{"title":"Hemodynamics in Cerebral Aneurysms and Parent Arteries With Incompletely Expanded Flow Diverter Stents","authors":"Soichiro Fujimura, Kazuya Yuzawa, Katharina Otani, Kostadin Karagiozov, Hiroyuki Takao, Toshihiro Ishibashi, Koji Fukudome, Makoto Yamamoto, Yuichi Murayama","doi":"10.1002/cnm.70033","DOIUrl":"https://doi.org/10.1002/cnm.70033","url":null,"abstract":"<p>Braided stents for cerebral aneurysms, including flow diverter stent (FDS), may exhibit incomplete stent expansion (IncompSE) during deployment, depending on factors related to the parent artery. Poor stent apposition due to IncompSE can increase the risk of complications or incomplete aneurysm occlusion. Since hemodynamics may play a critical role in these adverse events, we investigated hemodynamic parameters associated with IncompSE using computational fluid dynamics (CFD) analysis. Three basic geometries were generated to represent an aneurysm located on the siphon of the internal carotid artery. CFD analysis was conducted for each geometry under a total of 12 patterns, including before deployment, complete stent expansion (CompSE), and IncompSE on the distal and proximal sides. We focused on hemodynamic parameters reported to influence occlusion or complications after FDS deployment. The change rate (CR) of these parameters was calculated by comparing conditions before and after FDS deployment. In the cases of CompSE, volume flow (VF) into the aneurysm and maximum wall shear stress (WSS) on the aneurysmal wall decreased on average by 52.7% and 34.7%, respectively. Conversely, in the cases of IncompSE, higher VF, inflow jets, and vortices were observed within the aneurysm. Increased WSS at the aneurysmal neck and parent artery was also noted. While static pressure on the aneurysmal wall and energy loss through the aneurysm region showed minimal change in the case of CompSE, both parameters increased in cases of IncompSE. These findings suggest that IncompSE may result in hemodynamic conditions that are suboptimal for treatment. IncompSE of FDS can potentially induce unfavorable hemodynamic changes, including increased blood flow into the aneurysm and elevated pressure on the aneurysmal wall compared to pre-deployment conditions.</p>","PeriodicalId":50349,"journal":{"name":"International Journal for Numerical Methods in Biomedical Engineering","volume":"41 4","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cnm.70033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741488","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Felix Hehnen, Henri Wolff, Sophia Krakowski, Gabi Bondzio, Michael Lommel, Ulrich Kertzscher, Paul Friedrich Geus
{"title":"Numerical Assessment of the Efficiency of a New Minimally Invasive Probe for the Isolation of Circulating Tumor Cells","authors":"Felix Hehnen, Henri Wolff, Sophia Krakowski, Gabi Bondzio, Michael Lommel, Ulrich Kertzscher, Paul Friedrich Geus","doi":"10.1002/cnm.70032","DOIUrl":"https://doi.org/10.1002/cnm.70032","url":null,"abstract":"<p>Liquid biopsy, particularly the isolation of circulating tumor cells (CTCs) from blood, is a promising approach in the fight against cancer. However, the main reason why CTCs are hardly used as biomarkers in the clinic is their complicated isolation from the patient's blood. Existing ex vivo systems use a small volume of blood and can therefore only isolate very few CTCs. To overcome this problem and increase the number of isolated CTCs, a new in vivo method—the BMProbe was introduced, which can isolate CTCs directly from the patient's bloodstream. This study investigates the efficiency of the BMProbe by using Computational Fluid Dynamics simulations to evaluate parameters influencing the attachment probability of CTCs to the probe surface. The analyzed parameters include screened blood volume, residence time, and wall normal rate. Additionally, the impact of probe geometry, vein diameter, and blood flow velocity on probe efficiency was examined. The numerical data suggest that the geometry has a strong influence on cell binding efficiency. Increasing the number of windings from 4 to 32 improves the transport of cells to the surface (negative wall normal rate) from 0 to −29 [mm<sup>2</sup>/s] and the screened blood volume by 138% but decreases the residence time of particles in the close vicinity of the probe by 77%. When compared to experimental data, the screened blood volume and the wall normal rate indicate cell attachment very well, whereas the residence time does not show a significant impact on the attachment of cells. For the 32-windings BMProbe, the screened blood volume is determined to be 130–313 mL, depending on the vein diameter, which is a multiple of the volume achieved by common CTC isolation techniques.</p>","PeriodicalId":50349,"journal":{"name":"International Journal for Numerical Methods in Biomedical Engineering","volume":"41 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cnm.70032","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Machine Learning-Based Rapid Prediction of Torsional Performance of Personalized Peripheral Artery Stent","authors":"Xiang Shen, Jiahao Chen, Zewen He, Yue Xu, Qiang Liu, Hongyu Liang, Hengfeng Yan","doi":"10.1002/cnm.70029","DOIUrl":"https://doi.org/10.1002/cnm.70029","url":null,"abstract":"<div>\u0000 \u0000 <p>The complex mechanical environment of peripheral arteries makes stents with poor torsional performance more prone to fracture, and stent fracture is considered a precursor to in-stent restenosis (ISR). Therefore, studying the torsional performance of stents is crucial. However, while the finite element method (FEM) can accurately simulate the torsional behavior of stents, its time-consuming nature makes it difficult to meet the rapid design requirements for individualized stents. Thus, integrating efficient machine learning (ML) models into the stent design process may be a viable approach. In this study, a machine learning-based rapid prediction method was established to achieve the rapid prediction of torsional performance of personalized peripheral artery stents. A dataset containing 200 different stent designs was generated using Latin Hypercube Sampling (LHS) and FEM. The dataset was divided into a training set (160 samples) and a test set (40 samples). Based on four input variables—the length of strut ring (LS), the width of strut (WS), the width of link (WL), and the thickness of stent (T)—the predictive performance of polynomial regression (PR), random forest regression (RFR), and support vector regression (SVR) for the twist metric (TM) was compared. To simulate the real-world application of ML models, after training and testing the ML models, the entire dataset (combining the training and test sets) was used for re-learning while keeping the control parameters unchanged. A validation set (10 samples) was generated through sampling and FEM, and the re-learned ML models were used to predict and validate their performance. By comprehensively comparing the predictive performance of the ML models on the training set, test set, and validation set, the algorithm performance ranked as follows: PR>SVR>RFR. The PR model achieved a mean absolute error (MAE) of (training set = 0.02847; test set = 0.03083; validation set = 0.04311) and a coefficient of determination (<i>R</i><sup>2</sup>) of (training set = 0.95148; test set = 0.97822; validation set = 0.94397). This method can effectively shorten the design cycle of stents and meet the need for personalized stent rapid design and choice. In addition, this method can also be extended to predict other mechanical properties of the stent and can be used in stent multi-objective design optimization.</p>\u0000 </div>","PeriodicalId":50349,"journal":{"name":"International Journal for Numerical Methods in Biomedical Engineering","volume":"41 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143638997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Using Approximate Bayesian Computation to Calibrate the Model Parameters Characterizing the Autoregulatory Behavior of Microvessels","authors":"Ali Daher","doi":"10.1002/cnm.70023","DOIUrl":"https://doi.org/10.1002/cnm.70023","url":null,"abstract":"<p>This study aims to leverage available experimental data on the myogenic and endothelial responses of the microvessels to calibrate the parameters and refine the functional form of the compliance feedback model. The experimental data used in this study trace the changes in the vessel calibre of individual arteriolar vessels in response to changes in the intraluminal pressure and/or the pressure gradient, which correspond to the myogenic and endothelial mechanisms, respectively. The compliance feedback model was previously developed to characterize the elastic and autoregulatory behavior of microvessels. We devise and employ a two-stage sequential Monte Carlo (MC) approximate Bayesian computation (ABC) scheme to obtain the posterior distribution of the model's parameters, such that the final parameter space distribution integrates information from any prior knowledge of the parameters, the model dynamics, and the available experimental data. Furthermore, the calibration scheme provides key insights into the underlying mechanistic features of the dynamical system; namely, the ABC scheme reveals that there is a marked difference in the time constants between the myogenic-induced dilation and constriction. Overall, upon parameter calibration, the computationally low-cost compliance feedback model achieves very good agreement with the experimental measurements, despite limited data availability, demonstrating that the model provides a simple, compact, yet robust and physiologically grounded characterization of the autoregulatory response, all of which are essential attributes to increase the translatability of hemodynamic models into the clinical environment for future clinical applications.</p>","PeriodicalId":50349,"journal":{"name":"International Journal for Numerical Methods in Biomedical Engineering","volume":"41 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cnm.70023","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143632844","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Rodrigo López-Vaca, Carlos A. Narváez-Tovar, Raj Das, Gregory de Boer, Salah Ramtani, Abdelkader Boucetta, Diego A. Garzón-Alvarado
{"title":"Mechanobiological Model of Endochondral Ossification and Trabecular Bone Modeling","authors":"Rodrigo López-Vaca, Carlos A. Narváez-Tovar, Raj Das, Gregory de Boer, Salah Ramtani, Abdelkader Boucetta, Diego A. Garzón-Alvarado","doi":"10.1002/cnm.70024","DOIUrl":"https://doi.org/10.1002/cnm.70024","url":null,"abstract":"<div>\u0000 \u0000 <p>This work presents the integration of mechanobiological models to predict the natural evolution of bone modeling and remodeling processes to obtain the architecture of trabecular bone from the embryonic stage in mammalians. Bone modeling is simulated in two and three dimensions using a reaction–diffusion mechanism with parameters in Turing space. This approach involves the interaction of two molecular factors (VEGF and MMP13) released by hypertrophic chondrocytes that diffuse and interact within a hyaline cartilage matrix. The bone remodeling process follows the model proposed by Komarova et al. employing a set of differential equations to describe autocrine and paracrine interactions between osteoblastic and osteoclastic cells, determining cellular dynamics and changes in bone mass. Bidimensional and tridimensional results for a cartilage portion predict morphological self-organization parameters between VEGF and MMP13, similar to those present in the architecture of immature trabecular bone. These findings suggest that the dynamic properties of molecular factors play a crucial role in the temporal self-organization of bone mineralization metabolism, leading to a heterogeneous trabecular architecture characteristic of primary trabecular bone. Through the three-dimensional bone remodeling model performed on the surface of trabeculae, it is established that equilibrium in population dynamics leads to asynchronous homeostatic remodeling for bone renewal, culminating in the formation of secondary trabecular bone.</p>\u0000 </div>","PeriodicalId":50349,"journal":{"name":"International Journal for Numerical Methods in Biomedical Engineering","volume":"41 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143622456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Andrea Colombo, Claudio Chiastra, Diego Gallo, Poay Huan Loh, Socrates Dokos, Mingzi Zhang, Hamed Keramati, Dario Carbonaro, Francesco Migliavacca, Tapabrata Ray, Nigel Jepson, Susann Beier
{"title":"Advancements in Coronary Bifurcation Stenting Techniques: Insights From Computational and Bench Testing Studies","authors":"Andrea Colombo, Claudio Chiastra, Diego Gallo, Poay Huan Loh, Socrates Dokos, Mingzi Zhang, Hamed Keramati, Dario Carbonaro, Francesco Migliavacca, Tapabrata Ray, Nigel Jepson, Susann Beier","doi":"10.1002/cnm.70000","DOIUrl":"https://doi.org/10.1002/cnm.70000","url":null,"abstract":"<p>Coronary bifurcation lesions present complex challenges in interventional cardiology, necessitating effective stenting techniques to achieve optimal results. This literature review comprehensively examines the application of computational and bench testing methods in coronary bifurcation stenting, offering insights into procedural aspects, stent design considerations, and patient-specific characteristics. Structural mechanics finite element analysis, computational fluid dynamics, and multi-objective optimization are valuable tools for evaluating stenting strategies, including provisional side branch stenting and two-stenting techniques. We highlight the impact of procedural factors, such as balloon positioning and rewiring techniques, and stent design features on the outcome of percutaneous coronary interventions with stents. We discuss the importance of patient-specific characteristics in deployment strategies, such as bifurcation angle and plaque properties. This understanding informs present and future research and clinical practice on bifurcation stenting. Computational simulations are a continuously maturing advance that has significantly enhanced stenting devices and techniques for coronary bifurcation lesions over the years. However, the accurate account of patient-specific vessel and lesion characteristics, both in terms of anatomical and accurate physiological behavior, and their large variation between patients, remains a significant challenge in the field. In this context, advancements in multi-objective optimization offer significant opportunities for refining stent design and procedural practices.</p>","PeriodicalId":50349,"journal":{"name":"International Journal for Numerical Methods in Biomedical Engineering","volume":"41 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/cnm.70000","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143629809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"One-Dimensional Blood Flow Modeling in the Cardiovascular System. From the Conventional Physiological Setting to Real-Life Hemodynamics","authors":"Pablo J. Blanco, Lucas O. Müller","doi":"10.1002/cnm.70020","DOIUrl":"https://doi.org/10.1002/cnm.70020","url":null,"abstract":"<div>\u0000 \u0000 <p>Research in the dynamics of blood flow is essential to the understanding of one of the major driving forces of human physiology. The hemodynamic conditions experienced within the cardiovascular system generate a highly variable mechanical environment that propels its function. Modeling this system is a challenging problem that must be addressed at the systemic scale to gain insight into the interplay between the different time and spatial scales of cardiovascular physiology processes. The vast majority of scientific contributions on systemic-scale distributed parameter-based blood flow modeling have approached the topic under relatively simple scenarios, defined by the resting state, the supine position, and, in some cases, by disease. However, the physiological states experienced by the cardiovascular system considerably deviate from such conditions throughout a significant part of our life. Moreover, these deviations are, in many cases, extremely beneficial for sustaining a healthy life. On top of this, inter-individual variability carries intrinsic complexities, requiring the modeling of patient-specific physiology. The impact of modeling hypotheses such as the effect of respiration, control mechanisms, and gravity, the consideration of other-than-resting physiological conditions, such as those encountered in exercise and sleeping, and the incorporation of organ-specific physiology and disease have been cursorily addressed in the specialized literature. In turn, patient-specific characterization of cardiovascular system models is in its early stages. As for models and methods, these conditions pose challenges regarding modeling the underlying phenomena and developing methodological tools to solve the associated equations. In fact, under certain conditions, the mathematical formulation becomes more intricate, model parameters suffer greater variability, and the overall uncertainty about the system's working point increases. This paper reviews current advances and opportunities to model and simulate blood flow in the cardiovascular system at the systemic scale in both the conventional resting setting and in situations experienced in everyday life.</p>\u0000 </div>","PeriodicalId":50349,"journal":{"name":"International Journal for Numerical Methods in Biomedical Engineering","volume":"41 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143602637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Vladislav Demenko, Igor Linetskiy, Larysa Linetska, Michael Sutcliffe, Andrii Kondratiev
{"title":"Prognosis of Crestally Placed Short Plateau Implants in Posterior Maxilla","authors":"Vladislav Demenko, Igor Linetskiy, Larysa Linetska, Michael Sutcliffe, Andrii Kondratiev","doi":"10.1002/cnm.70025","DOIUrl":"https://doi.org/10.1002/cnm.70025","url":null,"abstract":"<div>\u0000 \u0000 <p>Crestal placement of short plateau implants in compromised jaws may cause implant failure due to bone overstress. The aim was to evaluate the impact of different sized implants on adjacent bone overload and the implant load-bearing ability in terms of the proposed index—ultimate functional load (UFL). Three-dimensional models of osseointegrated implants placed in types III and IV bone were analysed by the FEM for the case of patient-specific variations in cortical bone elasticity modulus. Maximum von Mises stresses in surrounding bone were calculated and compared with the cortical and cancellous bone ultimate strength characteristics to determine the UFL index for the studied implants. The implant UFL magnitudes were influenced by their dimensions, bone elasticity, and quality. The implant load-bearing ability was predetermined by cancellous bone strength. The maxilla with moderate elasticity modulus allows for the placement of wide short screwless implants in the compromised maxilla molar site with good clinical perspective.</p>\u0000 </div>","PeriodicalId":50349,"journal":{"name":"International Journal for Numerical Methods in Biomedical Engineering","volume":"41 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143602634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Suqin Huang, Bao Li, Jincheng Liu, Liyuan Zhang, Hao Sun, Yanping Zhang, Jinping Dong, Fuyou Liang, Yanjun Gong, Youjun Liu
{"title":"Superficial Temporal Artery–Middle Cerebral Artery Bypass Treatment Planning for Cerebral Ischaemia Based on Multi-Scale Model","authors":"Suqin Huang, Bao Li, Jincheng Liu, Liyuan Zhang, Hao Sun, Yanping Zhang, Jinping Dong, Fuyou Liang, Yanjun Gong, Youjun Liu","doi":"10.1002/cnm.70026","DOIUrl":"https://doi.org/10.1002/cnm.70026","url":null,"abstract":"<div>\u0000 \u0000 <p>Superficial temporal artery and middle cerebral artery (STA–MCA) bypass surgery is an effective method to enhance cerebral blood flow (CBF) in ischemic patients. However, the effectiveness of various bypass techniques varies with the diversity of Circle of Willis (CoW) structures. This study aims to develop a physiologically realistic hemodynamic model to optimize STA–MCA bypass planning for cerebral ischemia patients with different CoW structures. This study developed a 0D–1D geometric multi-scale haemodynamic model that coupled the stenosis model and the cerebral autoregulation model. Based on this model, nine CoW structural models before and after end-to-side (E–S) and side-to-side (S–S) bypass were constructed, and their haemodynamic properties were calculated to evaluate the efficacy of different bypass methods in different CoW structures. The validity of the model and results was verified by clinical data. For the mRACA1, mRACA1–fRPCA1, and mACoA CoW structures, there was a risk of hyperperfusion (13.96%, 12.81%, and −2.64%) after E–S bypass but not S–S bypass. In the mACoA–mLPCoA structure, both bypass techniques posed hyperperfusion risk (112.41% and 30.57%). Other CoW structures showed that E–S bypass could restore CBF without the risk of hyperperfusion. The model's predictions were within 5% of clinical data. The mRACA1, mRACA1–fRPCA1, and mACoA structures were suitable for S-S bypass; the mACoA–mLPCoA structure was not suitable for bypass, and other CoW structures favored E–S bypass. The developed model can effectively simulate the cerebral hemodynamic environment and predict the risk of hyperperfusion, offering valuable insights for personalized bypass planning in cerebral ischemia patients.</p>\u0000 </div>","PeriodicalId":50349,"journal":{"name":"International Journal for Numerical Methods in Biomedical Engineering","volume":"41 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Huibin Shi, Ziming Yan, Yifeng Li, Yongtao Sun, Jie Wang, Zhanli Liu
{"title":"Revealing the Effects of Tympanic Membrane Implant Mechanical Properties on High-Frequency Hearing Loss After Clinical Myringoplasty: A Finite Element Analysis","authors":"Huibin Shi, Ziming Yan, Yifeng Li, Yongtao Sun, Jie Wang, Zhanli Liu","doi":"10.1002/cnm.70028","DOIUrl":"https://doi.org/10.1002/cnm.70028","url":null,"abstract":"<div>\u0000 \u0000 <p>Myringoplasty is most commonly used to treat tympanic membrane (TM) perforation. Clinical data have shown that unexplained high-frequency (above 3 kHz) hearing loss often occurs after myringoplasty. In this paper, a finite element (FE) model of the partial external and middle ear (ME) of the human ear, which considers the actual perforation and TM implants, is developed to reveal the mechanical mechanism of high-frequency hearing loss after implantation of temporalis fascia and cartilage commonly used in myringoplasty. The SFP displacement is proposed to evaluate the myringoplasty effect, which is proved to be better than the current practice of laser Doppler vibrometer (LDV) of umbo vibration. The model-derived results can replicate the phenomenon of better low-frequency (below 1 kHz) hearing recovery and severe high-frequency hearing loss after myringoplasty. Numerical results show that a temporalis fascia and cartilage implant, whose stiffness is smaller compared with normal PT, fails to fully restore hearing above 3 kHz, where higher-order vibration modes appear early, with more severe localization of TM energy and weakening of TM sound transmission. Moreover, the excessive thickness of implants compared to normal pars tensa (PT) leads to a decrease in the first resonant frequency (RF) and the high-frequency magnitude of the SFP displacement. Furthermore, the numerical study shows that TM implants with modulus higher than 45 MPa and density smaller than 1200 kg/m<sup>3</sup> can restore high-frequency hearing better. This study has implications for choosing and designing the appropriate TM implants for myringoplasty.</p>\u0000 </div>","PeriodicalId":50349,"journal":{"name":"International Journal for Numerical Methods in Biomedical Engineering","volume":"41 3","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143595070","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}