Computational fluid dynamics study in children with obstructive sleep apnea.

Objectives: This study aims to identify characteristics in image‐based computational fluid dynamics (CFD) in children with obstructive sleep apnea (OSA). Design: Diagnostic study. Setting: Hospital‐based cohort. Participants: Children with symptoms suggestive of OSA were recruited and underwent polysomnography. Main outcome measures: Three‐dimensional models of computational fluid dynamics were derived from cone‐beam computed tomography. Results: A total of 68 children participated in the study (44 boys; mean age: 7.8 years), including 34 participants having moderate‐to‐severe OSA (apnea‐hypopnea index [AHI] greater than 5 events/h), and 34 age, gender, and body mass index percentile matched participants having primary snoring (AHI less than 1). Children with moderate‐to‐severe OSA had a significantly higher total airway pressure (166.3 vs. 39.1 Pa, p =.009), total airway resistance (9851 vs. 2060 Newton‐metre, p =.004) and velocity at a minimal cross‐sectional area (65.7 vs. 8.8 metre per second, p =.017) than those with primary snoring. The optimal cut‐off points for moderate‐to‐severe OSA were 46.2 Pa in the total airway pressure (area under the curve [AUC] = 73.2%), 2373 Newton‐metre in the total airway resistance (AUC = 72.5%) and 12.6 metres per second in the velocity at a minimal cross‐sectional area (AUC = 70.5%). The conditional logistic regression model revealed that total airway pressure, total airway resistance and velocity at minimal cross‐sectional area were significantly associated with an increased risk of moderate‐to‐severe OSA. Conclusions: This study demonstrates that CFD could be a useful tool for evaluating upper airway patency in children with OSA. [ABSTRACT FROM AUTHOR]