title: The effect of geniglossal advancement on airway flow using a computational flow dynamics model.
abstract: OBJECTIVE
  Obstructive sleep apnea (OSA) is a sleep disorder caused by partial or complete collapse of the pharyngeal airway. Genioglossal advancement (GGA) is a well-tolerated surgical procedure intended to address hypopharyngeal collapse, yet there are few studies that monitor changes in airflow dynamics at this site. Computation fluid dynamics (CFD) utilizes airflow simulation to predict changes in airflow after anatomic manipulation.
  
  
  METHODS
  We investigated the change in volume and airflow dynamics of the pharyngeal airway after GGA in a cadaveric model.
  
  
  METHODS
  We performed serial GGA from 1 mm (control) to 3, 7, and 9 mm on a lightly preserved cadaver. After each intervention, we performed high-resolution computed tomography scans, reconstructed the pharyngeal airway, and quantified airspace volume and CFD analysis with both laminar and large eddy simulation models.
  
  
  RESULTS
  Airway volume increased with linear GGA. In both CFD simulation models, velocity increased and pressure decreased after 9-mm advancement secondary to increased airway diameter and less abrupt changes in airway geometry.
  
  
  CONCLUSIONS
  These results suggest that GGA may be effective in increasing airway volume and flow to address hypopharyngeal obstruction in OSA.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, University of Iowa, Iowa City, Iowa, U.S.A.
authors.forename: Aaron
authors.initials: A
authors.lastname: Fletcher
authors.forename: Jiwoong
authors.initials: J
authors.lastname: Choi
authors.forename: Maged
authors.initials: M
authors.lastname: Awadalla
authors.forename: Andrea E
authors.initials: AE
authors.lastname: Potash
authors.forename: Tanner J
authors.initials: TJ
authors.lastname: Wallen
authors.forename: Steven
authors.initials: S
authors.lastname: Fletcher
authors.forename: Eugene H
authors.initials: EH
authors.lastname: Chang
mesh_terms: D000403:Airway Resistance / Q000502:physiology*; D002102:Cadaver; D003198:Computer Simulation; D006801:Humans; D057446:Hydrodynamics; D021621:Imaging, Three-Dimensional; D010614:Pharynx / Q000000981:diagnostic imaging / Q000503:physiopathology*; D020181:Sleep Apnea, Obstructive / Q000175:diagnosis / Q000503:physiopathology*; D014057:Tomography, X-Ray Computed
keywords: Obstructive sleep apnea; computational flow dynamics; genioglossal advancement