Timing of tensor and levator veli palatini force application determines eustachian tube resistance patterns during the forced-response test.
Timing of tensor and levator veli palatini force application determines eustachian tube resistance patterns during the forced-response test.
复制标题
张量和提肌帕拉蒂尼力施加的时间决定了强制反应测试期间咽鼓管的阻力模式。
DOI：
10.1016/j.anl.2010.02.008
复制
发表时间：
2010
期刊：
影响因子：
--
通讯作者：
Swarts,JDouglas
中科院分区：
文献类型：
--
作者：
Ghadiali,SamirN;Bell,EDavid;Swarts,JDouglas
强迫反应试验（FRT）用于评估中耳疾病（中耳炎）患者的咽鼓管（ET）功能。该测试通常记录吞咽期间管腔扩张和收缩的动态模式，其可以被量化为与主动输卵管阻力与时间相关的函数。本研究的目的是使用一个广义的有限元模型（FEM）来测试的假设，即由腭帆张肌（mTVP）和腭帆提肌（mLVP）上的ET确定的形式的主动阻力functions.METHODS甚至阻力波形的肌肉力量应用的相对时间在FRT在5名成年受试者。从成人组织学标本构建ET的2D FEM，并根据每个受试者的测量结果指定粘弹性组织力学特性。使用最小二乘回归程序改变对ET施加mTVP和mLVP力的时间和幅度，以匹配FRT期间记录的主动阻力函数。FEM模拟中肌肉力时间和幅度的变化以高保真度再现了7个主动阻力波形。早期应用mTVP力与mLVP力联合产生以初始扩张为特征的波形（低阻力）随后是管腔收缩（更高的电阻），结论：FRT过程中所观察到的主动阻力波形反映了mLVP和mTVP施力于ET的时间模式的差异并强调，与mTVP一样，mLVP在功能上与ET相互作用。结果还表明，在正常成人中，mLVP的收缩促进管腔收缩，并且初始管腔收缩对mTVP和mLVP施力的相对延迟时间高度敏感。
OBJECTIVESThe forced-response test (FRT) is used to assess eustachian tube (ET) function in patients with middle ear disease (otitis media). This test often documents a dynamic pattern of luminal dilation and constriction during swallowing which can be quantified as a function relating active tubal resistance with time. The goal of this study is to use a generalized finite element model (FEM) to test the hypothesis that the relative timing of muscle force application by the tensor veli palatini muscle (mTVP) and levator veli palatini muscle (mLVP) on the ET determines the form of active resistance functions.METHODSSeven resistance waveforms were obtained during the FRT in five adult subjects. A 2D FEM of the ET was constructed from an adult histological specimen and viscoelastic tissue mechanical properties were specified based on measurements obtained in each subject. Least-squared regression routines were used to vary the timing and magnitude of mTVP and mLVP force applications to the ET in order to match the active resistance functions recorded during the FRT.RESULTSVariation of muscle force timing and magnitude in the FEM simulations reproduced the seven active resistance waveforms with high fidelity. Early application of mTVP force in combination with mLVP force produced a waveform characterized by an initial dilation (low resistances) followed by lumen constriction (higher resistances), while delayed mTVP force application caused an initial lumen constriction followed by dilation.CONCLUSIONSThese results indicate that the active resistance waveforms observed during the FRT reflect differences in the temporal pattern of mLVP and mTVP force application to the ET and emphasize that, like the mTVP, the mLVP functionally interacts with the ET. Results also indicate that in normal adults contraction of the mLVP promotes lumen constriction and that the initial lumen constriction is highly sensitive to the relative delay timing of mTVP and mLVP force application.