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Relationship between pharyngeal airway depth and ventilation condition in mandibular setback surgery : A computational fluid dynamics study 外科的下顎後退術を行った骨格性下顎前突症患者の咽頭気道前後径と通気状態の関係 : 上気道流体シミュレーションによる解析 白澤, 良執 シラザワ, ヨシト Shirazawa, Yoshito open access skeletal Class III mandibular setback surgery pharyngeal airway depth obstructive sleep apnea computational fluid dynamics 博士論文全文, 博士論文要旨, 最終試験結果の要旨, 論文審査の要旨 Objectives: This study aimed to determine the anteroposterior depth (APD) of the pharyngeal airway (PA) where post-operative PA obstruction was predicted, using computer fluid dynamics (CFD), in order to prevent obstructive sleep apnoea after mandibular setback surgery. Settings and sample population: Nineteen skeletal Class III patients (8 men; mean age, 26.7 years) who required mandibular setback surgery had computed tomography images taken before and 6 months after surgery. Methods: The APD of each site of the four cross-sectional reference planes (retropalatal airway [RA], second cervical vertebral airway, oropharyngeal airway and third cervical vertebral airway) were measured. The Maximum negative pressure (Pmax) of the PA was measured at inspiration using CFD, based on a three-dimensional PA model. Intersite differences were determined using analysis of variance and the Friedman test with Bonferroni correction. The relationship between APD and Pmax was evaluated by Spearman correlation coefficients and non-linear regression analysis. Results: The smallest PA site was the RA. Pmax was significantly correlated with the APD of the RA (rs = .628, P < .001). The relationship between Pmax and the APD-RA was fitted to a curve, which showed an inversely proportional relationship of Pmax to the square of the APD-RA. Pmax substantially increased even with a slight reduction of the APD-RA. In particular, when the APD-RA was 7 mm or less, Pmax increased greatly, suggesting that PA obstruction was more likely to occur. Conclusions: The results of this study suggest that APD-RA is a useful predictor of good PA ventilation after surgery. This is the peer reviewed version of the following article: Yoshito Shirazawa, Tomonori Iwasaki, Kazuhiro Ooi, Yutaka Kobayashi, Ayaka Yanagisawa-Minami, Yoichiro Oku, Anna Yokura, Yuusuke Ban, Hokuto Suga, Shuichi Kawashiri, Youichi Yamasaki. Relationship between pharyngeal airway depth and ventilation condition in mandibular setback surgery: A computational fluid dynamics study Orthodontics & Craniofacial Research (2020), 23(3), 313-322 © 2020 John Wiley & Sons A/S. which has been published in final form at https://doi.org/10.1111/ocr.12371 This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions. John Wiley & Sons 鹿児島大学 eng doctoral thesis VoR http://hdl.handle.net/10232/00031361 https://ir.kagoshima-u.ac.jp/records/15470 甲総研第568号 博士(歯学) Doctor of Philosophy in Dental Science 2020-08-20 17701 鹿児島大学 https://ir.kagoshima-u.ac.jp/record/15470/files/Diss_白澤_良執_ISK568_2020.pdf application/pdf 1.1 MB 2021-05-21 2020-08-06 https://ir.kagoshima-u.ac.jp/record/15470/files/Abstract_白澤_良執_4516800061_2020.pdf application/pdf 28.1 kB 2021-05-13 2020-08-06 https://ir.kagoshima-u.ac.jp/record/15470/files/Result_Shirazawa_Yoshito_isk_568.pdf application/pdf 193.7 kB 2020-10-01 2020-08-06 https://ir.kagoshima-u.ac.jp/record/15470/files/Comments_Shirazawa_Yoshito_isk_568.pdf application/pdf 94.8 kB 2020-10-01 2020-08-06