Computational Fluid Dynamic Analysis of Different Velopharyngeal Closure Patterns

2019 ◽  
Vol 129 (2) ◽  
pp. 157-163 ◽  
Author(s):  
Hanyao Huang ◽  
Heng Yin ◽  
Yang Wang ◽  
Nan Chen ◽  
Dantong Huang ◽  
...  
Keyword(s):  
Fluid Dynamic ◽  
Clinical Care ◽  
Upper Airway ◽  
Computational Fluid Dynamic Analysis ◽  
Orifice Area ◽  
Flow Simulations ◽  
Velopharyngeal Closure ◽  
Computed Tomography Scans ◽  
Closure Conditions

Objective: Velopharyngeal (VP) closure has high impact on the quality of life, especially in patients with cleft palate. For better understanding the VP closure, it is important to understand the airflow dynamics of different closure patterns, including circular, coronal, sagittal, and circular with a Passavant’s ridge. The purpose of this study was to demonstrate the airflow characteristics of different velopharyngeal closure patterns. Methods: Sixteen adults with no notable upper airway abnormality who needed multislice spiral computed tomography scans as part of their clinical care. Airways were reconstructed. A cylinder and a cuboid were used to replace the VP port in three models of VP port patterns. Flow simulations were carried using computational fluid dynamics. Airflow pressures in the VP orifice, oral cavity and nasal cavity, as well as airflow velocity through the velopharyngeal orifice, were calculated. Results: The airflow dynamics at the velopharynx were different among different velopharyngeal patterns as the area of the velopharyngeal port increased from 0 to 25 mm2. The orifice areas of different closure conditions in four velopharyngeal closure patterns were significantly different. The maximal orifice area for adequate velopharyngeal closure was 7.57 mm2 in the coronal pattern and 6.21 mm2 in the sagittal pattern. Conclusions: Airflow dynamics of the velopharynx were correlated to the velopharyngeal closure patterns. Different closure patterns had different largest permitted orifice areas for getting the appropriate oral pressures for normal speech.

Applications of Acoustic Rhinometry in the Modeling of Living Human Nasal Cavity Based on CT Scan

2005 ◽  
Author(s):  
Yingxi Liu ◽  
Jun Zhang ◽  
Xiuzhen Sun
Keyword(s):  
Nasal Cavity ◽  
Fluid Dynamic ◽  
Upper Airway ◽  
Acoustic Rhinometry ◽  
Cavity Model ◽  
Cfd Model ◽  
Cross Sectional ◽  
Significant Information ◽  
3 Dimensional ◽  
Computed Tomography Scans

Acoustic rhinometry can quantify upper airway condition of air draft by drawing a graph plotting the distance from the nostril vs. the cross-sectional area. Some decrease on the graph corresponds to the typical anatomic structures of human nasal cavity. The 3-dimensional, computing fluid dynamic model of the same person was developed based on computed tomography scans. The veracity of the CFD model were valued by contrasting the relevant areas of stenosis site between the model and the AR graph. The aim in this study is to make clear how to use an AR to help improve and enrich the CFD model with the information of graph acquired from the measurement. The combination of AR and CT can be used to establish a living human nasal cavity model with higher significant information content.

Distraction Osteogenesis in the Treatment of Craniofacial Anomalies: Applications and Outcomes

2020 ◽  
Vol 5 (6) ◽  
pp. 1469-1481 ◽  
Author(s):  
Joseph A. Napoli ◽  
Carrie E. Zimmerman ◽  
Linda D. Vallino
Keyword(s):  
Distraction Osteogenesis ◽  
Bone Growth ◽  
Upper Airway ◽  
Craniofacial Anomalies ◽  
Craniofacial Skeleton ◽  
Facial Skeleton ◽  
Psychosocial Impairment ◽  
And Function ◽  
Correct Structure

Purpose Craniofacial anomalies (CFA) often result in growth abnormalities of the facial skeleton adversely affecting function and appearance. The functional problems caused by the structural anomalies include upper airway obstruction, speech abnormalities, feeding difficulty, hearing deficits, dental/occlusal defects, and cognitive and psychosocial impairment. Managing disorders of the craniofacial skeleton has been improved by the technique known as distraction osteogenesis (DO). In DO, new bone growth is stimulated allowing bones to be lengthened without need for bone graft. The purpose of this clinical focus article is to describe the technique and clinical applications and outcomes of DO in CFA. Conclusion Distraction can be applied to various regions of the craniofacial skeleton to correct structure and function. The benefits of this procedure include improved airway, feeding, occlusion, speech, and appearance, resulting in a better quality of life for patients with CFA.

Gastroesophageal Reflux Disease: A Gastroenterologist's Perspective

2011 ◽  
Vol 21 (3) ◽  
pp. 89-99
Author(s):  
Michael F. Vaezi
Keyword(s):  
Gastroesophageal Reflux Disease ◽  
Gastroesophageal Reflux ◽  
Reflux Disease ◽  
Best Practice ◽  
Clinical Care ◽  
Diagnostic Testing ◽  
Diagnostic Tools ◽  
Swallowing Function ◽  
Atypical Symptoms

Gastroesophageal reflux disease (GERD) is a commonly diagnosed condition often associated with the typical symptoms of heartburn and regurgitation, although it may present with atypical symptoms such as chest pain, hoarseness, chronic cough, and asthma. In most cases, the patient's reduced quality of life drives clinical care and diagnostic testing. Because of its widespread impact on voice and swallowing function as well as its social implications, it is important that speech-language pathologists (SLPs) understand the nature of GERD and its consequences. The purpose of this article is to summarize the nature of GERD and GERD-related complications such as GERD-related peptic stricture, Barrett's esophagus and adenocarcinoma, and laryngeal manifestations of GERD from a gastroenterologist's perspective. It is critical that SLPs who work with a multidisciplinary team understand terminology, diagnostic tools, and treatment to ensure best practice.

Treatment of painful bone metastases in prostate and breast cancer patients with the therapeutic radiopharmaceutical rhenium-188-HEDP

2016 ◽  
Vol 55 (05) ◽  
pp. 188-195 ◽  
Author(s):  
Floor Overbeek ◽  
John de Klerk ◽  
Pieternel Pasker-de Jong ◽  
Alexandra van den Berk ◽  
Rob ter Heine ◽  
...  
Keyword(s):  
Bone Metastases ◽  
Clinical Benefit ◽  
Response Rate ◽  
Clinical Care ◽  
Pain Response ◽  
Pain Palliation ◽  
Breast Cancer Patients ◽  
Routine Clinical Care ◽  
Painful Bone Metastases

Summary Aim: Rhenium-188-HEDP (188Re-HEDP) is an effective radiopharmaceutical for the palliative treatment of osteoblastic bone metastases. However, only limited data on its routine use are available and its effect on quality of life (QoL) has not been studied. Therefore, we evaluated the clinical benefit of 188Re-HEDP in routine clinical care. Patients and methods: Prostate or breast cancer patients with painful bone metastases receiving 188Re-HEDP as a routine clinical procedure were eligible for evaluation. Clinical benefit was assessed in terms of efficacy and toxicity. Pain palliation and QoL were monitored using the visual analogue scale (VAS), corrected for opioid intake, and the EORTC QLQ-C30 Global health status/QoL-scale. Thrombocyte and leukocyte nadirs were used to assess haematological toxicity. Results: 45 and 47 patients were evaluable for pain palliation and QoL, respectively. After a single injection of 188Re-HEDP, the overall pain response rate was 69% and mean VAS-scores decreased relevantly and significantly (p < 0.05). Repeated treatment resulted in similar pain response. The overall QoL response rate was 68% and mean Global health status/QoL-scores increased relevantly and significantly. Haematological side effects were mild and transient. Conclusion: The clinically relevant response on pain and quality of life and the limited adverse events prove clinical benefit of treatment with 188Re-HEDP and support its use in routine clinical care. Its effectiveness appears comparable to that of external beam radiotherapy.

Quality of Life for Children with Persistent Sinonasal Symptoms

2003 ◽  
Vol 128 (1) ◽  
pp. 17-26 ◽  
Author(s):  
David J. Kay ◽  
Richard M. Rosenfeld
Keyword(s):  
Quality Of Life ◽  
Clinical Care ◽  
Longitudinal Change ◽  
Good Test ◽  
Routine Clinical Care ◽  
Before And After ◽  
The Mean ◽  
The Individual ◽  
Sinonasal Symptoms

OBJECTIVE: The goal was to validate the SN-5 survey as a measure of longitudinal change in health-related quality of life (HRQoL) for children with persistent sinonasal symptoms. DESIGN AND SETTING: We conducted a before and after study of 85 children aged 2 to 12 years in a metropolitan pediatric otolaryngology practice. Caregivers completed the SN-5 survey at entry and at least 4 weeks later. The survey included 5 symptom-cluster items covering the domains of sinus infection, nasal obstruction, allergy symptoms, emotional distress, and activity limitations. RESULTS: Good test-retest reliability ( R = 0.70) was obtained for the overall SN-5 score and the individual survey items ( R ≥ 0.58). The mean baseline SN-5 score was 3.8 (SD, 1.0) of a maximum of 7.0, with higher scores indicating poorer HRQoL. All SN-5 items had adequate correlation ( R ≥ 0.36) with external constructs. The mean change in SN-5 score after routine clinical care was 0.88 (SD, 1.19) with an effect size of 0.74 indicating good responsiveness to longitudinal change. The change scores correlated appropriately with changes in related external constructs ( R ≥ 0.42). CONCLUSIONS: The SN-5 is a valid, reliable, and responsive measure of HRQoL for children with persistent sinonasal symptoms, suitable for use in outcomes studies and routine clinical care.

scholarly journals A novel p-harmonic descent approach applied to fluid dynamic shape optimization

2021 ◽  
Author(s):  
Peter Marvin Müller ◽  
Niklas Kühl ◽  
Martin Siebenborn ◽  
Klaus Deckelnick ◽  
Michael Hinze ◽  
...  
Keyword(s):  
Shape Optimization ◽  
Large Deformations ◽  
Fluid Dynamic ◽  
Shape Optimisation ◽  
Shape Features ◽  
Floating Bodies ◽  
Novel Method ◽  
Sharp Corners ◽  
Dynamic Shape

AbstractWe introduce a novel method for the implementation of shape optimization for non-parameterized shapes in fluid dynamics applications, where we propose to use the shape derivative to determine deformation fields with the help of the $$p-$$ p - Laplacian for $$p > 2$$ p > 2 . This approach is closely related to the computation of steepest descent directions of the shape functional in the $$W^{1,\infty }-$$ W 1 , ∞ - topology and refers to the recent publication Deckelnick et al. (A novel $$W^{1,\infty}$$ W 1 , ∞ approach to shape optimisation with Lipschitz domains, 2021), where this idea is proposed. Our approach is demonstrated for shape optimization related to drag-minimal free floating bodies. The method is validated against existing approaches with respect to convergence of the optimization algorithm, the obtained shape, and regarding the quality of the computational grid after large deformations. Our numerical results strongly indicate that shape optimization related to the $$W^{1,\infty }$$ W 1 , ∞ -topology—though numerically more demanding—seems to be superior over the classical approaches invoking Hilbert space methods, concerning the convergence, the obtained shapes and the mesh quality after large deformations, in particular when the optimal shape features sharp corners.

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