Calculated deposition in growing tracheobronchial airways: effect of growth-rate assumptions

Most current deterministic computer dosimetry models use idealized dichotomous symmetrical infant, child, and adolescent tracheobronchial geometries for dosimetry predictions. These tracheobronchial geometries were derived from either the morphometric measurements of J. D. Mortensen and colleagues or those of R. F. Phalen and colleagues. The airway growth curves used to create these geometries are typically means from all airways within a single generation in the tracheobronchial tree. This idealized approach implies that the growth rate of all airways in the same generation is identical (symmetric growth, SG), which is unlikely. In this study, existing morphometric measurements of airway dimensions were used to determine growth equations for airway length, diameter, branch angle, and inclination to gravity as a function of body height for each airway in the first four tracheobronchial generations. Tracheobronchial geometries (asymmetrical growth, AG) were created from these growth curves for the first 4 tracheobronchial generations representing a 4- and 11-yr-old child and an adult. Particle deposition predictions for steady inspiratory flow using 0.1- to 20-microm diameter monodisperse particles in these AG geometries were compared with predictions using the SG geometries using the uniform growth rate approach. Each airway in the first four generations had a unique airway length and diameter growth rate. Airway branch angle and inclination to gravity did not change as a function of body height. The unique airway growth rates resulted in significant differences in predicted deposition efficiency between the AG and SG geometry. Use of AG geometry may provide improved estimates of regional particle deposition in infants, children, and adolescents.