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目的研究伴鼻腔结构异常的OSAHS患者经鼻腔结构矫正手术后,气道结构形态的改变对患者整个上气道流场分布以及软腭运动姿态的影响。方法基于患者手术前后CT影像学数据,建立上气道及软腭三维有限元模型,采用流固耦合的方法模拟手术前后上气道流场特性及软腭的运动情况。结果手术矫正了异常的鼻腔结构形态,鼻腔及整个上气道阻力明显下降。术后软腭的肥厚水肿明显缓解,其游离缘的运动幅度减小。软腭运动幅度随弹性模量的减小而增大。术后的模拟结果与文献报道的正常人实验与模拟结果接近。结论鼻腔结构矫正手术改变了上气道结构,影响了气流流场的分布和软腭的运动姿态;不同病理生理状态下,软腭弹性模量的变化对其运动姿态有影响。
Objective To investigate the effects of changes of airway structure on the distribution of upper airway flow field and posture of soft palate in OSAHS patients with nasal structure abnormalities after nasal surgery. Methods Three-dimensional finite element models of the upper airway and the soft palate were established based on the CT images of the patients before and after surgery. The fluid-solid coupling characteristics were used to simulate the characteristics of the upper airway flow field and the movement of the soft palate. Results Surgery corrected abnormal nasal structure, nasal cavity and the entire upper airway resistance decreased significantly. Postoperative hypertrophy of the soft palate edema was significantly alleviated, the free edge of the exercise range decreases. The amplitude of soft palate increases with decreasing elastic modulus. The postoperative simulation results are close to those reported by the normal people in the literature. CONCLUSIONS: Nasal structure correction surgery changes the structure of the upper airway and affects the distribution of airflow and the movement of the soft palate. Under different pathophysiological conditions, the change of the elastic modulus of the soft palate affects its posture.