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，每年花费美国医疗保健系统约50亿美元。尽管导致OM病症持续存在的主要病因是咽鼓管（ET）功能障碍，但OM的标准治疗方法无法解决导致ET功能障碍的潜在生物力学和结构异常。最近，已经提出了几种针对特定机械和/或物理性质的临床疗法来改善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，本研究项目的目标是深入了解各种生物力学和生物物理特性如何影响不同OM易感患者人群的ET功能。由于大量的物理特性，以及这些特性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ET功能障碍的机制。首先，建立计算建模技术将被用来调查如何ET组织的病理解剖影响开放现象在各种OM倾向的人群。其次，流体-结构相互作用和多尺度现象将被纳入组织变形模型，以研究各种临床相关的属性（即表面张力和粘膜粘附力）如何影响ET开放。将进行几项敏感性分析，以确定哪些生物力学或生物物理特性对不同患者人群的ET功能影响最大。此外，计算模型将用于估计在各种病理条件下ET功能的变化。因此，本研究将确定负责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.