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Assessment of the effect of mouthpiece design on upper airway geometry using functional respiratory imaging

Cedric Van Holsbeke, Wim Vos, Melanie Hamilton, Rita Claes, Dave Prime, Floris Vanhevel, Jan De Backer, Nasser Nadjmi, Paul Parizel, Wilfried De Backer
European Respiratory Journal 2014 44: P553; DOI:
Cedric Van Holsbeke
1Respiratory, Fluidda nv, Kontich, Belgium
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Wim Vos
1Respiratory, Fluidda nv, Kontich, Belgium
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Melanie Hamilton
2R&D, GlaxoSmithKline, Ware, United Kingdom
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Rita Claes
3Respiratory Medicine, University Hospital Antwerp, Edegem, Belgium
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Dave Prime
2R&D, GlaxoSmithKline, Ware, United Kingdom
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Floris Vanhevel
4Radiology, University Hospital Antwerp, Edegem, Belgium
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Jan De Backer
1Respiratory, Fluidda nv, Kontich, Belgium
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Nasser Nadjmi
5Maxillofacial Surgery, AZ Monica, Antwerp, Belgium
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Paul Parizel
4Radiology, University Hospital Antwerp, Edegem, Belgium
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Wilfried De Backer
3Respiratory Medicine, University Hospital Antwerp, Edegem, Belgium
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Abstract

Rationale

This study investigated the impact of mouthpiece design on the upper airway geometry. The influence of mouthpiece variation in height, width, protrusion and resistance to airflow were investigated by performing functional respiratory imaging. The designs were selected to represent those typically found in pressurized metered dose inhalers and dry powder inhalers.

Methods

12 healthy adult male subjects with a height between 175cm and 185cm and a normal BMI were included in the study. An incomplete Box-Behnken block design using 25 mouthpiece designs was used. Ultrafast spoiled gradient echo sequence MRI scans were taken with 11 different mouthpieces for each subject during tidal breathing. The upper airway was segmented and coupled with optically scanned dental impressions and computer aided design models of the mouthpieces (figure 1).

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Results

Multiple regression analysis showed that protrusion had the largest positive effect on average cross sectional area and volume, followed by height. These effects were mainly steered by the oral cavity. For the oropharynx, only the protrusion showed a small inverse correlation. None of the design parameters had an effect on the hypopharynx.

Conclusions

This study demonstrated that mouthpiece design can have an influence on the upper airway geometry.

This study was funded by GlaxoSmithKline.

  • Morphology
  • Physiology
  • Imaging
  • © 2014 ERS
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Assessment of the effect of mouthpiece design on upper airway geometry using functional respiratory imaging
Cedric Van Holsbeke, Wim Vos, Melanie Hamilton, Rita Claes, Dave Prime, Floris Vanhevel, Jan De Backer, Nasser Nadjmi, Paul Parizel, Wilfried De Backer
European Respiratory Journal Sep 2014, 44 (Suppl 58) P553;

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Assessment of the effect of mouthpiece design on upper airway geometry using functional respiratory imaging
Cedric Van Holsbeke, Wim Vos, Melanie Hamilton, Rita Claes, Dave Prime, Floris Vanhevel, Jan De Backer, Nasser Nadjmi, Paul Parizel, Wilfried De Backer
European Respiratory Journal Sep 2014, 44 (Suppl 58) P553;
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