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CC BY-NC-ND 4.0 · Sleep Sci 2023; 16(04): e430-e438
DOI: 10.1055/s-0043-1776868
Original Article

Effects of 3D Airway Geometry on the Airflow of Adults with Cleft Lip and Palate and Obstructive Sleep Apnea: A Functional Imaging Study

Leticia Dominguez Campos
1   Laboratory of Physiology, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo, Bauru, SP, Brazil
,
Inge Elly Kiemle Trindade
1   Laboratory of Physiology, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo, Bauru, SP, Brazil
2   School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
3   Department of Biological Sciences, School of Dentistry, Universidade de São Paulo, Bauru, SP, Brazil
,
Sergio Henrique Kiemle Trindade 
1   Laboratory of Physiology, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo, Bauru, SP, Brazil
4   Department of Pediatric Dentistry, Orthodontics and Public Health, School of Medicine, Universidade de São Paulo, Bauru, SP, Brazil
,
Luiz André Freire Pimenta
3   Department of Biological Sciences, School of Dentistry, Universidade de São Paulo, Bauru, SP, Brazil
,
Julia Kimbell
5   School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
,
Amelia Drake
5   School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
,
Maria Noel Marzano-Rodrigues
1   Laboratory of Physiology, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo, Bauru, SP, Brazil
,
Ivy Kiemle Trindade-Suedam
1   Laboratory of Physiology, Hospital de Reabilitação de Anomalias Craniofaciais, Universidade de São Paulo, Bauru, SP, Brazil
2   School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
3   Department of Biological Sciences, School of Dentistry, Universidade de São Paulo, Bauru, SP, Brazil
› Author Affiliations Funding The authors declare that the present work was supported by the Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq).
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Abstract

Objective Individuals with cleft lip and palate (CLP) are at a high risk of developing obstructive sleep apnea (OSA). Hypothetically, the severity of OSA might be associated with the morphology of the upper airway (UAW) and the characteristics of the airflow. Thus, the present study aimed to assess and compare, in adults with CLP and skeletal class-III discrepancy, with or without OSA, simulations of airflow resistance and pressure according to the geometrical characteristics of the UAW and cephalometric parameters.

Materials and Methods According to the results of type-I polysomnography tests, the sample (n = 21) was allocated in 2 groups: 1) without OSA (N-OSA; n = 6); and 2) with OSA (OSA; n = 15). Cephalometric measurements were performed on the cone-beam computed tomography (CBCT) scans of the groups. After three-dimensional (3D) reconstructions, the volume (V) and minimal cross-sectional area (mCSA) of the UAW were generated. Computational fluid dynamics (CFD) simulations were used to assess key airflow characteristics. The results were presented at a significance level of 5%.

Results The UAW pressure values and airway resistance did not differ between the groups, but there was a tendency for more negative pressures (26%) and greater resistance (19%) in the OSA group. Volume and mCSA showed a moderate negative correlation with resistance and pressure. The more inferior the hyoid bone, the more negative the pressures generated on the pharyngeal walls.

Conclusion The position of the hyoid bone and the geometry of the UAW (V and mCSA) exerted effects on the airway-airflow resistance and pressure. However, key airflow characteristics did not differ among subjects with CLP, were they affected or not by OSA.

Keywords

congenital, hereditary, and neonatal diseases and abnormalities - diagnostic imaging - sleep apnea, obstructive


Publication History

Received: 25 June 2022

Accepted: 09 February 2023

Article published online:
22 November 2023

© 2023. Brazilian Sleep Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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