Development of Virtual Surgery Technology Platform for Obstructive Sleep Apnea
Abstract
Obstructive sleep apnea (OSA) is a major health issue with partial or complete obstruction of breathing that can occur hundreds of time during sleep. Due to disturbed sleep, OSA patients often have issues such as excessive daytime sleepiness, poor quality of life, lack of energy, initiative and reduced alertness often leading to fatal accidents. The other side effects include hypertension, obesity, heart problems, and diabetes. It is a very common sleep disorder with one in every five Americans having at least mild OSA. Medical options to treat OSA include positive pressure machines such as continuous positive airway pressure (CPAP) and weight loss. Most patients have adherence issues with long-term use of CPAP or with maintaining benefits from weight loss. These non-surgical treatments are effective in minimizing and controlling from aggravating the issue with sleep apnea but cannot cure OSA completely. Surgical interventions are the next best alternative for sleep apnea patients. However, the success rates for surgical treatment of sleep apnea are also far from ideal, with most surgeries below 70%. Furthermore, many patients require multiple procedures to effectively treat OSA, which increases the risk of post-operative complications and cost of care. At present, the choice of surgical procedures is subjective and guided mainly by the experience of the clinical team. The best and most appropriate surgical interventions are not well established, and long-term success of sleep apnea surgeries is yet to be determined. To cover this gap in clinical practice, we propose to develop a software technology to test possible surgical procedures in a virtual model prior to surgical intervention which would facilitate a more personalized approach with a potential to achieve higher OSA cure rates. The objective is to provide the surgeon a virtual environment simulated on a computer, with a view of the upper airway, similar as in an operation theater, and also add a touch-feedback system to feel the tissue in the virtual environment. The plan includes creating software for the surgeons to reconstruct patient anatomy from their MRI scans; predict airflow features in the reconstructed airway models; and obtain information regarding patient anatomy such as areas, volumes, curvature, the degree of airway obstruction, etc. Additional features to operate different possible surgeries on reconstructed preoperative airway shapes “virtually” by a surgeon will be added in the software. The changes in airway shapes and flow features, before and after virtual surgical intervention(s), will be evaluated to identify desirable and effective surgery based on a patient’s airway shape. The software would also present a visual and quantitative map of the patient’s airway, the desired post-treatment airway shape, and a personalized plan of how an airway shape should be altered for least resistance in airflow while breathing. The proposed virtual surgery software will have a significant impact on the surgical outcomes of OSA surgeries for the benefit of both patients and caregivers by improving their confidence in the surgical plan. Ultimately, this technology is intended to minimize unsuccessful surgeries and lower treatment costs.
Document Details
- Document Type
- DoD Grant Award
- Publication Date
- Nov 19, 2019
- Source ID
- W81XWH1910043
Entities
People
- Goutham Mylavarapu
Organizations
- Cincinnati Children's Hospital Medical Center
- United States Army