Assessment of airway characteristics in Pierre Robin sequence using computed tomography-based 3-dimensional reconstruction and numerical simulation.

BACKGROUND: Pierre Robin sequence (PRS) syndrome has clinical features of small mandible, tongue drooping, and respiratory obstruction. This study compared the 3-dimensional (3D) reconstruction of the upper airway anatomy based on computed tomography (CT) data between PRS and normal control (NC) children, and analyzed the dynamical changes and airflow field using computer fluid dynamics (CFD) between the two populations. METHODS: A retrospective study was conducted on 66 PRS and 23 NC children, and all CT data were obtained and used for reconstruction and numerical simulation. 10 anatomical landmarks were used to estimate the mandibular morphology, while the sectional area (SA), pressure, and velocity of five upper airway cross sections (CS) were measured. The measurement results of 3D reconstruction and CFD were subjected to mean processing. The propensity score matching (PSM) method was used to enhance the degree of demographic matching. RESULTS: After PSM correction, 21 cases were finally included in each group. The average month age was (5.29 ± 4.26) months, with 52.4% (n = 22) being male. Besides the similar narrowest SA of the tongue base in the anterior-posterior direction, there were differences in other measurement parameters between two groups. Meanwhile, the SA of CS-1 in the PRS group was larger than that in the NC group (P < 0.001); Correspondingly, the pressure and velocity in the PRS group were significantly lower (both P < 0.001). Furthermore, except for similar SA of CS-5, the other three SA in the PRS group were significantly smaller than those in the NC group (all P < 0.001). CONCLUSIONS: This study identified the abnormal anatomical characteristics in PRS, thereby helping clinicians establish appropriate airway management plans in clinical practice.