A Biomechanical Modeling of Human Pharyngeal Muscular Dysfunction by Using FEM(Finite Element Method)

유한요소법을 이용한 인두의 기능이상에 대한 생체역학적 모델

  • Kim Sung Jae (School of Biomedical Engineering College of Medicine Konkuk University) ;
  • Bae Ha Suk (Dept. of Rehabilitation Medicine, College of Medicine Yonsei University) ;
  • Choi Byeong Cheol (Dept. of Biomedical Engineering, Choonhae College) ;
  • Kim Sung Min (School of Biomedical Engineering College of Medicine Konkuk University)
  • 김성재 (건국대학교 의과대학 의학공학부) ;
  • 배하석 (연세대학교 의과대학 재활의학교실) ;
  • 최병철 (춘해대학교 의료공학과) ;
  • 김성민 (건국대학교 의과대학 의학공학부)
  • Published : 2003.12.01

Abstract

Pharynx is a system transporting foods by peristaltic motion(contraction and expansion movement! into the esophagus and functioning as airway passages. In this study, structural changes of pharyngeal dysfunction are analyzed by biomechanical model using CT and FEM(finite clement method). Loading condition was assumed that equal pressure was loaded sequentially to inside of pharyngeal tissue. In order to analyze the pharyngeal muscular dysfunction by biomechanical model. the pharyngeal dysfunctions was classified into 3 cases. Taking into account the clinical complication by neuromuscular symptoms such as pharyngeal dysfunction after stroke. we assumed that a change of material property is caused by muscular tissue stiffness. A deformation of cross sectional area of the pharynx is analyzed increasing the stiffness $25\%,\;50\%,\;75\%$ in each case on the basis of stress-strain relationship. Based on three-dimensional reconstruction of pharyngeal structure using limited factor - techniques and the optimization procedure by means of inverse dynamic approach. the biomechanical model of the human pharynx is implemented. The results may be used as clinical index illustrating the degree of pharyngeal muscular dysfunction. This study may be used as useful diagnostic model in discovering early deglutitory impediment caused by physiological or pathological pharyngeal dysfunction.

인두는 구강과 식도, 비강과 폐의 중간에서 능동적으로 구강을 통해 섭취되는 음식물과 비강을 통해 흡입되는 공기의 통로역할을 하는 주요한 기관이다. 본 연구는 유한요소기법을 이용한 인두의 3차원 구조의 재구성 과정을 거쳐 인두의 생체역학모델을 구현하였으며, 연하곤란환자의 인두근육의 주요부분에 대한 구조적 변형특성을 3가지로 분류하여 유한요소기법을 이용하여 인두내의 압력에 대한 형상의 변형을 관찰 후 최적화 과정을 거쳐 각 부분에서의 추정 압력 구배를 측정하여 연하과정에서 내부에 생성되는 압력의 연속적인 압력분포를 추정하였다. CT에 의한 인두의 변형 형상을 추정하여 임의 압력에 의한 인두구조의 변형 형상을 유한요소 해석에 의해 계산한 후 비교하여 실제 인두강 내에 형성되는 압력을 추정하였다. 재료적 특성은 인두의 기능이상 시 근조직경화가 발생, 즉 stiffness 가 증가하는 것으로 가정하여 응력-변형률 관계에 있어서 각각 $25\%,\;50\%,\;75\%$씩 증가시켜 분석하였다. 이러한 인두의 생체역학모델은 인두기능장애를 가진 환자의 치료 계획 수립에 도움이 되는 유용한 자료를 제공 할 것으로 생각된다.

Keywords

References

  1. FMS. McConnel, 'Analysis of pressure generation and bolus transit during pharngeal swallowing'. Laryngoscope, Vol. 98, pp. 71 78, 1988
  2. Finestone HM, Greene Finestone LS, Wilson ES, Teasell RW, 'Malnutrition in stroke patients on the rehabilitation service and at follow up:prevalence and predictors'. Arch Phys Med Rehabil Vol. 76, pp. 310 316, 1995
  3. Gordon C, Hewer RL, Wade DT, 'Dysphagia in acute stroke', Br Med J vol. 295, pp. 411 414
  4. J.L.Elliltt, 'Swallowing disorders in the elderly', Ge riatrics, vol. 43, pp. 95 113, 1988
  5. DJ. Curtis, DF. Cruess and AH. Dachman, 'Normal erect swallowing. Normal function and incidence of variations.', Invest Radiol, Vol. 20, pp. 717-726, 1985
  6. EM. Sokol, P. Heitmann, BS. Wolf and BR. Cohen, 'Simultaneous cineradiographic and manometric study of the pharynx.', hypopharynx and cervical esophagus. Gastroenterology, Vol. 51, pp. 960-974, 1966
  7. P. Pouderoux, P. J. Kahrilas, 'Deglutive tongue force modulation by volition, volume, and viscosity in humans.', Gastroenterology, Vol. 108 pp. 1418-1426, 1995
  8. Brasseur JG and Dodds WJ. 'Interpretation of intraluminal manometric measurements In terms of swallowing mechanics', Dysphagia, Vol. 6, pp. 100-119, 1991
  9. Kim SM, McCulloch TM and Lim K., 'Pharyngeal pressure analysis by the finite element method during liquid bolus swallow', Ann Otol Rhinol Laryngol, Vol. 109, No. 6, pp. 585-589, 2000 https://doi.org/10.1177/000348940010900610
  10. Kim SM, McCllouc and TM, Rim K., 'Evaluation of the Viscoelastic Properties of Pharyngeal Tissue', Tissue Eng, Vol. 4, No. 4, pp. 393-398, 1998
  11. Kahrilas, P.J., Logemann, J.A. and Gibbons, P., Food intake by maneuver; an extreme compensation for impaired swallowing, Dysphagia, Vol. 5, pp. 155-160, 1992
  12. P.J. Kahrilas, J. Chen and J.A. Logemann, 'Oropharyngeal Accommodation to swallow volume.', Gastroenterology, 1996
  13. P.J. Kahrilas, J. Chen and J.A. Logemann, 'Three-dimensional modeling of the Oropharynx during swallowing.', Radiology, Vol. 194, pp. 575-579, 1995
  14. P. Pouderoux, P.J. Kahrilas, 'Deglutive tongue force modulation by volition, volume, and viscosity in humans.', Gastroenterology, Vol. 108 pp. 1418-1426, 1995