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설암 환자에서 경부청소술 및 재건술에 따른 수술 전 후 기도 내 공기 유동 특성

Flow Characteristics of Upper Airway After Neck Dissection and Reconstructive Surgery in Tongue Cancer Patients

  • 송재민 ;
  • 서희림 ;
  • 염은섭
  • Jae Min Song (Department of Oral and Maxillofacial Surgery, School of Dentistry, PNU) ;
  • Heerim Seo (School of Mechanical Engineering, PNU) ;
  • Eunseop Yeom (School of Mechanical Engineering, Pusan National University (PNU))
  • 투고 : 2024.06.11
  • 심사 : 2024.07.19
  • 발행 : 2024.07.31

초록

This study examined changes in airway airflow characteristics before and after extensive surgery for tongue cancer, which includes neck dissection and reconstruction. Pre- and post-operative CBCT scans were used to model 3D upper airways. Computational fluid dynamics (CFD) simulations analyzed airflow and pressure variations. Results showed a significant reduction in airway volume post-surgery, especially in the posterior tongue and epiglottis areas, leading to increased airflow velocity and complex vortex formations. Pressure drop analysis revealed that post-surgery, higher negative pressure is required for inhalation, indicating increased breathing effort. This suggests that the surgical removal of cancerous tissues and lymph nodes, along with reconstruction, alters airway geometry significantly, potentially impacting respiratory function. The findings highlight the clinical importance of assessing airway changes in tongue cancer surgery to anticipate and mitigate postoperative respiratory complications.

키워드

과제정보

이 과제는 2021학년도 부산대학교 교수국외 장기파견 지원비에 의하여 연구되었음.

참고문헌

  1. Kang, M. J., Jung, K. W., Bang, S. H., Choi, S. H., Park, E. H. and Yun, E. H., 2023, "Cancer Statistics in Korea: Incidence, Mortality, Survival, and Prevalence in 2020," Cancer Res Treat, Vol. 55(2), pp.385~399. 
  2. Jung, K. W., Won, Y. J., Kang, M. J., Kong, H. J., Im, J. S. and Seo, H. G., 2022, "Prediction of Cancer Incidence and Mortality in Korea," Cancer Res Treat, vol. 54(2), pp. 345~351. 
  3. Itoh, H., Katsumata, A., Kashimura, K., Iida, Y., Noguchi, T., Sarukawa, S., Jinbu, Y. and Kusama, M., 2015, "Morphological changes of upper airway and dysphasia problems in oral cancer patients with oropharyngeal reconstruction surgery," Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology, vol. 27(5), pp.608~613. 
  4. Gong, X., Li, W., and Gao, X., 2018, "Effects of Craniofacial Morphology on Nasal Respiratory Function and Upper Airway Morphology," Journal of Craniofacial Surgery, Vol. 29(7), pp.1717~1722. 
  5. Kim, M. S., Park, J. H., Lee, K. Y., Choi, S. H., Jung, H. H., Kim, J. H. and Lee, B., 2019, "Influence of head and neck position on the performance of supraglottic airway devices: A systematic review and meta-analysis," PloS one, Vol. 14(5), e0216673. 
  6. Paeng, J. Y., Kim, J. W. and Lee, S. T., 2019, "Changes in Hyoid Bone Position and Crosssectional Area of Pharyngeal Airway After Oral Cancer Surgery," Anticancer Research, Vol. 39(4), pp.2097~2104. 
  7. Staderini, E., Patini, R., De Luca, M. and Gallenzi, P., 2018, "Three-dimensional stereophotogrammetric analysis of nasolabial soft tissue effects of rapid maxillary expansion: A systematic review of clinical trials," Acta Otorhinolaryngologica Italica, Vol. 38(5), pp.399~408. 
  8. Staderini, E., Patini, R., Camodeca, A., Guglielmi, F. and Gallenzi, P., 2019, "Three-dimensional assessment of morphological changes following nasoalveolar molding therapy in cleft lip and palate patients: A case report," Dentistry Journal, Vol. 7(1), 27 
  9. Song, J. M., Seo, H., Choi, N. R., Yeom, E. and Kim, Y. D., 2020, "Application of computational fluid dynamics analysis after bimaxillary orthognathic surgery," Applied Sciences, Vol. 10(5), 1676. 
  10. Mihaescu M., Murugappan, S., Kalra, M., Khosla, S., and Gutmark, E., "Large eddy simulation and reynolds-averaged navier-stokes modeling of flow in a realistic pharyngeal airway model: An investigation of obstructive sleep apnea," J. Biomech., vol. 41, pp. 2279-2288, 2008. 
  11. Choi, N.R., Seo, H., and Yeom, E., Song, J. M., 2022, "Application of computational fluid dynamics for the analysis of postoperative airway changes in oral cancer patients", Journal of Visualization, Vol. 25(5), 1063-1073 
  12. Seo, H., Song, J. M., and Yeom, E., 2020, "Numerical Simulation of Air Flows in Human Upper Airway for Free Flap Reconstruction Following Resection Surgery in Oral Cancer Patients", Journal of the Korean Society of Visualization, Vol. 18(3), 96-102 
  13. Na, J. S., Jung, H. D., Cho, H. J., Choi, Y. J. and Lee, J. S., 2019, "Computational analysis of airflow dynamics for predicting collapsible sites in the upper airways: a preliminary study," J Appl Physiol, Vol. 126(2), pp.330~340. 
  14. Suga, H., Iwasaki, T., Mishima, K., Nakano, H., Ueyama, Y. and Yamasaki, Y., 2019, "Evaluation of the effect of oral appliance treatment on upper-airway ventilation conditions in obstructive sleep apnea using computational fluid dynamics," CRANIO®, Vol. 39(3), pp.209~217. 
  15. Huang, H., Yin, H., Wang, Y., Chen, N., Huang, D., Luo, X., Yin, X., Zheng, Q., Shi, B. and Li, J., 2020, "Computational Fluid Dynamic Analysis of Different Velopharyngeal Closure Patterns," Ann Otol Rhinol Laryngol, Vol. 129(2), pp.157~163. 
  16. Yajima, Y., Oshima, M., Iwai, T., Kitajima, H., Omura, S. and Tohnai, I., 2017, "Computational fluid dynamics study of the pharyngeal airway space before and after mandibular setback surgery in patients with mandibular prognathism," Int J Oral Maxillofac Surg, Vol. 46(7), pp.839~844. 
  17. Won, S. Y., Zhang, Q., and Ligrani, P. M., 2005, "Comparisons of flow structure above dimpled surfaces with different dimple depths in a channel," Physics of fluids, Vol. 17(4), pp.045105.