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Pharyngeal narrowing in obstructive sleep apnea (OSA) results from flow-induced displacement of soft tissue. The objective of this study is to evaluate the effect of airflow parameters and material model on soft tissue displacement for planning surgical treatment in pediatric patients with OSA and Down syndrome (DS). Anatomically accurate, three-dimensional geometries of the pharynx and supporting tissue were reconstructed for one pediatric OSA patient with DS using magnetic resonance images. Six millimeters of adenoid tissue was virtually removed based on recommendations from the surgeon, to replicate the actual adenoidectomy. Computational simulations of flow-induced obstruction of the pharynx during inspiration were performed using patient-specific values of tissue elasticity for pre and post-operative airways. Sensitivity of tissue displacement to selection of turbulence model, variation in inspiratory airflow, nasal airway resistance and choice of non-linear material model was evaluated. The displacement was less sensitive to selection of turbulence model (10% difference) and more sensitive to airflow rate (20% difference) and nasal resistance (30% difference). The sensitivity analysis indicated that selection of Neo-Hookean, Yeoh, Mooney-Rivlin or Gent models would result in identical tissue displacements (less than 1% difference) for the same flow conditions. Change in pharyngeal airway resistance between the rigid and collapsible models was nearly twice for the pre-operative case as compared to the post-operative scenario. The tissue strain at the site of obstruction in the velopharyngeal airway was lowered by approximately 84% following surgery. Inclusion of tissue elasticity resulted in better agreement with the actual surgical outcome compared to a rigid wall assumption, thereby emphasizing the importance of pharyngeal compliance for guiding treatment in pediatric OSA patients., (Copyright © 2017. Published by Elsevier Ltd.)

Particle suspensions are common to biological fluid flows; for example, flow of red- and white-blood cells, and platelets. In medical technology, current and proposed methods for drug delivery use membrane-bounded liquid capsules for transport via the microcirculation. In this paper, we consider a 3D linear elastic particle inserted into a Newtonian fluid and investigate the time-dependent deformation using a numerical simulation. Specifically, a boundary element technique is used to investigate the motion and deformation of initially spherical or spheroidal particles in bounded linear shear flow. The resulting deformed shapes reveal a steady-state profile that exhibits a 'tank-treading' motion for initially spherical particles. Wall effects on particle trajectory are seen to include a modified Jeffrey׳s orbit for spheroidal inclusions with a period that varies inversely with the strength of the shear flow. Alternately, spheroidal inclusions may exhibit either a 'tumbling' or 'trembling' motion depending on the initial particle aspect ratio and the capillary number (i.e., ratio of fluid shear to elastic restoring force). We find for a capillary number of 0.1, a tumbling mode transitions to a trembling mode at an aspect ratio of 0.87 (approx.), while for a capillary number of 0.2, this transition takes place at a lower aspect ratio. These oscillatory modes are consistent with experimental observations involving similarly shaped vesicles and thus serves to validate the use of a simple elastic constitutive model to perform relevant physiological flow calculations., (Copyright © 2016 Elsevier Ltd. All rights reserved.)