Obstructive Sleep Apnea Syndrome in Children

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DYMOSA • Using dynamic MRI imaging, create a 3D computational model of the airway – Apply Computational Fluid Dynamics modeling (CFD) – Apply Flow Structure Interaction modeling (FSI) • Evaluate the flow of air through the model to determine major site of obstruction • Perform virtual surgery on the model and evaluate how this changes air flow • Use the model to plan and to predict surgical outcomes
Computational Fluid Dynamics (CFD) • Measures flow characteristics: velocity, turbulence, pressure, wall sheer stress • RANS Formulation (Reynolds Averaged Navier-Strokes) – To date, most popular formulation to evaluate flow in the upper respiratory tract – Assumes rigid airway, not taking into account dynamic air flow and compliance of airway tissue
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Obstructive Sleep Apnea (OSA) in Ch
Page 3 and 4:
Obstructive Sleep Apnea Syndrome (O
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OSA • More difficult to diagnosis
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• Not diagnostic of OSA Diagnosis
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Diagnosis of OSA Sleep patterns •
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Higher incidence of OSAS in: • Ob
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Down Syndrome • 50% also have an
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Before 1980’s • Despite 50% of
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Child Abuse Amendments 1984 • All
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Parents Of Children With DS Underes
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Behavior Changes with OSAS • Dayt
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Children who snore vs those who do
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OSAS and Growth • T&A hypertrophy
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• What is the incidence of OSA in
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Dyken et al (2003) • Prospective
Page 32 and 33: Shott et al 2006 • Prospective st
Page 34 and 35: Objective diagnosis of OSAS • Sle
Page 36 and 37: Sleep studies in children with deve
Page 38 and 39: Definitions of Sleep Abnormalities
Page 40 and 41: Obstructive Index Apnea-Hypopnea in
Page 42 and 43: Hypoventilation Syndrome • You br
Page 44 and 45: Repetitive Arousals and Sleep Fragm
Page 46 and 47: Treatment of OSA • Removal of ton
Page 49 and 50: Persistent OSA after T&A Current tr
Page 51 and 52: Treatment of OSA • Removal of ton
Page 53 and 54: Treatment is dependent upon appropr
Page 55 and 56: Lateral neck xray White arrow = lin
Page 57 and 58: Cine MRI • High resolution, dynam
Page 59 and 60: Results of cine MRI used to: • Pl
Page 61 and 62: Case 1 • 12 yr old F with DS •
Page 63 and 64: Case 1 - Treatment and results •
Page 65 and 66: Case 2 - Cine MRI • Adenoid regro
Page 67 and 68: Case 3 • 8 year old male with DS
Page 69 and 70: Case 3 • Lingual tonsillectomy do
Page 71: Medical options for persistent OSA
Page 75 and 76: Oral splints and dental appliances
Page 77 and 78: Medical and Surgical Treatment afte
Page 79 and 80: DYMOSA Dynamic Computational Modeli
Page 81: Division of Pulmonary Medicine, Cin
Page 85 and 86: Flow Structure Interaction modeling
Page 87 and 88: FSI and LES • LES can predict are
Page 89 and 90: Structure and Compliance Baseline M
Page 91 and 92: ROADMAP :: FSI MODELING :: 3D Case
Page 93 and 94: DYMOSA Aims • Aim 1: Collect data
Page 95 and 96: Long Term Goal Improve surgical out
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Obstructive Sleep Apnea Syndrome in Children

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