Finite Element Analysis of Eustachian Tube Function in Cleft Palate Infants Based on Histological Reconstructions

Sheer, Francis J.; Swarts, J. Douglas; Ghadiali, Samir N.

doi:10.1597/09-131

Cited by 14 publications

(17 citation statements)

References 47 publications

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“…Given that the major utility of these types of computational models is their ability to help interpret ex perimental data, we suggest that future studies first focus on con ducting in vitro studies that investigate cell injury during airway reopening in a bifurcating geometry and in silico studies that extend the current model to 3D so that it accurately captures the geometry used in in vitro experiments. Future studies could then use imagebased finite element modeling techniques [51,52] to develop com putational models of airway reopening in more realistic geometries.…”

Section: Model Limitationsmentioning

confidence: 99%

Computational Analysis of Microbubble Flows in Bifurcating Airways: Role of Gravity, Inertia, and Surface Tension

Chen

Zielinski

Ghadiali

2014

Journal of Biomechanical Engineering

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Although mechanical ventilation is a life-saving therapy for patients with severe lung disorders, the microbubble flows generated during ventilation generate hydrodynamic stresses, including pressure and shear stress gradients, which damage the pulmonary epithelium. In this study, we used computational fluid dynamics to investigate how gravity, inertia, and surface tension influence both microbubble flow patterns in bifurcating airways and the magnitude/distribution of hydrodynamic stresses on the airway wall. Direct interface tracking and finite element techniques were used to simulate bubble propagation in a two-dimensional (2D) liquid-filled bifurcating airway. Computational solutions of the full incompressible Navier-Stokes equation were used to investigate how inertia, gravity, and surface tension forces as characterized by the Reynolds (Re), Bond (Bo), and Capillary (Ca) numbers influence pressure and shear stress gradients at the airway wall. Gravity had a significant impact on flow patterns and hydrodynamic stress magnitudes where Bo > 1 led to dramatic changes in bubble shape and increased pressure and shear stress gradients in the upper daughter airway. Interestingly, increased pressure gradients near the bifurcation point (i.e., carina) were only elevated during asymmetric bubble splitting. Although changes in pressure gradient magnitudes were generally more sensitive to Ca, under large Re conditions, both Re and Ca significantly altered the pressure gradient magnitude. We conclude that inertia, gravity, and surface tension can all have a significant impact on microbubble flow patterns and hydrodynamic stresses in bifurcating airways.

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Section: Model Limitationsmentioning

confidence: 99%

Computational Analysis of Microbubble Flows in Bifurcating Airways: Role of Gravity, Inertia, and Surface Tension

Chen

Zielinski

Ghadiali

2014

Journal of Biomechanical Engineering

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“…Although previous models indicate that increasing TVP forces leads to better ET function, these models could not evaluate how increased mucosal adhesion influences TVP assisted opening of the ET. As shown in Figure , the percentage of springs ruptured for n = 6 subjects followed a sigmoidal relationship with TVP force on a semi‐log scale.…”

Section: Resultsmentioning

confidence: 96%

“…In previous finite element models of ET function, which did not account for mucosal adhesion, muscle contraction resulted in uniform opening of the ET. However, for a baseline adhesion energy density of 8.0e − 3 N/m, muscle contraction in the current multi‐scale models of ET function resulted in heterogeneous opening profiles along the length of the ET.…”

Section: Resultsmentioning

confidence: 99%

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Multi‐scale finite element modeling of Eustachian tube function: influence of mucosal adhesion

Malik

Swarts

Ghadiali

2016

Numer Methods Biomed Eng

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The inability to open the collapsible Eustachian tube (ET) leads to the development of chronic Otitis Media (OM). Although mucosal inflammation during OM leads to increased mucin gene expression and elevated adhesion forces within the ET lumen, it is not known how changes in mucosal adhesion alter the biomechanical mechanisms of ET function. In this study, we developed a novel multi-scale finite element model of ET function in adults that utilizes adhesion spring elements to simulate changes in mucosal adhesion. Models were created for six adult subjects and dynamic patterns in muscle contraction were used to simulate the wave-like opening of the ET that occurs during swallowing. Results indicate that ET opening is highly sensitive to the level of mucosal adhesion and that exceeding a critical value of adhesion leads to rapid ET dysfunction. Parameter variation studies and sensitivity analysis indicate that increased mucosal adhesion alters the relative importance of several tissue biomechanical properties. For example, increases in mucosal adhesion reduced the sensitivity of ET function to tensor veli palatini muscle forces but did not alter the insensitivity of ET function to levator veli palatini muscle forces. Interestingly, although changes in cartilage stiffness did not significantly influence ET opening under low adhesion conditions, ET opening was highly sensitive to changes in cartilage stiffness under high adhesion conditions. Therefore, our multi-scale computational models indicate that changes in mucosal adhesion as would occur during inflammatory OM alter the biomechanical mechanisms of ET function.

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“…For children with NSCL/P, considerable emphasis has been given their high prevalence of middle ear deficits that are most likely due to Eustachian tube dysfunction [5]. Inner ear disorder is rare in children with NSCL/P compared to children with syndromic clefts.…”

Section: Introductionmentioning

confidence: 99%

Behavioral assessment of auditory processing disorder in children with non-syndromic cleft lip and/or palate

McPherson

Ma³

2015

International Journal of Pediatric Otorhinolaryngology

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Finite Element Analysis of Eustachian Tube Function in Cleft Palate Infants Based on Histological Reconstructions

Abstract: Introduction-The prevalence of otitis media with effusion approaches 100% in infants with cleft palate (CP), and disease pathogenesis is believed to be caused by eustachian tube (ET) dysfunction.

Cited by 14 publications

References 47 publications

Computational Analysis of Microbubble Flows in Bifurcating Airways: Role of Gravity, Inertia, and Surface Tension

Computational Analysis of Microbubble Flows in Bifurcating Airways: Role of Gravity, Inertia, and Surface Tension

Multi‐scale finite element modeling of Eustachian tube function: influence of mucosal adhesion

Behavioral assessment of auditory processing disorder in children with non-syndromic cleft lip and/or palate

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