Faculty Collaboration Database

Upper airway reconstruction using long-range optical coherence tomography: Effects of airway curvature on airflow resistance. Lasers Surg Med 2019 Feb;51(2):150-160

Date

07/28/2018

Pubmed ID

30051633

Pubmed Central ID

PMC6424583

DOI

10.1002/lsm.23005

Scopus ID

2-s2.0-85051074999 (requires institutional sign-in at Scopus site)   17 Citations

Abstract

OBJECTIVES: Adenotonsillectomy (AT) is commonly used to treat upper airway obstruction in children, but selection of patients who will benefit most from AT is challenging. The need for diagnostic evaluation tools without sedation, radiation, or high costs has motivated the development of long-range optical coherence tomography (LR-OCT), providing real-time cross-sectional airway imaging during endoscopy. Since the endoscope channel location is not tracked in conventional LR-OCT, airway curvature must be estimated and may affect predicted airway resistance. The study objective was to assess effects of three realistic airway curvatures on predicted airway resistance using computational fluid dynamics (CFD) in LR-OCT reconstructions of the upper airways of pediatric patients, before and after AT.

METHODS: Eight subjects (five males, three females, aged 4-9 years) were imaged using LR-OCT before and after AT during sedated endoscopy. Three-dimensional (3D) airway reconstructions included three airway curvatures. Steady-state, inspiratory airflow simulations were conducted under laminar conditions, along with turbulent simulations for one subject using the k-ω turbulence model. Airway resistance (pressure drop/flow) was compared using two-tailed Wilcoxon signed rank tests.

RESULTS: Regardless of the airway curvatures, CFD findings corroborate a surgical end-goal with computed post-operative airway resistance significantly less than pre-operative (P < 0.01). The individual resistances did not vary significantly for different airway curvatures (P > 0.25). Resistances computed using turbulent simulations differed from laminar results by less than ∼5%.

CONCLUSIONS: The results suggest that reconstruction of the upper airways from LR-OCT imaging data may not need to account for airway curvature to be predictive of surgical effects on airway resistance. Lasers Surg. Med. 51:150-160, 2019. © 2018 Wiley Periodicals, Inc.

Author List

Kimbell JS, Basu S, Garcia GJM, Frank-Ito DO, Lazarow F, Su E, Protsenko D, Chen Z, Rhee JS, Wong BJ

Authors

Guilherme Garcia PhD Assistant Professor in the Biomedical Engineering department at Medical College of Wisconsin
John S. Rhee MD Chair, Professor in the Otolaryngology department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adenoids
Airway Obstruction
Airway Resistance
Child
Child, Preschool
Computer Simulation
Esophagoscopy
Female
Humans
Hydrodynamics
Hypertrophy
Male
Palatine Tonsil
Tomography, Optical Coherence