Biomechanics of the soft-palate in sleep apnea patients with polycystic ovarian syndrome

Dhananjay Radhakrishnan Subramaniam, Raanan Arens, Mark E. Wagshul, Sanghun Sin, David M. Wootton, Ephraim J. Gutmark

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Highly compliant tissue supporting the pharynx and low muscle tone enhance the possibility of upper airway occlusion in children with obstructive sleep apnea (OSA). The present study describes subject-specific computational modeling of flow-induced velopharyngeal narrowing in a female child with polycystic ovarian syndrome (PCOS) with OSA and a non-OSA control. Anatomically accurate three-dimensional geometries of the upper airway and soft-palate were reconstructed for both subjects using magnetic resonance (MR) images. A fluid-structure interaction (FSI) shape registration analysis was performed using subject-specific values of flow rate to iteratively compute the biomechanical properties of the soft-palate. The optimized shear modulus for the control was 38 percent higher than the corresponding value for the OSA patient. The proposed computational FSI model was then employed for planning surgical treatment for the apneic subject. A virtual surgery comprising of a combined adenoidectomy, palatoplasty and genioglossus advancement was performed to estimate the resulting post-operative patterns of airflow and tissue displacement. Maximum flow velocity and velopharyngeal resistance decreased by 80 percent and 66 percent respectively following surgery. Post-operative flow-induced forces on the anterior and posterior faces of the soft-palate were equilibrated and the resulting magnitude of tissue displacement was 63 percent lower compared to the pre-operative case. Results from this pilot study indicate that FSI computational modeling can be employed to characterize the mechanical properties of pharyngeal tissue and evaluate the effectiveness of various upper airway surgeries prior to their application.

Original languageEnglish (US)
JournalJournal of Biomechanics
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Soft Palate
Biomechanics
Polycystic Ovary Syndrome
Sleep Apnea Syndromes
Biomechanical Phenomena
Fluid structure interaction
Obstructive Sleep Apnea
Tissue
Surgery
Pharyngeal Muscles
Adenoidectomy
Magnetic resonance
Flow velocity
Muscle
Magnetic Resonance Spectroscopy
Elastic moduli
Flow rate
Planning
Mechanical properties
Geometry

Keywords

  • Biomechanical properties
  • Fluid-structure interaction
  • Pharyngeal airflow
  • Sleep apnea
  • Virtual surgery

ASJC Scopus subject areas

  • Biophysics
  • Orthopedics and Sports Medicine
  • Biomedical Engineering
  • Rehabilitation

Cite this

Biomechanics of the soft-palate in sleep apnea patients with polycystic ovarian syndrome. / Subramaniam, Dhananjay Radhakrishnan; Arens, Raanan; Wagshul, Mark E.; Sin, Sanghun; Wootton, David M.; Gutmark, Ephraim J.

In: Journal of Biomechanics, 01.01.2018.

Research output: Contribution to journalArticle

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