title: A preliminary study of computer assisted evaluation of congenital tracheal stenosis: a new tool for surgical decision-making.
abstract: OBJECTIVE
  Congenital tracheal stenosis is a rare but severe condition with tracheal narrowing. There is no absolute correlation between luminal diameter and prognosis, and therapeutic decisions are difficult for intermediate cases. The aim of this study was to develop a dynamic model of the ventilatory consequences of congenital tracheal stenosis using computational fluid dynamics.
  
  
  METHODS
  In 8 children with congenital tracheal stenosis and 1 healthy child, 3-dimensional geometries of the trachea were constructed with computed tomography images and specialized software (ITK-SNAP). Airflow simulations were performed for each geometry using 2 physiologic inhalation flow rates under steady and laminar flow conditions. Flow velocity, static and total airway pressure, and pressure drop across the entire trachea were determined.
  
  
  RESULTS
  In the patients with congenital tracheal stenosis, the pressure drop from the tracheal inlet to outlet, at flow rate 3L/min, ranged from 14 to 430Pa; the pressure drop at flow rate 7.3L/min ranged from 60 to 1825Pa. The pressure drop enabled a classification based on the severity of stenosis. The classification based on pressure drop was retrospectively consistent with the classification based on clinical data from the patients.
  
  
  CONCLUSIONS
  Simulations with computational fluid dynamics may provide an objective method to evaluate the severity of the symptoms in patients with congenital tracheal stenosis and may help guide treatment.
authors.affiliation: Department of Pediatric Otolaryngology, Head and Neck Surgery, La Timone Children's Hospital, Aix Marseille Université, Marseille, France.
authors.forename: Olivia
authors.initials: O
authors.lastname: Mimouni-Benabu
authors.forename: Lionel
authors.initials: L
authors.lastname: Meister
authors.forename: Jérôme
authors.initials: J
authors.lastname: Giordano
authors.forename: Pierre
authors.initials: P
authors.lastname: Fayoux
authors.forename: Natalie
authors.initials: N
authors.lastname: Loundon
authors.forename: Jean Michel
authors.initials: JM
authors.lastname: Triglia
authors.forename: Richard
authors.initials: R
authors.lastname: Nicollas
mesh_terms: D002675:Child, Preschool; D003198:Computer Simulation; D003657:Decision Making; D006801:Humans; D057446:Hydrodynamics; D007091:Image Processing, Computer-Assisted; D007223:Infant; D007231:Infant, Newborn; D008954:Models, Biological; D011312:Pressure; D015656:Respiratory Mechanics / Q000502:physiology*; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012984:Software; D014057:Tomography, X-Ray Computed; D014132:Trachea / Q000000981:diagnostic imaging / Q000503:physiopathology; D014135:Tracheal Stenosis / Q000145:classification / Q000151:congenital* / Q000000981:diagnostic imaging / Q000503:physiopathology*