiratory airflow.Computers in biology and medicine · 2020Article
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
Abstract
objectivesSubglottic stenosis (SGS) is the most common type of laryngeal stenosis in neonates. SGS severity is currently graded based on percent area of obstruction (%AO) via the Myer-Cotton grading scale. However, patients with similar %AO can have widely different clinical courses. Computational fluid dynamics (CFD) based on patient-specific imaging can quantify the relationship between airway geometry and flow dynamics. We investigated the effect of %AO and axial position of SGS on work of breathing (WOB) in neonates using magnetic resonance imaging.
methodsHigh-resolution ultrashort echo-time MRI of the chest and airway was obtained in three neonatal patients with no suspected airway abnormalities; images were segmented to construct three-dimensional (3D) models of the neonatal airways. These models were then modified with virtual SGSs of varying %AO and axial positioning. CFD simulations of peak inspiratory flow were used to calculate patient-specific WOB in nonstenotic and artificially stenosed airway models.
resultsCFD simulations demonstrated a relationship between stenosis geometry and WOB increase. WOB rapidly increased with %AO greater than about 70%. Changes in axial position could also increase WOB by approximately the same amount as a 10% increase in %AO. Increased WOB was particularly pronounced when the SGS lumen was misaligned with the glottic jet.
conclusionThe results indicate a strong, predictable relationship between WOB and axial position of the stenotic lumen relative to the glottis, which has not been previously reported. These findings may lead to precision diagnosis and treatment prediction tools in individual patients. LEVEL OF EVIDENCE: 4 Laryngoscope, 131:E1220-E1226, 2021.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.