In-silico quantification of intersubject variability on aerosol deposition in the oral airway
The extrathoracic oral airway I s not only a major mechanical barrier for pharmaceutical aerosols to reach the lung but also a major source of variability in lung deposition. Using computational fluid dynamics, deposition of 1-30 µm particles was predicted in 11 CT-based models of the oral airways of adults (7 healthy subjects and 4 patients with chronic obstructive pulmonary disease). Simulations were performed for mouth breathing during both inspiration and expiration at two steady-state flow rates representative of resting/light activity (18 L/min) and of that typically used during aerosol inhalation from a dry powder inhaler (45 L/min). For each subject, oral deposition increased with increasing particle size and flow rate. When averaged over all subjects, there was no significant difference in oral deposition efficiency between inspiration and expiration, unlike subregional deposition that show significantly different patterns between the two breathing phases. Consistent with previous in-vitro inspiratory studies, our data showed a large intersubject variability in oral deposition. These results highlight the need for incorporating morphological variation of the upper airway in predictive models of aerosol deposition for accurate predictions of particle dosimetry in the intrathoracic region of the lung.