{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T15:38:50Z","timestamp":1783352330949,"version":"3.54.6"},"reference-count":66,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T00:00:00Z","timestamp":1653350400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000098","name":"NIH Clinical Center","doi-asserted-by":"publisher","award":["R01DE028554"],"award-info":[{"award-number":["R01DE028554"]}],"id":[{"id":"10.13039\/100000098","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec><jats:title>Objectives\/Hypothesis<\/jats:title><jats:p>Laryngotracheal stenosis (LTS) is a functionally devastating condition with high respiratory morbidity and mortality. This preliminary study investigates airflow dynamics and stenotic drug delivery in patients with one\u2010 and two\u2010level LTS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>A Computational Modeling Restropective Cohort Study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Computed tomography scans from seven LTS patients, five with one\u2010level (three subglottic, two tracheal), and two with two\u2010level (glottis\u2009+\u2009trachea, glottis\u2009+\u2009subglottis) were used to reconstruct patient\u2010specific three\u2010dimensional upper airway models. Airflow and orally inhaled drug particle transport were simulated using computational fluid dynamics modeling. Drug particle transport was simulated for 1\u201320\u2009\u03bcm particles released into the mouth at velocities of 0\u2009m\/s, 1\u2009m\/s, 3\u2009m\/s, and 10\u2009m\/s for metered dose inhaler (MDI) and 0\u2009m\/s for dry powder inhaler (DPI) simulations. Airflow resistance and stenotic drug deposition in the patients' airway models were compared.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Overall, there was increased airflow resistance at stenotic sites in subjects with two\u2010level versus one\u2010level stenosis (0.136\u2009Pa\u2009s\/ml vs. 0.069\u2009Pa\u2009s\/ml averages). Subjects with two\u2010level stenosis had greater particle deposition at sites of stenosis compared to subjects with one\u2010level stenosis (average deposition 2.31% vs. 0.96%). One\u2010level stenosis subjects, as well as one two\u2010level stenosis subject, had the greatest deposition using MDI with a spacer (0\u2009m\/s): 2.59% and 4.34%, respectively. The second two\u2010level stenosis subject had the greatest deposition using DPI (3.45%). Maximum deposition across all stenotic subtypes except one\u2010level tracheal stenosis was achieved with particle sizes of 6\u201310\u2009\u03bcm.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Our results suggest that patients with two\u2010level LTS may experience a more constricted laryngotracheal airflow profile compared to patients with one\u2010level LTS, which may enhance overall stenotic drug deposition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>NA <jats:italic>Laryngoscope<\/jats:italic>, 133:366\u2013374, 2023<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.30212","type":"journal-article","created":{"date-parts":[[2022,5,24]],"date-time":"2022-05-24T12:56:23Z","timestamp":1653396983000},"page":"366-374","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Comparison of Inhaled Drug Delivery in Patients With One\u2010 and Two\u2010level 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