下颌逐步前伸对阻塞性睡眠呼吸暂停低通气综合征患者舌咽部影响的三维有限元研究

目的 通过下颌逐步前伸对阻塞性睡眠呼吸暂停低通气综合征（OSAHS）患者舌咽部三维有限元模型进行加载，观察OSAHS患者舌咽部生物力学和形态学改变。方法 对OSAHS患者上气道行薄层CT扫描，获得OSAHS患者上气道DICOM格式的图像信息，采用Mimics10.0、Imageware10.0和Ansys8.0软件建立上气道、下颌骨、舌骨及 相关周围结构的三维有限元模型，然后通过逐步前伸下颌骨，观察舌咽部生物力学和形态的变化及规律。结果 成功建立了OSAHS患者上气道及结构的三维有限元模型。通过逐步前伸下颌骨，舌咽部发生相应形态变化，其主要表现为：上气道舌咽部会厌尖横截面横径增加，而上气道舌咽部会厌尖横截面矢状径减小；S1主应力主要分布于上气道前壁区肌肉牵拉处，应力位置未发生明显改变，舌咽部主应力值随下颌前伸距离增加而不断增加。结论 使用Mimics、Imageware和Ansys软件提高了建模效率和模型的精确性。通过对整体有限元模型的下颌逐步前伸加载，有效展示了下颌骨前伸与舌咽部两者之间的关系，研究方法可行。

Three-dimensional finite element study on the change of glossopharyngeum in patient with obstructive sleep apnea hypopnea syndrome during titrated mandible advancement

Objective  To construct a three -dimensional finite element model of the upper airway and adjacent structure of an obstructive sleep apnea hypopnea syndrome (OSAHS) patient for biomechanical analysis. And to study the influence of glossopharyngeum of an OSAHS patient with three -dimensional finite element model during titrated mandible advancement. Methods  DICOM format image information of an OSAHS patient，upper airway was obtained by thin-section CT scanning and digital image processing were utilized to construct a three-dimensional finite element model by Mimics 10.0, Imageware 10.0 and Ansys software. The changes and the law of glossopharyngeum were observed by biomechanics and morphology after loading with titrated mandible advancement. Results  A three -dimensional finite element model of the adjacent upper airway structure of OSAHS was established successfully. After loading, the transverse diameter of epiglottis tip of glossopharyngeum increased significantly, although the sagittal diameter decreased correspondingly. The principal stress was mainly distributed in anterior wall of the upper airway. The location of principal stress concentration did not change significantly with the increasing of distance. The stress of glossopharyngeum increased during titrated mandible advancement. Conclusion  A more precise three -dimensional finite model of upper airway and adjacent structure of an OSAHS patient is established and improved efficiency by Mimics, Image ware and Ansys software. The glossopharyngeum of finite element model of OSAHS is analyzed by titrated mandible advancement and can effectively show the relationship between mandible advancement and the glossophaiyngeum.