{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,11]],"date-time":"2026-03-11T13:29:18Z","timestamp":1773235758253,"version":"3.50.1"},"reference-count":13,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Background<\/jats:title>\n Eustachian tube (ET) dysfunction is associated with middle ear pathologies; however, the quantitative relationship between ET opening and pressure equalization remains insufficiently characterized. Computational fluid dynamics (CFD) offers a robust tool for analyzing middle ear pressure dynamics, particularly in elucidating pressure equilibrium mechanisms under partial ET opening conditions.<\/jats:p>\n <\/jats:sec>\n \n Objective<\/jats:title>\n This study aimed to investigate pressure dynamics in the tympanic cavity, mastoid antrum, and air cells during ET opening using CFD, to compare pressure distributions between full and partial openings, and to determine whether partial opening can achieve equilibration equivalent to full opening.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n Eight normal temporal bones were reconstructed from high-resolution computed tomography scans of four healthy adults. ET openings were simulated at 10%, 30%, 50%, and 100% patency using CFD, and results were validated against in vivo Tubomanometry data. Pressure variations in the tympanic cavity, mastoid antrum, and air cells were monitored throughout the process. Mesh independence was verified to ensure reliability, and statistical analyses were conducted using SPSS 27.0, with\n P<\/jats:italic>\n \u2009<\u20090.05 considered significant.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n CFD simulations revealed distinct pressure dynamics within the ET\u2013middle ear system. Airflow velocity peaked at the narrow isthmus, generating a localized pressure drop. Effective middle ear pressure equilibration\u2014across the tympanic cavity, antrum, and mastoid air cells\u2014was achieved with partial ET opening in most cases: 30% opening sufficed for full equilibration in two ears, while 50% opening achieved complete equilibration in six. This equivalence to full patency was consistently observed during pressurization, stabilization, and depressurization phases.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Effective middle ear pressure equilibration can be achieved with partial ET opening (50%) in most cases (75% of ears). These findings provide valuable insight into middle ear physiology and its response under pathological conditions, offering a theoretical basis for optimizing the management of ET dysfunction.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0344128","type":"journal-article","created":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T17:26:47Z","timestamp":1773163607000},"page":"e0344128","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Computational fluid dynamics analysis of middle ear pressure dynamics: Evidence for efficient pressure equalization during partial eustachian tube 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system","volume":"28","author":"YY Tang","year":"2021","journal-title":"Chinese Archives of Otolaryngology-Head and Neck Surgery"},{"issue":"8","key":"pone.0344128.ref008","doi-asserted-by":"crossref","first-page":"1901","DOI":"10.1007\/s00405-011-1829-y","article-title":"New insights into mechanism of Eustachian tube ventilation based on cine computed tomography images","volume":"269","author":"MH McDonald","year":"2012","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"pone.0344128.ref009","doi-asserted-by":"crossref","first-page":"583","DOI":"10.1177\/000348949710600710","article-title":"Narrowest (isthmus) portion of eustachian tube: a computer-aided three-dimensional reconstruction and measurement study","volume":"106","author":"M Sudo","year":"1997","journal-title":"Ann Otol Rhinol Laryngol"},{"issue":"5","key":"pone.0344128.ref010","doi-asserted-by":"crossref","first-page":"793","DOI":"10.1007\/s10103-009-0646-7","article-title":"The improvement of middle ear ventilation by laser ablation of the epipharyngeal eustachian tube: a prospective study","volume":"24","author":"B Sedlmaier","year":"2009","journal-title":"Lasers Med Sci"},{"issue":"6","key":"pone.0344128.ref011","doi-asserted-by":"crossref","first-page":"543","DOI":"10.1007\/s00234-016-1663-4","article-title":"Imaging of the Eustachian tube and its function: a systematic review","volume":"58","author":"ME Smith","year":"2016","journal-title":"Neuroradiology"},{"issue":"4","key":"pone.0344128.ref012","first-page":"452","article-title":"Numerical simulation modeling of middle ear-eustachian tube ventilation based on Chinese digital visual human body","volume":"57","author":"XH Zhu","year":"2022","journal-title":"Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi"},{"key":"pone.0344128.ref013","first-page":"1","article-title":"Mechanics of the human middle ear. 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