TY - JOUR
T1 - Upper airway reconstruction using long-range optical coherence tomography
T2 - Effects of airway curvature on airflow resistance
AU - Kimbell, Julia S.
AU - Basu, Saikat
AU - Garcia, Guilherme J.M.
AU - Frank-Ito, Dennis O.
AU - Lazarow, Frances
AU - Su, Erica
AU - Protsenko, Dimitry
AU - Chen, Zhongping
AU - Rhee, John S.
AU - Wong, Brian J.
N1 - Funding Information:
Contract grant sponsor: National Heart, Lung, and Blood Institute; Contract grant numbers: R01HL105215, R01HL122154.
Funding Information:
This research was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health (NIH) under R01HL105215. The content does not necessarily represent the official views of the NIH. Authors thank Nichole Witten, Gurpreet Ahuja, Tony Nguyen, and Anthony Chin Loy for their assistance.
Publisher Copyright:
© 2018 Wiley Periodicals, Inc.
PY - 2019/2
Y1 - 2019/2
N2 - 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.
AB - 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.
KW - adenotonsillectomy
KW - computational fluid dynamics
KW - long-range optical coherence tomography
KW - obstructive sleep apnea
KW - pediatric airway
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U2 - 10.1002/lsm.23005
DO - 10.1002/lsm.23005
M3 - Article
C2 - 30051633
AN - SCOPUS:85051074999
SN - 0196-8092
VL - 51
SP - 150
EP - 160
JO - Lasers in Surgery and Medicine
JF - Lasers in Surgery and Medicine
IS - 2
ER -