Application of Computational Fluid Dynamics Analysis after Bimaxillary Orthognathic Surgery

• Published in: Applied sciences 2020-03, Vol.10 (5), p.1676
• Main Authors: Song, Jae Min, Seo, Heerim, Choi, Na-Rae, Yeom, Eunseop, Kim, Yong-Deok
• Format: Article
• Language: English
• Subjects: 2 jaw surgery; Aerodynamics; Air flow; airway change; bimaxillary orthognathic surgery; computational fluid dynamic simulation; Computational fluid dynamics; Computed tomography; Computer applications; Computer simulation; Epiglottis; Fluid dynamics; Hydrodynamics; Oropharynx; Patients; Pressure; Pressure drop; Pressure gradients; Shear stress; Simulation; Sleep apnea; Soft tissues; Stress analysis; Surgery; Turbulence models; Velocity; Volumetric analysis; Vortices; Wall shear stresses
• ISSN: 2076-3417; 2076-3417
• DOI: 10.3390/app10051676

Bimaxillary orthognathic surgery is widely used to treat skeletal class III malocclusion. Changes in jaw position affect the shape of surrounding soft tissues. We used computational fluid dynamics (CFD) simulation to observe changes in airways observed in a patient who underwent bimaxillary orthognathic surgery. For CFD simulation, we performed cone beam computed tomography (CBCT) preoperatively (T0), 3 days postoperatively (T1), and 7 months postoperatively (T2). The values of velocity, pressure drop (ΔP), and wall shear stress all increased 7 months after surgery (Vmax 7.038 m/s to 12.054 m/s, ΔP −7.723 Pa to −53.739 Pa, WSSmax 4.214 Pa to 14.323 Pa). Locations where the velocity and pressure gradients are large included the velopharynx, oropharynx, and epiglottis, with narrow cross-sectional areas. Wall shear stress was also observed at these locations. The velopharynx, oropharynx, and epiglottis are structures most vulnerable to morphological changes, that is, they can easily become obstructed.