Finite element analysis of eustachian tube function in cleft palate infants based on histological reconstructions.

INTRODUCTION

The prevalence of otitis media with effusion approaches 100% in infants with cleft palate (CP), and disease pathogenesis is believed to be caused by eustachian tube (ET) dysfunction.

OBJECTIVES

Quantify the functional consequences of ET anatomy in infant CP specimens, and identify the relative importance of various tissue biomechanical properties on ET function in infants with CP.

METHODS

Finite element models of ET anatomy and physiology were developed by using image analysis and three-dimensional (3D) reconstruction techniques. Models were developed using histological images of ET structures obtained from five infant CP specimens. The models were parameterized, and the effects of varying model parameters, which included tensor veli palatini and levator veli palatini force, ET cartilage, periluminal mucosal compliance, and hamular position on resistance to airflow through the tubal lumen, were determined.

RESULTS

Of the evaluated parameters, only applied tensor veli palatini muscle force and compliance of the periluminal mucosa and cartilage tissues were significant predictors of resistance to airflow through the ET during muscle-assisted opening.

CONCLUSIONS

Finite element models of ET function in the CP infant identified tensor veli palatini muscle force as a direct predictor and mucosal/cartilage compliance as an indirect predictor of ET opening during muscle-assisted lumen dilations. Hamular position and levator veli palatini force were not found to have an effect on ET function in CP infants.