Sims Andrew, Simmons Anne, Hoffman Mark, Schindhelm Klaus
Graduate School of Biomedical Engineering, The University of New South Wales, Australia; ResMed Ltd., Australia.
School of Mechanical and Manufacturing Engineering, The University of New South Wales, Australia.
J Biomech. 2016 Dec 8;49(16):3848-3854. doi: 10.1016/j.jbiomech.2016.10.027. Epub 2016 Oct 22.
Obstructive Sleep Apnoea (OSA), characterised by repeated collapse of the pharyngeal airway during sleep, causes cessation of breathing followed by arousal, restoring normality. Continuous Positive Airway Pressure (CPAP) is a non-invasive, effective treatment for OSA where positive pressure is applied to the airway through a mask, maintaining patency. Nasal masks are commonly used, contacting the face across the upper lip, sides of the nose and the nasal bridge. Despite health benefits, therapy compliance is sub-optimal, often due to poor mask fit and discomfort. Masks have been designed to conform to the facial profile, but have not taken into account facial deformations. The nature of facial deformations while undergoing CPAP therapy is unknown. This study investigates the facial deformations experienced by a patient while undergoing nasal CPAP therapy. Magnetic Resonance Imaging (MRI) scans of the face were acquired of participants in the reference configuration and while undergoing CPAP therapy. The CPAP scan volume was registered onto the reference volume prior to surface generation for each state. Perpendicular deformation was measured from the reference facial profile to the deformed profile. Large facial deformations were measured at the sides of the nose (4.6±1.6mm) and the upper lip (4.9±1.8mm) with much smaller deformations at the nasal bridge (2.4±0.2mm). When normalised by applied load and tissue thickness, no difference was found. These findings and techniques can be used to consider facial deformation in the development of future nasal CPAP masks to improve comfort and compliance to therapy.
阻塞性睡眠呼吸暂停（OSA）的特征是睡眠期间咽部气道反复塌陷，导致呼吸停止，随后唤醒，恢复正常。持续气道正压通气（CPAP）是一种治疗OSA的非侵入性有效方法，通过面罩向气道施加正压，保持通畅。鼻面罩常用，横跨上唇、鼻侧和鼻梁与面部接触。尽管有健康益处，但治疗依从性不理想，通常是由于面罩贴合不佳和不适。面罩设计成符合面部轮廓，但未考虑面部变形。接受CPAP治疗时面部变形的性质尚不清楚。本研究调查了一名患者在接受鼻CPAP治疗时所经历的面部变形。在参考配置下以及接受CPAP治疗时，对参与者的面部进行磁共振成像（MRI）扫描。在为每种状态生成表面之前，将CPAP扫描体积配准到参考体积上。从参考面部轮廓到变形轮廓测量垂直变形。在鼻侧（4.6±1.6mm）和上唇（4.9±1.8mm）测量到较大的面部变形，而在鼻梁处变形较小（2.4±0.2mm）。当通过施加的负荷和组织厚度进行归一化时，未发现差异。这些发现和技术可用于在未来鼻CPAP面罩的开发中考虑面部变形，以提高舒适度和治疗依从性。
