Published Online November 5, 2015
Otolaryngology-Head and Neck Surgery

In a feasibility study that could transform surgical strategies for children with persistent obstructive sleep apnea (OSA), researchers at Cincinnati Children's found insight from an unlikely corner.

The team sought to improve surgical outcomes involving the soft tissues of the upper airway. They got a hard-data assist from decidedly non-medical scientists in the University of Cincinnati’s Department of Aerospace Engineering and Engineering Mechanics.

The challenge: Airway tissue above the larynx is much more elastic than tissue below it. The soft tissue reacts differently to changes in air pressure and behaves differently after surgery, which can lead to multiple procedures.

The solution: engineers and physicians applied principles of airflow, turbulence, resistance and fluid dynamics to create a 3D “virtual surgery” system that predicts soft tissue behavior after a procedure.

Results from digitally replicated surgeries appeared Nov. 15, 2015, in Otolaryngology-Head and Neck Surgery. The testing led to adjustments that would have achieved desired results in eight of the 10 cases, compared to just six successes achieved in the actual surgeries.

The research team included senior author Sally Shott, MD; Raouf Amin, MD, director of Pulmonary Medicine; and Stacey Ishman, MD, MPH, surgical director of the Upper Airway Center.

“Aerospace engineers design the outside of the airplane such that it can move through the air with the least resistance," Shott says. "We applied similar principles. In obstructive sleep apnea, each patient’s airway collapses in different degrees and at different locations. This study shows the potential for tailoring specific surgeries for each individual patient.”

Ishman adds, "For those who truly need surgery, we can use the ideal approach.”