Computational Analysis of Adhesion Dynamics in the Eustachian Tube During Inflammatory Otitis Media

Otitis Media (OM) is an inflammation of the middle ear (ME) that is the most commonly diagnosed childhood illness and the cost of treating OM has been estimated at four billion dollars annually. [1] The onset of OM is typically due to bacterial/viral infections that cause tissue swelling, rapid ME gas exchange and painful sub-ambient ME pressures. Normally, periodic openings of the ET are used to relieve ME pressures. However, the up-regulation of various adhesion proteins within the ET lumen make it difficult for the surrounding muscles to open the ET. The goal of this study is to use computational models to investigate how changes in adhesion dynamics during inflammation influence ET function in three different patient populations: healthy adults, normal children, and CP infants. We have developed a multi-scale computational models of the ET based on histo-morphological data obtained in each population. Adhesive forces within the lumen are modeled as non-linear, reputable spring elements. These models indicate that tissue morphology and mechanics can significantly influence the ET’s response to inflammatory adhesion forces. Specifically, changes in mucosal tissue stiffness and TVP muscle forces are most effective in overcoming inflammatory adhesion forces.