{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T15:38:50Z","timestamp":1783352330065,"version":"3.54.6"},"reference-count":28,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2017,11,24]],"date-time":"2017-11-24T00:00:00Z","timestamp":1511481600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","award":["R01HL105241"],"award-info":[{"award-number":["R01HL105241"]}],"id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2018,7]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>Subglottic stenosis (SGS) is one of the most common airway disorders in pediatric patients. Currently, treatment decisions rely primarily on the Cotton\u2010Myer scale, which classifies SGS severity based on percentage reduction in airspace cross\u2010sectional area (CSA). However, the precise relationship between upper airway resistance and subglottic CSA is unknown. We hypothesize that airway resistance can be described by the Bernoulli Obstruction Theory, which predicts that airway resistance is inversely proportional to airspace CSA (\n<jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/lary27006-math-0010.png\" xlink:title=\"urn:x-wiley:0023852X:media:lary27006:lary27006-math-0010\"\/>) in cases of severe constriction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Computed tomography (CT) scans of six healthy subjects and five SGS patients were used to create three\u2010dimensional models of the respiratory tract from nostrils to carina. Cylindrical segments of varying lengths and varying diameters were digitally inserted in the subglottis of the healthy subjects to create simulated SGS models. Computational fluid dynamics simulations were run, and airway resistance was computed in the simulated SGS models and actual SGS models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Constriction diameter had a greater impact in airway resistance than constriction length. In agreement with the Bernoulli Obstruction Theory, airway resistance in the simulated SGS models was well represented by the power law \n<jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/lary27006-math-0011.png\" xlink:title=\"urn:x-wiley:0023852X:media:lary27006:lary27006-math-0011\"\/>, where \n<jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/lary27006-math-0012.png\" xlink:title=\"urn:x-wiley:0023852X:media:lary27006:lary27006-math-0012\"\/> is a constant and the exponent <jats:italic>b<\/jats:italic> ranged from \u22120.85 to \u22121.07. The percentage reduction in airflow \n<jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/lary27006-math-0013.png\" xlink:title=\"urn:x-wiley:0023852X:media:lary27006:lary27006-math-0013\"\/> at a constant pressure drop was found to be directly proportional to the percentage reduction in CSA \n<jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/lary27006-math-0014.png\" xlink:title=\"urn:x-wiley:0023852X:media:lary27006:lary27006-math-0014\"\/> in the limit of severe constrictions, namely \n<jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/lary27006-math-0015.png\" xlink:title=\"urn:x-wiley:0023852X:media:lary27006:lary27006-math-0015\"\/>, where \n<jats:inline-graphic xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"graphic\/lary27006-math-0016.png\" xlink:title=\"urn:x-wiley:0023852X:media:lary27006:lary27006-math-0016\"\/>. Airway resistances in the simulated SGS models were similar to resistances in models based on CT scans of actual SGS patients, suggesting that our simulated SGS models were representative of airway resistance in actual SGS patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our computer simulations suggest that the degree of airflow limitation in SGS patients may be estimated based on anatomic measurements alone. Future studies are recommended to test these predictions in larger cohorts.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>4. <jats:italic>Laryngoscope<\/jats:italic>, 128:1551\u20131557, 2018<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.27006","type":"journal-article","created":{"date-parts":[[2017,11,24]],"date-time":"2017-11-24T12:44:55Z","timestamp":1511527495000},"page":"1551-1557","source":"Crossref","is-referenced-by-count":33,"title":["Relationship between degree of obstruction and airflow limitation in subglottic stenosis"],"prefix":"10.1002","volume":"128","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2340-852X","authenticated-orcid":false,"given":"Emily L.","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Biomedical Engineering Marquette University &amp; The Medical College of Wisconsin Milwaukee Wisconsin U.S.A"},{"name":"Department of Otolaryngology and Communication Sciences Medical College of Wisconsin Milwaukee Wisconsin U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4367-7527","authenticated-orcid":false,"given":"Jonathan M.","family":"Bock","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology and Communication Sciences Medical College of Wisconsin Milwaukee Wisconsin U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlton J.","family":"Zdanski","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of North Carolina School of Medicine Chapel Hill North Carolina U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1969-6373","authenticated-orcid":false,"given":"Julia S.","family":"Kimbell","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery University of North Carolina School of Medicine Chapel Hill North Carolina U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2995-9226","authenticated-orcid":false,"given":"Guilherme J. M.","family":"Garcia","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering Marquette University &amp; The Medical College of Wisconsin Milwaukee Wisconsin U.S.A"},{"name":"Department of Otolaryngology and Communication Sciences Medical College of Wisconsin Milwaukee Wisconsin U.S.A"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,11,24]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200101000-00009"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348949410300410"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00383-013-3397-2"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-199212000-00004"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348940111000103"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/000348948709600123"},{"key":"e_1_2_6_8_1","first-page":"1437","volume-title":"Pediatric Otolaryngology","author":"Hartnick CJ","year":"2002"},{"key":"e_1_2_6_9_1","volume-title":"Fluid Mechanics: Fundamentals and Applications","author":"Cengel YA","year":"2006"},{"key":"e_1_2_6_10_1","volume-title":"Fluid Mechanics","author":"White FM","year":"2008"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.resp.2008.07.027"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2009.03.035"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2016.03.051"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.media.2014.03.001"},{"key":"e_1_2_6_15_1","first-page":"295","article-title":"The virtual pediatric airways workbench","volume":"220","author":"Quammen CW","year":"2016","journal-title":"Stud Health Technol Inform"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/08958370802320186"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1002\/cnm.2825"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199909000-00029"},{"key":"e_1_2_6_19_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.107.3.741"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24192"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24641"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24061"},{"key":"e_1_2_6_23_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbiomech.2013.06.016"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25482"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.01063.2006"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.1097\/MOO.0b013e328358566d"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.2174\/157339611795429125"},{"key":"e_1_2_6_28_1","first-page":"1194","volume-title":"Pediatric Otolaryngology","author":"Cotton RT","year":"1990"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aer420"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Flary.27006","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.27006","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,9,17]],"date-time":"2023-09-17T13:34:45Z","timestamp":1694957685000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.27006"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11,24]]},"references-count":28,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2018,7]]}},"alternative-id":["10.1002\/lary.27006"],"URL":"https:\/\/doi.org\/10.1002\/lary.27006","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,11,24]]}}}