PDF(Pubmed)
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.
摘要：
目的唇腭裂(CLP)患者发生阻塞性睡眠呼吸暂停(OSA)的风险较高。假设，OSA的严重程度可能与上气道（UAW）的形态和气流特征有关。因此，本研究旨在评估和比较，在患有CLP和骨骼III类差异的成年人中，不管有没有OSA,根据UAW的几何特征和头影测量参数模拟气流阻力和压力。材料和方法根据I型多导睡眠图测试的结果，样本(n=21)分为2组:1)无OSA(N-OSA;n=6);2)有OSA(OSA;n=15).对各组的锥形束计算机断层扫描（CBCT）扫描进行头影测量。在三维(3D)重建后，产生UAW的体积(V)和最小横截面积(mCSA)。计算流体动力学(CFD)模拟用于评估关键气流特性。结果以5%的显著性水平呈现。结果两组之间的UAW压力值和气道阻力没有差异。但OSA组有更多负压(26%)和更大阻力(19%)的趋势。体积和mCSA与阻力和压力呈中度负相关。舌骨越下,咽壁产生的负压越大。结论舌骨的位置和UAW的几何形状（V和mCSA）对气道气流阻力和压力有影响。然而,CLP受试者之间的关键气流特征没有差异，他们是否受到OSA的影响。
