Acoustic Rhinometry in the diagnosis of sleep apnea
This summer I worked with Dr. Ignacio Tapia, Dr. Christopher Cielo, and their research team in the Sleep Lab at the Children’s Hospital of Philadelphia. The Sleep Lab focuses on researching multiple aspects of pediatric sleep with a strong lean towards sleep apnea and genetic disorders.
Obstructive sleep apnea syndrome (OSAS) is a breathing disorder characterized by recurrent partial or complete episodes of upper airway obstruction during sleep associated with gas exchange abnormality and sleep fragmentation. My research for the summer focused on the data compilation and analysis of a study comparing acoustic rhinometry (AR) measurements in pediatric patients treated with either a nasal corticosteroid (NCS) or a placebo in order to determine the validity of AR as a supplementary diagnostic tool of OSAS. Acoustic rhinometry (AR) is a non-invasive technique that measures nasal airway distances and cross-sectional areas and volumes by sending an acoustic pulse down the airway and recording the cross-sectional area at discrete distances from the device.
Through this research project, I learned how to utilize MATLAB as an initial screening tool for the reliability of the data. This software was used to visualize the data by creating the waveforms produced by the AR device and comparing the biomarkers in the graphical output of the program to anatomical structures in the nasal passageway. I also learned how Stata was used as a statistical analysis software to make conclusions from the data as well as pose follow-up questions for further research.
Through the weekly lab meetings, I was exposed to the different approaches and projects that other researchers in this lab were working on which gave me different perspectives on Sleep Medicine as a discipline. I was fascinated by how many different fields intersect in the field of Pediatric sleep medicine which is not surprising given that sleep itself is affected by many different factors! As I am majoring in Computational Biology, being able to learn how and why the data analysis of a study is conducted is a very important and essential experience.
My favorite part of the summer was being mentored by such experienced researchers by learning the inner workings and behind-the-scenes of a medical research paper. I was supported as well as taught how to work independently on parts of this project which helped me understand how clinical research is conducted. Although I was unable to go in-person to the lab at CHOP, I learned a lot about the different techniques and approaches that are necessary in a medical research project as well as explored different computer softwares used in research under the mentorship of knowledgeable advisors.
Comments
Shubha, what a great project…
Shubha, what a great project and poster. Having only really heard about OSAS in adults, can you tell me how common it is in children? Also, it seems that the relationship between sleep apnea and CSA of nose anatomy is not certain (at least in children). Is it more well established in adults? How transferable is this data?
Re: Shubha, what a great project…
Hi! Thanks so much for checking my poster out!
OSAS ranges in severity from light snoring to complete obstruction of the nasal valve. Less than 10% of children experience symptoms and even less experience the most serve symptoms, I believe. This percentage increases significantly in children with craniofacial abnormalities.
At the moment, yes, the relationship between sleep apnea and the CSA of the nose anatomy in children is not established in medical literature. At the moment, I believe that rhinometry may be as a supplement to pharyngometry and the usual PSG in adults. However, due to the larger CSA values of adult patients compared to pediatric patients, the sites of significant changes may not be the same between the two populations.
Hope this answers your questions!
Re: Shubha, what a great project…
Hi! Thanks so much for checking my poster out!
OSAS ranges in severity from light snoring to complete obstruction of the nasal valve. Less than 10% of children experience symptoms and even less experience the most serve symptoms, I believe. This percentage increases significantly in children with craniofacial abnormalities.
At the moment, yes, the relationship between sleep apnea and the CSA of the nose anatomy in children is not established in medical literature. At the moment, I believe that rhinometry may be as a supplement to pharyngometry and the usual PSG in adults. However, due to the larger CSA values of adult patients compared to pediatric patients, the sites of significant changes may not be the same between the two populations.
Hope this answers your questions!
Shubha, Really interesting…
Shubha,
Really interesting research. I am actually most intrigued by the results - there were no significant differences on the CSA of placebo patients and patients receiving intranasal corticosteroids. Do you have any thoughts on why this happens? I'm also wondering if there are non invasive surgical procedures to permanently enhance CSA the same way you can have surgery to fix cleft palates etc. I know its not the focus of your research, but this is to help me understand why NCS was chosen as the potential treatment method for OSAS. Are there other drugs that have potential?
How does the drug affect the nose anatomy?
Hi Shubha,
I found your project to be very interesting and really well done. I saw that you were testing the effectiveness of the AR technique by using a placebo or a nasal corticosteroid to alter the anatomy of the nose. I was wondering how the drug affects the nose's anatomy, as it seems to affect the available space for air to enter. I assume the steroid helps increase the volume available, but I am curious how this happens. Do you know how it works?
Very Neat!
Hi Shuba,
This is a very neat project! I know that your study was mainly focused on children, but I was wondering if there is any relation of OSAS seen in adults? Also, based on the sample, it appears that the sample demographics heavily erred towards African American children? Is there a genetic and/or environmental reason to this? Thanks!
Hi, This is very…
Hi,
This is very interesting! I'm curious, the age range of children enrolled in the study seems broad enough, is it accurate that nasal cross-sectional areas grow as the child grows? I see that your significant result is a correlation between CSA and age, is there any meaning to this other than that children grow?