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Peer-reviewedCC BYApplied Mathematics in Science and Engineering

Computational fluid dynamics assessment of upper airway morphology and flow dynamics in infants with Robin sequence treated with the Stanford Orthodontic Airway Plate

  • Susie Ryu1
  • HyeRan Choo2
  • Young Woo Kim1
  • Yoon Jeong Choi2
  • Jin-Woo Kim2
  • Christopher R. Forrest3
  • Joon Sang Lee1
  1. 1Division of Obstructive Sleep Apnea Syndrome Diagnosis, School of Mechanical Engineering, College of Engineering, Yonsei University, Seoul, South Korea
  2. 2Department of Surgery, Division of Plastic and Reconstructive Surgery, Section of Craniofacial Airway Orthodontics, Stanford University School of Medicine, Lucile Packard Children’s Hospital Stanford, Palo Alto, CA, USA
  3. 3Department of Surgery, Division of Plastic, Reconstructive and Aesthetic Surgery, The Hospital for Sick Children, University of Toronto, Toronto, Canada
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Abstract

Infants with Robin sequence (RS) may develop upper airway obstruction (UAO) due to glossoptosis. The Stanford orthodontic airway plate (SOAP) improves the obstructive apnoea–hypopnoea index (OAHI), but treatment-related airway changes are difficult to quantify. We used computational fluid dynamics (CFD) to assess pre- and post-treatment CT scans from eight infants with RS. Unsteady Reynolds-averaged Navier–Stokes simulations with the SST k–ω model were performed to evaluate paired changes and associations with ΔOAHI. After treatment, airflow became more uniform and peak local breathing resistance decreased (Wilcoxon p = 0.016). Pearson analysis showed the strongest association with ΔOAHI for local breathing resistance (r = 0.847, p = 0.008), followed by narrowing gradient (r = 0.775, p = 0.024). Minimum cross-sectional area was not significantly associated (r = −0.233, p = 0.579). Spearman analysis showed consistent directions for local breathing resistance and narrowing gradient, although associations were weaker; velocity showed a strong rank-based association (ρ = 0.810, p = 0.022). Integrating airway morphology with CFD-derived flow metrics may enable quantitative assessment of UAO in infants with RS. Local breathing resistance and narrowing gradient may complement UAO assessment and warrant validation in larger cohorts.

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Cite

BibTeXRIS
BibTeX
@article{ryu2026computational,
  title = {{Computational fluid dynamics assessment of upper airway morphology and flow dynamics in infants with Robin sequence treated with the Stanford Orthodontic Airway Plate}},
  author = {Susie Ryu and HyeRan Choo and Young Woo Kim and Yoon Jeong Choi and Jin-Woo Kim and Christopher R. Forrest and Joon Sang Lee},
  journal = {Applied Mathematics in Science and Engineering},
  year = {2026},
  month = nov,
  doi = {10.1080/27690911.2026.2746950},
  url = {https://doi.org/10.1080/27690911.2026.2746950},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Computational fluid dynamics assessment of upper airway morphology and flow dynamics in infants with Robin sequence treated with the Stanford Orthodontic Airway Plate
AU  - Susie Ryu
AU  - HyeRan Choo
AU  - Young Woo Kim
AU  - Yoon Jeong Choi
AU  - Jin-Woo Kim
AU  - Christopher R. Forrest
AU  - Joon Sang Lee
PY  - 2026
DA  - 2026/11/04
JO  - Applied Mathematics in Science and Engineering
DO  - 10.1080/27690911.2026.2746950
UR  - https://doi.org/10.1080/27690911.2026.2746950
AB  - Infants with Robin sequence (RS) may develop upper airway obstruction (UAO) due to glossoptosis. The Stanford orthodontic airway plate (SOAP) improves the obstructive apnoea–hypopnoea index (OAHI), but treatment-related airway changes are difficult to quantify. We used computational fluid dynamics (CFD) to assess pre- and post-treatment CT scans from eight infants with RS. Unsteady Reynolds-averaged Navier–Stokes simulations with the SST k–ω model were performed to evaluate paired changes and associations with ΔOAHI. After treatment, airflow became more uniform and peak local breathing resistance decreased (Wilcoxon p = 0.016). Pearson analysis showed the strongest association with ΔOAHI for local breathing resistance (r = 0.847, p = 0.008), followed by narrowing gradient (r = 0.775, p = 0.024). Minimum cross-sectional area was not significantly associated (r = −0.233, p = 0.579). Spearman analysis showed consistent directions for local breathing resistance and narrowing gradient, although associations were weaker; velocity showed a strong rank-based association (ρ = 0.810, p = 0.022). Integrating airway morphology with CFD-derived flow metrics may enable quantitative assessment of UAO in infants with RS. Local breathing resistance and narrowing gradient may complement UAO assessment and warrant validation in larger cohorts.
SN  - 2769-0911
ER  -