A computational model of upper airway respiratory function with muscular coupling

Ilegbusi, Olusegun J.; Kuruppumullage, Don Nadun; Schiefer, Matthew A.

doi:10.1080/10255842.2021.1973445

Cited by 3 publications

(9 citation statements)

References 45 publications

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“…The first focused on the microgravity [ 41 ], while the second one targeted on Down syndrome [ 42 ]. A Google Scholar search for grey literature yielded four results, totaling 27 studies conclusive for qualitative synthesis in this review [ 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 ].…”

Section: Study Selectionmentioning

confidence: 99%

“…Airflow pressure/velocity exhibited a bi-directional connection with the cross-sectional area of the airway. Ilegbusi et al [ 56 ] discovered that a supine position without dilator muscle activation decreased airway cross-sectional width at the tongue, epiglottis, and larynx levels. Dhaliwal et al [ 52 ] reported that different patients had different sites of maximal collapse, including the soft palate, tongue base, and oropharynx.…”

Section: Thematic Analysismentioning

confidence: 99%

“…As given in Table 5 , OSA was presumed by initiating an apnea breathing condition and compared to eupnea (i.e., normal breathing) by adjusting the boundary inlet air pressure [ 48 , 54 ], or by “paralyzing” the tongue (dilator) muscle [ 52 , 56 , 60 , 65 ]. The former could be accomplished by measuring pressure in vivo using a pressure transducer [ 48 ].…”

Section: Thematic Analysismentioning

confidence: 99%

“…Specific techniques were presented to “paralyze” the tongue, i.e., to compare activation and inactivation of the dilator muscle, where collapsibility was defined by the changes in result between activation and inactivation [ 52 ]. Ilegbusi et al [ 56 ] applied a force–time activation function for the genioglossus, in which the magnitude of the force was determined by matching the profile of the airway opening at the epiglottis level observed in trials of neurostimulation. Malhotra et al [ 60 ] “activated” the dilator muscle by altering the elastic modulus of the soft tissue, whereas Rong et al [ 65 ] utilized spring elements to simulate the function of muscle to resist deformation.…”

Section: Thematic Analysismentioning

confidence: 99%

“…While some studies presented a normal surrogate (i.e., they generated the disorder by impoverishing the model of a “healthy” individual) [ 56 , 61 ], there were also patient-specific models [ 48 , 52 , 55 , 68 ]. Sun et al [ 68 ] reconstructed models from both OSA and non-OSA individuals to account for morphological variations.…”

Section: Thematic Analysismentioning

confidence: 99%

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Computational Biomechanics of Sleep: A Systematic Mapping Review

et al. 2023

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Biomechanical studies play an important role in understanding the pathophysiology of sleep disorders and providing insights to maintain sleep health. Computational methods facilitate a versatile platform to analyze various biomechanical factors in silico, which would otherwise be difficult through in vivo experiments. The objective of this review is to examine and map the applications of computational biomechanics to sleep-related research topics, including sleep medicine and sleep ergonomics. A systematic search was conducted on PubMed, Scopus, and Web of Science. Research gaps were identified through data synthesis on variants, outcomes, and highlighted features, as well as evidence maps on basic modeling considerations and modeling components of the eligible studies. Twenty-seven studies (n = 27) were categorized into sleep ergonomics (n = 2 on pillow; n = 3 on mattress), sleep-related breathing disorders (n = 19 on obstructive sleep apnea), and sleep-related movement disorders (n = 3 on sleep bruxism). The effects of pillow height and mattress stiffness on spinal curvature were explored. Stress on the temporomandibular joint, and therefore its disorder, was the primary focus of investigations on sleep bruxism. Using finite element morphometry and fluid–structure interaction, studies on obstructive sleep apnea investigated the effects of anatomical variations, muscle activation of the tongue and soft palate, and gravitational direction on the collapse and blockade of the upper airway, in addition to the airflow pressure distribution. Model validation has been one of the greatest hurdles, while single-subject design and surrogate techniques have led to concerns about external validity. Future research might endeavor to reconstruct patient-specific models with patient-specific loading profiles in a larger cohort. Studies on sleep ergonomics research may pave the way for determining ideal spine curvature, in addition to simulating side-lying sleep postures. Sleep bruxism studies may analyze the accumulated dental damage and wear. Research on OSA treatments using computational approaches warrants further investigation.

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Section: Study Selectionmentioning

confidence: 99%

Section: Thematic Analysismentioning

confidence: 99%

Section: Thematic Analysismentioning

confidence: 99%

Section: Thematic Analysismentioning

confidence: 99%

Section: Thematic Analysismentioning

confidence: 99%

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Computational Biomechanics of Sleep: A Systematic Mapping Review

et al. 2023

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Hyoid bone position and upper airway patency: A computational finite element modeling study

Salman,

Amatoury

2024

Preprint

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Background and ObjectivesThe hyoid bone’s inferior baseline position in obstructive sleep apnea (OSA) has led to surgical hyoid repositioning treatment, yet outcomes vary widely. The influence of baseline hyoid position (phenotype) and surgical hyoid repositioning on upper airway function remains unclear. We aimed to investigate their impact on the upper airway using computational modeling.MethodsA validated finite element model of the rabbit upper airway was advanced and used to simulate changes in baseline hyoid position and surgical hyoid repositioning, alone and in combination. The hyoid was displaced in cranial, caudal, anterior, anterior-cranial and anterior-caudal directions from 1-4mm. Model outcomes included upper airway collapsibility, measured using closing pressure (Pclose), cross-sectional area (CSA) and soft tissue mechanics (stress and strain).ResultsGraded baseline hyoid position increments increased Pclose for all directions, and up to 29-43% at 4mm (relative to the original baseline hyoid position). Anterior-based surgical hyoid repositioning decreased Pclose (∼-115% at 4mm) and increased ΔCSA (∼+35% at 4mm). Cranial surgical hyoid repositioning decreased ΔPclose (−29%), minimally affecting CSA. Caudal surgical hyoid repositioning increased ΔPclose (+27%) and decreased ΔCSA (−7%). Anterior-cranial and anterior-caudal surgical hyoid repositioning produced the highest stresses and strains. Surgical hyoid repositioning effects on upper airway outcomes were dependent on baseline hyoid position, with more caudal baseline hyoid positions leading to less effective surgeries.ConclusionsBaseline hyoid position (phenotype) and surgical hyoid repositioning both alter upper airway outcomes, with effects dependent on hyoid displacement direction and magnitude. Baseline hyoid position influences the effectiveness of surgical hyoid repositioning in reducing upper airway collapsibility. These findings provide further insights into the hyoid’s role in upper airway patency and suggest that considering the hyoid’s baseline position and surgical repositioning direction/increment may help improve hyoid surgeries for OSA treatment.

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Computational Simulations of Hyoid Bone Position and Tracheal Displacement: Effects on Upper Airway Patency and Tissue Mechanics

Bekdache,

Amatoury

2024

Preprint

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Background and Objectives:Surgical hyoid repositioning (HR) improves upper airway (UA) patency. Tracheal displacement (TD) is likely to impact HR outcomes, and vice versa, due to hyoid-trachea connections. This study used computational modeling to investigate the influence of TD and HR on UA outcomes and examine the impact of a more caudal baseline hyoid position (OSA phenotype).Methods:A 2D finite element model of the rabbit UA was used to simulate TD and HR (in different directions), separately and combined. Model outcomes included UA closing pressure (Pclose), area, anteroposterior diameter (APD) and soft tissue mechanics (stress/strain). Simulations were repeated with a more caudal baseline hyoid position.Results:Compared to baseline (TD=HR=0mm), TD alone reduced Pclose by -34%, increased area by 21% and APD by up to 18%. HR alone (except caudal) improved outcomes, particularly anterior-cranial HR which decreased Pclose by -106%, increased area by 32% and APD by up to 107%. TD+HR (except caudal) enhanced these outcomes, with TD+anterior-cranial HR further decreasing Pclose (-131%) and increasing area (55%) and APD (128%). A more caudal baseline hyoid position reduced the effect of TD+anterior-cranial HR on Pclose (-43%), area (49%) and APD (115%).Conclusion:The combination of TD and HR (except caudal) improved UA outcomes even further than when either intervention was applied alone. A more caudal baseline hyoid position reduced the overall impact of each intervention. This study suggests that considering the baseline hyoid position, the degree of TD, and the extent/direction of surgical HR could be crucial in optimizing OSA treatment outcomes.

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A computational model of upper airway respiratory function with muscular coupling

Cited by 3 publications

References 45 publications

Computational Biomechanics of Sleep: A Systematic Mapping Review

Computational Biomechanics of Sleep: A Systematic Mapping Review

Hyoid bone position and upper airway patency: A computational finite element modeling study

Computational Simulations of Hyoid Bone Position and Tracheal Displacement: Effects on Upper Airway Patency and Tissue Mechanics

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