ID | 115757 |
タイトル別表記 | Evaluation of Pharyngeal Airway in Acromegaly
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著者 |
Mukaihara, Keika
Kagoshima University
Hasegawa-Moriyama, Maiko
Kagoshima University
Yamasaki, Youichi
Kagoshima University
Kanmura, Yuichi
Kagoshima University
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キーワード | Acromegaly
pharyngeal airway
computational fluid dynamics
computed tomography
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資料タイプ |
学術雑誌論文
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抄録 | Objectives: Perioperative airway management may be particularly challenging in patients with acromegaly undergoing trans‐sphenoidal pituitary surgery (TSS). Management for airway obstruction is required prior to pituitary surgery to minimize perioperative hypoxia. The purpose of this retrospective study was to evaluate airway obstruction by simulation of computational fluid dynamics (CFD) using computed tomography (CT) images in patients who had undergone TSS.
Methods: CT images of the nasopharyngeal airways of patients with acromegaly (n = 5) or nonfunctional pituitary adenoma (n = 6) undergoing TSS from April 2012 to January 2017 were used to construct these airways in three dimensions. Estimated airflow pressure and velocity in the retropalatal airway (RA), oropharyngeal airway (OA), and hypopharyngeal airway (HA) were simulated using CFD. Results: Estimated pharyngeal airflow pressure in the HA, OA, and RA was significantly greater in patients with acromegaly than in those with nonfunctional pituitary adenomas whereas the estimated pharyngeal airflow velocity was significantly impaired only in the RA of patients with acromegaly. Minimum postoperative SpO2 both within 3 hours and from 3 to 12 hours after the end of anesthesia was significantly lower in the patients with acromegaly. Additionally, estimated volume of tongue and pharyngeal airflow pressure in the HA, OA, and RA correlated with minimum postoperative SpO2. Conclusion: Pharyngeal airflow pressure estimated from CT images is high in patients with acromegaly, and these values correlate with postoperative minimum values for SpO2. Preoperative evaluation of CT images by CFD can predict difficulty in airway management and perioperative hypoxia. |
掲載誌名 |
Laryngoscope Investigative Otolaryngology
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ISSN | 23788038
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出版者 | The American Laryngological, Rhinological and Otological Society|Wiley
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巻 | 3
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号 | 2
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開始ページ | 133
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終了ページ | 138
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発行日 | 2018-03-25
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権利情報 | This is an open access article under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs License(https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits use and distribution in any medium, provided the original work is properly cited, the use is non-commercial and no modifications or adaptations are made.
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言語 |
eng
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出版社版
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部局 |
歯学系
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