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Fluid dynamics of the upper airway in pediatric patients with severe laryngomalacia

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Abstract

Laryngomalacia is the top cause of pediatric laryngeal wheeze. We used computational fluid dynamics to study the inspiratory airflow dynamics in severe pediatric laryngomalacia. Computed tomography was performed on the upper airways of two infants, one with severe laryngomalacia and one with normal airway, and 3D models were reconstructed. ANSYS CFD-POST software was used to simulate airflow in these models to compare the volumetric flow rate, flow velocity, pressure, wall shear, and vortex. The volume flow rate in the laryngomalacia model was significantly reduced compared with the control model. Under inspiratory pressures, the peak flow velocity, pressure, and shear force in the control model appeared at the soft palate stenosis, while that in the laryngomalacia model appeared at the supraglottis stenosis. In both models, the maximum flow velocity and shear force increased with decreasing inspiratory pressure, while the minimum pressure decreased with decreasing inspiratory pressure. In the control model, the airflow vortex appeared anteriorly below the posterior section of the soft palate. In the laryngomalacia model, the vortex appeared anteriorly below the posterior section of the soft palate and anteriorly below the vocal folds. Our methodology provides a new mechanistic understanding of pediatric laryngomalacia.

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Funding

This research was funded by the Promotion Project of Medical Services and Security Capacity Supported by National Finance, and the Medical and Health Project of Guangxi Health Commission (Z20170351).

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Authors and Affiliations

  1. Department of Otolaryngology-Head and Neck Surgery, First Affiliated Hospital of Guangxi Medical University, 530021, Nanning, China

    Linsong Ye & Jiping Su

  2. Department of Otolaryngology & Head and Neck, The People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, 530021, Nanning, China

    Linsong Ye, Jiazhang Wei, Jingjin Weng & Shenhong Qu

  3. Department of Pediatrics, The People′s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, 530021, Nanning, China

    Zhenhua Liang

  4. Department of Neonatology, Guangxi Zhuang Autonomous Region Maternal and Child Health Hospital, 530002, Nanning, China

    Yan Li

  5. Xinghu Outpatient Clinic, The People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, 530021, Nanning, China

    Minghui Wu

  6. Department of Radiology, The People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, 530021, Nanning, China

    Chunli Zhao

  7. Department of Anesthesiology, The People’s Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, 530021, Nanning, China

    Xiaoqing Liu

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  1. Linsong Ye
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  2. Jiazhang Wei
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  3. Zhenhua Liang
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  4. Yan Li
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  5. Minghui Wu
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  6. Chunli Zhao
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  7. Jingjin Weng
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  8. Xiaoqing Liu
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  9. Jiping Su
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  10. Shenhong Qu
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Corresponding authors

Correspondence to Jiping Su or Shenhong Qu.

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The authors declare no conflict of interest. The funders had no role in the design of the study; in the collection, analyses, or interpretation of data; in the writing of the manuscript, or in the decision to publish the results.

Ethical approval

The study was conducted in accordance with the Declaration of Helsinki and with the approval of the ethics committee of The People’s Hospital of Guangxi Zhuang Autonomous Region (KY-LW-2017-4) and parental consent.

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Ye, L., Wei, J., Liang, Z. et al. Fluid dynamics of the upper airway in pediatric patients with severe laryngomalacia. Phys Eng Sci Med 45, 1083–1091 (2022). https://doi.org/10.1007/s13246-022-01174-8

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  • DOI: https://doi.org/10.1007/s13246-022-01174-8

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