Biomechanical Evaluation of Eustachian Tube Dysfunction

描述(由申请人提供)：中耳炎(OM)是儿童中最常见的疾病之一，每年给美国医疗系统造成的损失估计为50亿美元。尽管咽鼓管(ET)功能障碍是OM持续存在的主要原因，但OM的标准治疗方法不能解决导致ET功能障碍的潜在生物力学和结构异常。最近，一些针对特定机械和/或物理特性的临床治疗方法被建议用于改善ET功能。然而，这些疗法在具有不同结构病理的患者群体中的相对有效性尚不清楚。因此，该研究计划的目标是深入了解不同的OM倾向患者群体中各种生物力学和生物物理特性是如何影响ET功能的。由于大量的物理性质，以及这些性质之间复杂的相互作用，我们将使用复杂的多尺度计算方法来阐明导致ET功能障碍的机制。首先，已建立的计算模型技术将被用来研究ET组织的病理解剖如何影响各种易患OM人群的开放现象。其次，将流体-结构相互作用和多尺度现象纳入组织变形模型，以研究各种临床相关特性(即表面张力和粘膜粘附力)如何影响ET的开放。将进行几项敏感性分析，以确定在不同的患者群体中，哪些生物力学或生物物理特性对ET功能影响最大。此外，计算模型将被用来估计不同病理条件下ET功能的变化。因此，这项研究将确定导致ET功能障碍的生物力学和生物物理机制。这一信息对于寻求恢复OM患者正常ET功能的新型治疗方法的开发至关重要。

DESCRIPTION (provided by applicant): Otitis media (OM) is one of the most prevalent diseases in children and cost the US healthcare system an estimated $5 billion dollars annually. Although the primary etiology responsible for the persistence of OM conditions is a dysfunctional Eustachian tube (ET), standard treatment therapies for OM do not address the underlying biomechanical and structural abnormalities responsible for ET dysfunction. Recently, several clinical therapies which target specific mechanical and/or physical properties have been suggested to improve ET function. However, the relative effectiveness of these therapies in patient populations with different structural pathologies is not known. Therefore, the goal of this research program is to develop an in- depth understanding of how various biomechanical and biophysical properties influence ET function in different OM prone patient populations. Due to the large number of physical properties, and the complex interactions among these properties, we will elucidate the mechanisms responsible for ET dysfunction using a sophisticated multi-scale computational approach. First, established computational modeling techniques will be used to investigate how the pathological anatomy of ET tissues influences opening phenomena in various OM prone populations. Second, fluid-structure interactions and multi-scale phenomena will be incorporated into the tissue deformation models in order to investigate how various clinically relevant properties (i.e. surface tension and mucosal adhesion forces) influence ET opening. Several sensitivity analyses will be performed to identify which biomechanical or biophysical properties have the greatest impact on ET function in different patient populations. In addition, the computational models will be used to estimate changes in ET function during various pathological conditions. As a result, this research will identify the biomechanical and biophysical mechanisms responsible for ET dysfunction. This information is vital to the development of novel treatment therapies that seek to restore normal ET function in patients with OM.