A preliminary study of computer assisted evaluation of congenital tracheal stenosis: A new tool for surgical decision-making

Mimouni-Benabu, O.; Meister, Lionel; Giordano, J.; Fayoux, P.; Loundon, Natalie; Triglia, J.-M.; Nicollas, R.

doi:10.1016/j.ijporl.2012.07.009

Cited by 32 publications

(28 citation statements)

References 13 publications

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“…[1][2][3][4][5][6] Other methods are unable to provide this level of information due to the impracticalities of using flow instrumentation in the airway. The metrics provided by CFD are becoming increasingly useful clinically and have been used to assess the effort of breathing in goiters [7][8][9] in transplanted tracheas, 10 stenotic pediatric tracheas, 11 and nasal obstruction. [12][13][14][15] However, all of the above studies are limited in that they are based on an assumption of rigid airway anatomy due to the way the geometries are obtained.…”

Section: Introductionmentioning

confidence: 99%

A novel method to generate dynamic boundary conditions for airway CFD by mapping upper airway movement with non‐rigid registration of dynamic and static MRI

Bates

Schuh

McConnell

et al. 2018

Numer Methods Biomed Eng

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Computational fluid dynamics (CFD) simulations of airflow in the human airways have the potential to provide a great deal of information that can aid clinicians in case management and surgical decision making, such as airway resistance, energy expenditure, airflow distribution, heat and moisture transfer, and particle deposition, as well as the change in each of these due to surgical interventions. However, the clinical relevance of CFD simulations has been limited to date, as previous models either did not incorporate neuromuscular motion or any motion at all. Many common airway pathologies, such as obstructive sleep apnea (OSA) and tracheomalacia, involve large movements of the structures surrounding the airway, such as the tongue and soft palate. Airway wall motion may be due to many factors including neuromuscular motion, internal aerodynamic forces, and external forces such as gravity. Therefore, to realistically model these airway diseases, a method is required to derive the airway wall motion, whatever the cause, and apply it as a boundary condition to CFD simulations. This paper presents and validates a novel method of capturing in vivo motion of airway walls from magnetic resonance images with high spatiotemporal resolution, through a novel combination of non-rigid image, surface, and surface-normal-vector registration. Coupled with image-synchronous pneumotachography, this technique provides the necessary boundary conditions for dynamic CFD simulations of breathing, allowing the effect of the airway's complex motion to be calculated for the first time, in both normal subjects and those with conditions such as OSA.

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Section: Introductionmentioning

confidence: 99%

A novel method to generate dynamic boundary conditions for airway CFD by mapping upper airway movement with non‐rigid registration of dynamic and static MRI

Bates

Schuh

McConnell

et al. 2018

Numer Methods Biomed Eng

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“…They found that the CFD simulation results correlated well with those of pulmonary function tests (PFTs), indicating that CFD has the potential of being a clinical prognosis tool for the tracheobronchial stenosis. Mimouni-Benabu et al [16] evaluated congenital tracheal stenosis and suggested CFD as a new objective tool for surgical decision-making. Shih et al [17] reported the significant decrease of pressure drop, from 77.23 to 7.05 Pa after stent implantation for a 30.0 L/min airflow rate.…”

Section: Introductionmentioning

confidence: 99%

Computational fluid dynamics simulation of airflow in the trachea and main bronchi for the subjects with left pulmonary artery sling

Yue

et al. 2014

BioMedical Engineering OnLine

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BackgroundLeft pulmonary artery sling (LPAS) is a rare but severe congenital anomaly, in which the stenoses are formed in the trachea and/or main bronchi. Multi-detector computed tomography (MDCT) provides useful anatomical images, but does not offer functional information. The objective of the present study is to quantitatively analyze the airflow in the trachea and main bronchi of LPAS subjects through computational fluid dynamics (CFD) simulation.MethodsFive subjects (four LPAS patients, one normal control) aging 6-19 months are analyzed. The geometric model of the trachea and the two main bronchi is extracted from the MDCT images. The inlet velocity is determined based on the body weight and the inlet area. Both the geometric model and personalized inflow conditions are imported into CFD software, ANSYS. The pressure drop, mass flow ratio through two bronchi, wall pressure, flow velocity and wall shear stress (WSS) are obtained, and compared to the normal control.ResultsDue to the tracheal and/or bronchial stenosis, the pressure drop for the LPAS patients ranges 78.9 - 914.5 Pa, much higher than for the normal control (0.7 Pa). The mass flow ratio through the two bronchi does not correlate with the sectional area ratio if the anomalous left pulmonary artery compresses the trachea or bronchi. It is suggested that the C-shaped trachea plays an important role on facilitating the air flow into the left bronchus with the inertia force. For LPAS subjects, the distributions of velocities, wall pressure and WSS are less regular than for the normal control. At the stenotic site, high velocity, low wall pressure and high WSS are observed.ConclusionsUsing geometric models extracted from CT images and the patient-specified inlet boundary conditions, CFD simulation can provide vital quantitative flow information for LPAS. Due to the stenosis, high pressure drops, inconsistent distributions of velocities, wall pressure and WSS are observed. The C-shaped trachea may facilitate a larger flow of air into the left bronchus under the inertial force, and decrease the ventilation of the right lung. Quantitative and personalized information may help understand the mechanism of LPAS and the correlations between stenosis and dyspnea, and facilitate the structural and functional assessment of LPAS.

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“…Historically, CFD has been used to describe airflow in upper airway reconstructive surgery, as well as for modeling fluid flow through blood vessels . Previous work has shown that CFD has the potential for use in evaluating treatment planning for airway interventions . CFD allows for advanced diagnostic capabilities and is especially useful in cases involving multilevel or complex pathology.…”

Section: Discussionmentioning

confidence: 99%

“…4,[22][23][24] Previous work has shown that CFD has the potential for use in evaluating treatment planning for airway interventions. 4,[25][26][27] CFD allows for advanced diagnostic capabilities and is especially useful in cases involving multilevel or complex pathology. For example, if a patient has respiratory tract pathology at the level of the trachea, bronchi, and lungs, CFD allows for description the pathophysiology from each component in isolation or as a combined system.…”

Section: Discussionmentioning

confidence: 99%

Quantification of tissue‐engineered trachea performance with computational fluid dynamics

Eichaker

Li²,

King

et al. 2018

The Laryngoscope

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A preliminary study of computer assisted evaluation of congenital tracheal stenosis: A new tool for surgical decision-making

Cited by 32 publications

References 13 publications

A novel method to generate dynamic boundary conditions for airway CFD by mapping upper airway movement with non‐rigid registration of dynamic and static MRI

A novel method to generate dynamic boundary conditions for airway CFD by mapping upper airway movement with non‐rigid registration of dynamic and static MRI

Computational fluid dynamics simulation of airflow in the trachea and main bronchi for the subjects with left pulmonary artery sling

Quantification of tissue‐engineered trachea performance with computational fluid dynamics

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