In silico assessment of mouth-throat effects on regional deposition in the upper tracheobronchial airways

Regional deposition of inhaled medicines is a valuable metric of effectiveness in drug delivery applications to the lung. In silico methods are now emerging as a valuable tool for the detailed description of localized deposition in the respiratory airways. In this context, there is a need to minimize the computational cost of high-fidelity numerical approaches. Motivated by this need, the present study is designed to assess the role of the extrathoracic airways in determining regional deposition in the upper bronchial airways. Three mouth-throat geometries, with significantly different geometric and filtering characteristics, are merged onto the same tracheobronchial tree that extends to generation 8, and Large Eddy Simulations are carried out at steady inhalation flowrates of 30 and View the MathML source. At both flowrates, large flow field differences in the extrathoracic airways across the three geometries largely die out below the main bifurcation. Importantly, localized deposition fractions are found to remain practically identical for particles with aerodynamic diameters of up to View the MathML source and View the MathML source at 30 and View the MathML source, respectively. For larger particles, differences in the localized deposition fractions are shown to be mainly due to variations in the mouth-throat filtering rather than upstream flow effects or differences in the local flow field. Deposition efficiencies in the individual airway segments exhibit strong correlations across the three geometries, for all particle sizes. The results suggest that accurate predictions of regional deposition in the tracheobronchial airways can therefore be obtained if the particle size distribution that escapes filtering in the mouth-throat (ex-cast dose) of a particular patient is known or can be estimated. These findings open the prospect for significant reductions in the computational expense, especially in the context of in silico population studies, where the aerosol size distribution and precomputed flow field from standardized mouth-throat models could be used with large numbers of tracheobronchial trees available in chest-CT databases

Regional aerosol deposition in the human airways: the SimInhale benchmark case and a critical assessment of in silico methods

Regional deposition effects are important in the pulmonary delivery of drugs intended for the topical treatment of respiratory ailments. They also play a critical role in the systemic delivery of drugs with limited lung bioavailability. In recent years, significant improvements in the quality of pulmonary imaging have taken place, however the resolution of current imaging modalities remains inadequate for quantifying regional deposition. Computational Fluid-Particle Dynamics (CFPD) can fill this gap by providing detailed information about regional deposition in the extrathoracic and conducting airways. It is therefore not surprising that the last 15 years have seen an exponential growth in the application of CFPD methods in this area. Survey of the recent literature however, reveals a wide variability in the range of modelling approaches used and in the assumptions made about important physical processes taking place during aerosol inhalation. The purpose of this work is to provide a concise critical review of the computational approaches used to date, and to present a benchmark case for validation of future studies in the upper airways. In the spirit of providing the wider community with a reference for quality assurance of CFPD studies, in vitro deposition measurements have been conducted in a human-based model of the upper airways, and several groups within MP1404 SimInhale have computed the same case using a variety of simulation and discretization approaches. Here, we report the results of this collaborative effort and provide a critical discussion of the performance of the various simulation methods. The benchmark case, in vitro deposition data and in silico results will be published online and made available to the wider community. Particle image velocimetry measurements of the flow, as well as additional numerical results from the community, will be appended to the online database as they become available in the future