Journal of Shandong University (Health Sciences) ›› 2021, Vol. 59 ›› Issue (8): 67-73.doi: 10.6040/j.issn.1671-7554.0.2021.0148

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Simulation of upper airway hydrodynamic characteristics in 30 skeletal Class Ⅲ children with hypertrophic tonsils before and after tonsillectomy

WANG Yanhai, LIU Yinli, LIU Dongxu   

  1. Department of orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University &
    Shandong Key Laboratory of Oral Tissue Regeneration &
    Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan 250012, Shandong, China
  • Published:2021-09-16

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Abstract: Objective To construct the real three-dimensional models of skeletal Class Ⅲ children with hypertrophic tonsils to evaluate the hydrodynamic characteristics of their upper airways before and after tonsillectomy using computational fluid dynamics(CFD), and to provide theoretical basis when doctors develop treatment protocols for them. Methods Computed tomography images of 30 skeletal Class Ⅲ children with hypertrophic tonsils were collected and these patients were divided into groups A(tonsil grade=Ⅲ, n=18)and B(tonsil grade =Ⅳ, n=12). Three-dimensional models of their upper airways preoperative(T1)and postoperative(T2)were reconstructed. Simulations were then conducted using CFD. Measurements included area average pressure and area average velocity of representative planes(a: the plane of choana; b: minimum section of nasopharynx; c: the junction of nasopharynx and velopharynx; d: minimum section of velopharynx; e: the junction of velopharynx and glossopharynx; f: the plane of glossopharynx where tonsils were the biggest; g: the junction of glossopharynx and hypopharynx; h: the lowest plane of hypopharynx), maximal velocity(Vmax)and minimal pressure(Pmin)in plane f, maximal velocity of pharynx(Pharynx-Vmax), maximal velocity in upper airway(UA-Vmax), airflow resistance in pharynx(Rpharynx), pressure drop from choana to plane f(dP)and dP to flow ratio(PQR). Results The area average pressure and area average velocity in planes of subjects in group B decreased in T2 period. The differences of area average pressure in plane a, b, c, d, e, f, g and area average velocity in plane d, e, f, g, h were statistically significant(P<0.05). The cross-sectional parameters in group A also showed a downward trend in T2. The difference of area average pressure in plane b was statistically significant(P<0.05). For Vmax, Pmin, Pharynx-Vmax, UA-Vmax, Rpharynx, dP and PQR, the differences of subjects in group B were statistically significant(P<0.05)from T1 to T2, while those in group A were not significant(P>0.05). Besides area average velocity in planes a, b, c and area average pressure in plane h, the differences of the other measurements in groups A and B were statistically significant(P<0.05)at T1, but not significant(P>0.05)at T2. Conclusion From the point of CFD, tonsillectomy can change hydrodynamic characteristics significantly in skeletal Class III children with grade IV tonsil hypertrophy, while the same therapy can not influence those with grade III hypertrophy.

Key words: Skeletal Class Ⅲ children, Tonsil hypertrophy, Tonsillectomy, Upper airway, Computational fluid dynamics

CLC Number: 

  • R783.5
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