Numerical study of the effects of bronchial structural abnormalities on respiratory flow distribution.

BACKGROUND: The anatomical configurations of respiratory tract would be directly associated with their ventilatory function. It is necessary to fully understand the association between airway configurations and their functions as well as the interactions between different airway segments. In this study, we developed a respiratory airway model to investigate the effects of bronchial structural abnormalities on flow distribution in the bronchi and upper airway.

METHODS: Derived from computed tomography (CT) scanner data, three-dimensional (3D) finite element (FE) models of healthy human respiratory tracts were developed with anatomically realistic configurations, including the nasal cavity, oral cavity, pharynx, larynx, trachea, and partial bronchi. Abnormal bronchial configurations were built to correspond to four common bronchial diseases. Through numerical simulation, airway configurations of normal and abnormal bronchi were obtained, and flow patterns were compared between normal and abnormal respiratory tracts, as well as the effects of lower airway changes on flow distribution in the upper airway.

RESULTS: The simulation results showed that during inspiration, abnormal bronchial structures can cause flow redistribution in each generation of bronchi and have significant effects on flow distribution in the daughter bronchi of abnormal segments, but no effect on flow distribution of the upper airway. During expiration, abnormal bronchus structures had a remarkable influence on flow distribution in the trachea, while there was no significant difference in flow distribution when airflow passed from the vocal cords and entered the laryngeal cavity.

CONCLUSIONS: Therefore, abnormal bronchial structures can affect the downstream flow distribution and cause flow redistribution throughout the entire bronchial branches. During expiration, the configurations of the trachea and glottis can diminish the effects of abnormal bronchial structures on flow distribution.