Development of a computational biomechanical model of the human upper‐airway soft‐tissues toward simulating obstructive sleep apnea

Pelteret, Jean-Paul V.; Reddy, B. D.

doi:10.1002/ca.22313

Cited by 14 publications

(12 citation statements)

References 118 publications

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“…As such, the implementation

only depends on the current state of u (computed via the finite element method) and u at the previous time step. We implemented the model in the finite element library deal.II version 8.5.1 ( Arndt et al, 2017 ) using the tutorial step-44 ( Pelteret and McBride, 2012 ; Pelteret, 2014 ).…”

Section: Appendix 1: Details Of Model Formulationmentioning

confidence: 99%

The Energy of Muscle Contraction. III. Kinetic Energy During Cyclic Contractions

et al. 2021

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During muscle contraction, chemical energy is converted to mechanical energy when ATP is hydrolysed during cross-bridge cycling. This mechanical energy is then distributed and stored in the tissue as the muscle deforms or is used to perform external work. We previously showed how energy is distributed through contracting muscle during fixed-end contractions; however, it is not clear how the distribution of tissue energy is altered by the kinetic energy of muscle mass during dynamic contractions. In this study we conducted simulations of a 3D continuum muscle model that accounts for tissue mass, as well as force-velocity effects, in which the muscle underwent sinusoidal work-loop contractions coupled with bursts of excitation. We found that increasing muscle size, and therefore mass, increased the kinetic energy per unit volume of the muscle. In addition to greater relative kinetic energy per cycle, relatively more energy was also stored in the aponeurosis, and less was stored in the base material, which represented the intra and extracellular tissue components apart from the myofibrils. These energy changes in larger muscles due to greater mass were associated lower mass-specific mechanical work output per cycle, and this reduction in mass-specific work was greatest for smaller initial pennation angles. When we compared the effects of mass on the model tissue behaviour to that of in situ muscle with added mass during comparable work-loop trials, we found that greater mass led to lower maximum and higher minimum acceleration in the longitudinal (x) direction near the middle of the muscle compared to at the non-fixed end, which indicates that greater mass contributes to tissue non-uniformity in whole muscle. These comparable results for the simulated and in situ muscle also show that this modelling framework behaves in ways that are consistent with experimental muscle. Overall, the results of this study highlight that muscle mass is an important determinant of whole muscle behaviour.

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“…As such, the implementation

Section: Appendix 1: Details Of Model Formulationmentioning

confidence: 99%

The Energy of Muscle Contraction. III. Kinetic Energy During Cyclic Contractions

et al. 2021

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“…The evaluation of passive mechanical behaviour of the soft tissues in the upper airway is challenging because there will be a neural driving mechanism in the airway musculature. Pelteret and Reddy demonstrated in 2013 a considerable difference in the displacement of the tongue due to gravity in their FE model depending on whether active muscle control was applied or not . Studies of paralyzed human airways, however, demonstrate that the upper airways in OSA patients are more compliant than in healthy subjects suggesting that geometric characteristics alone can influence the biomechanical response of the airway .…”

Section: Discussionmentioning

confidence: 99%

Simulation of the upper airways in patients with obstructive sleep apnea and nasal obstruction: A novel finite element method

Moxness

Wülker

Skallerud

et al. 2018

Laryngoscope Investig Oto

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ObjectiveTo evaluate the biomechanical properties of the soft palate and velopharynx in patients with obstructive sleep apnea (OSA) and nasal obstruction.Study designProspective experimental study.Materials and methodsTwo finite element (FE) models of the soft palate were created in six patients undergoing nasal surgery, one homogeneous model based on CT images, and one layered model based on soft tissue composition. The influence of anatomy on displacement caused by a gravitational load and closing pressure were evaluated in both models. The strains in the transverse and longitudinal direction were obtained for each patient.ResultsThe individual anatomy influences both its structural stiffness and its gravitational displacement. The soft palate width was the sole anatomical parameter correlated to the critical closing pressure, but the maximal displacement due to gravity may have a relationship to closing pressure of possibly an exponential order. The airway occlusion occurred mainly at the lateral attachments of the soft palate. The total transverse strain showed a strong correlation with maximal closing pressure. There was no relationship between the critical closing pressure and the preoperative AHI levels, or the change in AHI after surgery.ConclusionHyperelastic FE models both in the homogeneous and layered model represent a novel method of evaluating soft tissue biomechanics of the upper airway. The obstruction occurs mainly at the level of the lateral attachments to the pharyngeal wall, and the width of the soft palate is an indicator of the degree of critical closing pressure. A less negative closing pressure corresponds to small total transverse strain. The effect of nasal surgery on OSA is most likely not explained by change in soft palate biomechanics.Level of EvidenceNA.

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“…Despite the drawbacks, including accuracy (see Soquet et al, for a review), it was the best available approach at that time and was used in many studies, including the 2D biomechanical model by Payan and Perrier . Later on, simultaneous multislice imaging made it possible to measure the area function directly using 3D images and also to develop 3D biomechanical models that are more realistic regarding the anatomy (eg, fiber direction of the muscles) and mechanical properties (eg, muscular hydrostat) of the structures. Despite the progress in biomechanical modeling, little attention yet has been paid to reconstructing the complex vocal tract geometry in 3D, and the area function is still the most common representation.…”

Section: Introductionmentioning

confidence: 99%

Reconstruction of vocal tract geometries from biomechanical simulations

Dabbaghchian

Arnela

Engwall

et al. 2018

Numer Methods Biomed Eng

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Medical imaging techniques are usually utilized to acquire the vocal tract geometry in 3D, which may then be used, eg, for acoustic/fluid simulation. As an alternative, such a geometry may also be acquired from a biomechanical simulation, which allows to alter the anatomy and/or articulation to study a variety of configurations. In a biomechanical model, each physical structure is described by its geometry and its properties (such as mass, stiffness, and muscles). In such a model, the vocal tract itself does not have an explicit representation, since it is a cavity rather than a physical structure. Instead, its geometry is defined implicitly by all the structures surrounding the cavity, and such an implicit representation may not be suitable for visualization or for acoustic/fluid simulation. In this work, we propose a method to reconstruct the vocal tract geometry at each time step during the biomechanical simulation. Complexity of the problem, which arises from model alignment artifacts, is addressed by the proposed method. In addition to the main cavity, other small cavities, including the piriform fossa, the sublingual cavity, and the interdental space, can be reconstructed. These cavities may appear or disappear by the position of the larynx, the mandible, and the tongue. To illustrate our method, various static and temporal geometries of the vocal tract are reconstructed and visualized. As a proof of concept, the reconstructed geometries of three cardinal vowels are further used in an acoustic simulation, and the corresponding transfer functions are derived.

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Development of a computational biomechanical model of the human upper‐airway soft‐tissues toward simulating obstructive sleep apnea

Cited by 14 publications

References 118 publications

The Energy of Muscle Contraction. III. Kinetic Energy During Cyclic Contractions

The Energy of Muscle Contraction. III. Kinetic Energy During Cyclic Contractions

Simulation of the upper airways in patients with obstructive sleep apnea and nasal obstruction: A novel finite element method

Reconstruction of vocal tract geometries from biomechanical simulations

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