FE simulation of human trachea swallowing movement before and after the implantation of an endoprothesis. (English) Zbl 1228.74050
Summary: Nowadays interventions associated to the implantation of tracheal stents in patients with airway pathologies, are a very common surgery that in the post-operating period can bear many problems such as migration of the stent, development of granulation tissue at the edges of the stent with overgrowth of the tracheal lumen, or accumulation of secretions inside the prosthesis. Among the movements that trachea carries out, swallowing seems to drive harmful consequences for the tracheal tissues surrounding the prosthesis. In this work a finite element model of a human trachea has been developed and used to analyze its behavior during swallowing. In the present work, a complete human trachea finite element model based on experimental study is developed. The real swallowing movement of two patients before and after the implantation of Dumon prosthesis was used to simulate and then analyze the effect that the tracheal implant has on the stress response of the trachea and on the physiological capacity to swallow. In both studied cases with an implanted Dumon prosthesis, patients showed a decrease of their ability to swallow; one lost 26.4% and the other one 18.9% of their tracheal ascending movements. Besides, the prosthesis implantation caused an increase of the stresses located in the superior contact border between the tracheal wall and the prosthesis. It could be seen that the resulting force equivalent to the elevating tracheal muscle forces for degluting, was around \(F = 13.5\) N for the two patients both before and after the stent implantation. The implantation of a Dumon prosthesis modifies the mechanical response of the trachea altering its stress distribution and its ascending movement.
MSC:
| 74L15 | Biomechanical solid mechanics |
| 92C50 | Medical applications (general) |
| 74S05 | Finite element methods applied to problems in solid mechanics |
References:
| [1] | Grillo, H. C.; Donahue, D. M.; Mathisen, D. J.; Wain, J. C.; Wright, C. D., Postintubation tracheal stenosis, treatment and results, J. Thorac. Cardiovasc. Surg., 109, 3, 486-492 (1995) |
| [2] | Huang, C. J., Use of the silicone T-tube to treat tracheal stenosis or tracheal injury, Ann. Thorac. Cardiacovasc. Surg., 7, 4 (2001) |
| [3] | Rob, Cg.; Bateman, Gh., Reconstruction of the trachea and cervical oesophagus preliminary report, Br. J. Surg., 37, 146, 202-205 (1949) |
| [4] | Belsey, R., Resection and reconstruction of the intrathoracic trachea, Br. J. Surg., 38, 200-205 (1951) |
| [5] | Grillo, H. C., Tracheal replacement a critical review, Ann. Thorac. Surg., 73, 1995-2004 (2002) |
| [6] | M.M. Wahidi, A. Ernst, The Montgomery T-tube tracheal stent, Clin. Chest Med.; M.M. Wahidi, A. Ernst, The Montgomery T-tube tracheal stent, Clin. Chest Med. |
| [7] | Xavier, R. G.; Stefani Sanches, P. R.; Viera de Macedo Neto, A.; Kuhl, G.; Bianchi Vearick, S.; Dall’Onder Michelon, M., Development of a modified Dumon stent for tracheal applications: an experimental study in dogs, J. Bras. Pneumol., 34, 1, 21-26 (2008) |
| [8] | Noppen, M.; Meysman, M.; Claes, I.; D’Haese, J.; Vincken, W., Screw-thread vs Dumon endoprosthesis in the management of tracheal stenosis, Chest, 115, 532-535 (1999) |
| [9] | Madden, B. P.; Datta, S.; Charokopos, N., Experience with ultraflex expandable metallic stents in the management of endobronchial pathology, Ann. Thorac. Surg., 73, 938-944 (2002) |
| [10] | Noppen, M.; Stratakos, G.; D’Haese, J.; Meysman, M.; Vincken, W., Removal of covered self-expandable metallic airway stents in benign disorders, Chest, 127, 482-487 (2005) |
| [11] | Freitag, L.; Eicker, R.; Linz, B.; Greschuchna, D., Theoretical and experimental basis for the development of a dynamic airway stent, Eur. Respir. J., 7, 2038-2045 (1994), doi:10.1183/09031936.94.07112038 |
| [12] | Mitsuoka, M.; Sakuragi, T.; Itoh, T., Clinical benefits and complications of Dumon stent insertion for the treatment of severe central stenosis or airway fistula. The Japanese Association for Thoracic Surgery 2007, Gen. Thorac. Cardiovasc. Surg., 55, 275-280 (2007) |
| [13] | Dumon, J. F.; Cavaliere, S.; Diaz-Gimenez, P.; Vergnon, J. M., Seven-year experience with the Dumon prosthesis. Solunum 3, Özel Sayi, 2, 255-259 (2001) |
| [14] | Dumon, J. F., A dedicated tracheobronchial stent, Chest, 97, 328-332 (1990) |
| [15] | Pereszlenyi, A.; Igaz, M.; Majer, I.; Harustiak, S., Role of endotracheal stenting in tracheal reconstruction surgery-retrospective analysis, Eur. J. Cardiothorac. Surg., 25, 1059-1064 (2004) |
| [16] | Holzhäuser, U.; Lambert, R. K., Analysis of tracheal mechanics and applications, J. Appl. Physiol., 91, 290-297 (2001) |
| [17] | Costantino, M. L.; Bagnoli, P.; Dini, G.; Fiore, G. B.; Soncini, M.; Corno, C.; Acocella, F.; Colombi, R., A numerical and experimental study of compliance and collapsibility of preterm lamb tracheae, J. Biomech., 37, 12, 1837-1847 (2004) |
| [18] | Gustin, B.; G’Sell, C.; Cochelin, B.; Wourms, P.; Potier-Ferry, M., Finite element determination of the forces exerted by endotracheal tubes on the upper airways, Biomaterials, 17, 1219-1225 (1996) |
| [19] | Wiggs, B. R.; Hrousis, C. A.; Drazen, J. M.; Kamm, R. D., On the mechanism of mucosal folding in normal and asthmatic airways, J. Appl. Physiol., 83, 1814-1821 (1997) |
| [20] | MIMICS Guide, Materialise Technologielaan 15, 3001 Leuven.; MIMICS Guide, Materialise Technologielaan 15, 3001 Leuven. |
| [21] | MCS, Patran Support, The MSC Institute of Technology, 2 Mac Arthur Place, Santa Ana, CA 92707.; MCS, Patran Support, The MSC Institute of Technology, 2 Mac Arthur Place, Santa Ana, CA 92707. |
| [22] | Concept Creators incorporation, Get Body Smart 2009: Respiratory system – trachea and Bronchi – trachea wall. www.getbodysmart.com. 19/6/09.; Concept Creators incorporation, Get Body Smart 2009: Respiratory system – trachea and Bronchi – trachea wall. www.getbodysmart.com. 19/6/09. |
| [23] | R. Shih, Introduction to finite element analysis using, Oregon Institute of Technology, SDC Publications, I-DEAS, ISBN 978-1-58503-085-9.; R. Shih, Introduction to finite element analysis using, Oregon Institute of Technology, SDC Publications, I-DEAS, ISBN 978-1-58503-085-9. |
| [24] | Peña, E.; Pérez del Palomar, A.; Calvo, B.; Martínez, M. A.; Doblaré, M., Computational modelling of diarthrodial joints physiological pathological and pos-surgery simulations, Arch. Comput. Methods Eng., 11, 4, 1-50 (2005) · Zbl 1177.92017 |
| [25] | Trabelsi, O.; Pérez Del Palomar, A.; López-Villalobos, J. L.; Ginel, A.; Doblaré, M., Experimental characterization and constitutive modeling of the mechanical behavior of the human trachea, Med. Eng. Phys., 32, 76-82 (2010) |
| [26] | Lambert, R. K.; Baile, E. M.; Moreno, R. H.; Bert, J.; Pare, P. D., A method for estimating the Young’s modulus of complete tracheal cartilage rings, J. Appl. Physiol., 70, 1152-1159 (1991) |
| [27] | Holzapfel, G. A.; Sommer, G.; Gasser, C. T.; Regitnig, P., Determination of layer-specific mechanical properties of human coronary arteries with nonatherosclerotic intimal thickening and related constitutive modeling, Am. J. Physiol. Heart Circ. Physiol., 289, H2048-H2058 (2005) |
| [28] | Holzapfel, G. A.; Gasser, T. C.; Ogden, R. W., A new constitutive framework for arterial wall mechanics and a comparative study of material models, J. Elasticity, 61, 1-48 (2000) · Zbl 1023.74033 |
| [29] | Wang, L.; Pinder, K. L.; Bert, J. L.; Okazawa, M.; Paré, P. D., Mechanical properties of the tracheal mucosal membrane in the rabbit II Morphometric analysis, J. Appl. Physiol., 88, 1022-1028 (2000) |
| [30] | M. Hopcroft, What is the Young’s Modulus of Silicon? Spring 2006.; M. Hopcroft, What is the Young’s Modulus of Silicon? Spring 2006. |
| [31] | MEMS and Nanotechnology Exchange, 1895 Preston White Drive, Suite 100 Reston, Virginia 20191-5434.; MEMS and Nanotechnology Exchange, 1895 Preston White Drive, Suite 100 Reston, Virginia 20191-5434. |
| [32] | Verkerke, G. J.; de Vries, M. P.; Schutte, H. K.; Van den Hoogen, F. J.A.; Rakhorst, G., Analysis of mechanical behavior of the Nijdam voice prosthesis, The Laryngoscope, 107 (1997) |
| [33] | Sera, T.; Satoh, S.; Horinouchi, H.; Kabayashi, K.; Tanishita, K., Respiratory flow in a realistic tracheostenosis model, J. Biomech. Eng., 125, 461-471 (2003) |
| [34] | Robert, D., Swallowing disorders following endotracheal intubation and tracheotomy, Réanimation, 13, 417-430 (2004) |
| [35] | ABAQUS, Inc., Version 6.8, 1080 Main Street Pawtucket, RI 02860-4847.; ABAQUS, Inc., Version 6.8, 1080 Main Street Pawtucket, RI 02860-4847. |
| [36] | M.A. González Ballester, A. Pérez del Palomar, J.L. López Villalobos, L. Lara Rodríguez, O. Trabelsi, F. Pérez, A. Ginel Cañamaque, E. Barrot Cortés, F. Rodríguez Panadero, M. Doblaré Castellano, J. Herrero Jover, Surgical Planning and Patient-Specific Biomechanical Simulation for Tracheal Endoprostheses Interventions, Springer (Medical Image Computing and Computer Assisted Interventions, London, UK), vol. 5762, 2009, pp. 275-282.; M.A. González Ballester, A. Pérez del Palomar, J.L. López Villalobos, L. Lara Rodríguez, O. Trabelsi, F. Pérez, A. Ginel Cañamaque, E. Barrot Cortés, F. Rodríguez Panadero, M. Doblaré Castellano, J. Herrero Jover, Surgical Planning and Patient-Specific Biomechanical Simulation for Tracheal Endoprostheses Interventions, Springer (Medical Image Computing and Computer Assisted Interventions, London, UK), vol. 5762, 2009, pp. 275-282. |
This reference list is based on information provided by the publisher or from digital mathematics libraries. Its items are heuristically matched to zbMATH identifiers and may contain data conversion errors. In some cases that data have been complemented/enhanced by data from zbMATH Open. This attempts to reflect the references listed in the original paper as accurately as possible without claiming completeness or a perfect matching.
