Department of Otolaryngology- Head and Neck Surgery, Children's Hospital of Shanghai, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
J Int Med Res. 2020 Jun;48(6):300060520926407. doi: 10.1177/0300060520926407.
This study was performed to investigate the feasibility of using a three-dimensional (3D) finite element model for laryngomalacia severity assessment. We analyzed laryngeal computed tomography images of seven children with laryngomalacia using Mimics software. The gray threshold of different tissues was distinguishable, and a 3D visualization model and finite element model were constructed. The laryngeal structure parameters were defined. The peak von Mises stress (PVMS) value was obtained through laryngeal mechanical analysis. The PVMS values of the laryngeal soft tissue and cartilage scaffolds were independently correlated with disease severity. After stress loading the model, the relationship between laryngomalacia severity and the PVMS value was apparent. However, the PVMS value of laryngeal soft tissue was not correlated with laryngomalacia severity. This study established the efficacy of a finite element model to illustrate the morphological features of the laryngeal cavity in infants with laryngomalacia. However, further study is required before widespread application of 3D finite element modeling of laryngomalacia. PVMS values of the laryngeal cartilage scaffold might be useful for assessment of laryngomalacia severity. These findings support the notion that structural abnormalities of the laryngeal cartilage may manifest as quantifiable changes in stress variants of the supraglottic larynx.
本研究旨在探讨使用三维（3D）有限元模型评估喉软化症严重程度的可行性。我们使用 Mimics 软件分析了 7 例喉软化症患儿的喉部计算机断层扫描图像。不同组织的灰度阈值具有可区分性，从而构建了 3D 可视化模型和有限元模型，并定义了喉部结构参数。通过喉部力学分析获得了峰值 von Mises 应力（PVMS）值。喉软组织结构和软骨支架的 PVMS 值与疾病严重程度独立相关。对模型进行应力加载后，喉软化症严重程度与 PVMS 值之间的关系明显。然而，喉软组织的 PVMS 值与喉软化症的严重程度不相关。本研究建立了有限元模型来阐明喉软化症患儿喉腔形态特征的功效。然而，在广泛应用喉软化症 3D 有限元建模之前，还需要进一步研究。喉软骨支架的 PVMS 值可能有助于评估喉软化症的严重程度。这些发现支持这样一种观点，即喉软骨的结构异常可能表现为上喉部的应力变化的可量化变化。
