Numerical Study of the Aerodynamic Effects of Septoplasty and Partial Lateral Turbinectomy

The Laryngoscope (Impact Factor: 2.03). 01/2008; 118(2):330 - 334. DOI: 10.1097/MLG.0b013e318159aa26
Source: PubMed

ABSTRACT Objectives: To investigate, first, the effects of septal deviation and concha bullosa on nasal airflow, and second, the aerodynamic changes induced by septoplasty and partial lateral turbinectomy, using computational fluid dynamics (CFD).Methods: A three-dimensional model of a nasal cavity was generated using paranasal sinus computed tomography images of a cadaver with concha bullosa and septal deviation. Virtual septoplasty and partial lateral turbinectomy were performed on this model to generate a second model representing the postoperative anatomy. Aerodynamics of the nasal cavity in the presence of concha bullosa and septal deviation as well as postoperative changes due to the virtual surgery were analyzed by performing CFD simulations on both models. Inspiratory airflow with a constant flow rate of 500 mL/second was used throughout the analyses.Results: In the preoperative model, the airflow mostly pass through a narrow area close to the base of the nasal cavity. Following the virtual operation, a general drop in the maximum intranasal air speed is observed with a significant increase of the airflow through right middle meatus. While in the preoperative model the greatest reduction in pressure is found to be in the localization of anterior septal deviation on the right side and confined to a very short segment, for the postoperative model, it is observed to be in the nasal valve region in both nasal cavities. Following septoplasty and partial lateral turbinectomy, total nasal resistance is reduced significantly.Conclusions: CFD simulations promise to make great contributions to understand the airflow characteristics of healthy and pathologic noses. Before surgery, planning for any specific intervention using CFD techniques on the nasal cavity model of the patient may help foreseeing the aerodynamic effects of the operation and might increase the success rate of the surgical treatment.

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Available from: Ergin Tönük, Aug 01, 2014
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    • "The study of nasal function, which broadly includes airflow, respiratory heat exchange, filtering of environmental contaminants, and chemical sensing, is of significance in the fields of respiratory physiology (Schmidt- Nielsen et al., 1970; Collins et al., 1971; Schroter and Watkin, 1989; Pless et al., 2004; Lindemann et al., 2004, 2006), otolaryngology (Kim and Chung, 2004; Ozlugedik et al., 2008; Rhee et al., 2011; Zhao et al., 2014), inhalation toxicology (Morgan and Monticello, 1990; Morgan et al., 1991; Kimbell et al., 1993, 2001), and olfaction (Keyhani et al., 1997; Zhao et al., 2006; Craven et al., 2010; Lawson et al., 2012). However, due to the anatomical complexity of the nasal fossa, in vivo experiments of nasal function are problematic. "
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    ABSTRACT: This special issue of The Anatomical Record is the outcome of a symposium entitled “Inside the Vertebrate Nose: Evolution, Structure and Function.” The skeletal framework of the nasal cavity is a complicated structure that often houses sinuses and comprises an internal skeleton of bone or cartilage that can vary greatly in architecture among species. The nose serves multiple functions, including olfaction and respiratory air-conditioning, and its morphology is constrained by evolution, development, and conflicting demands on cranial space, such as enlarged orbits. The nasal cavity of vertebrates has received much more attention in the last decade due to the emergence of nondestructive methods that allow improved visualization of the internal anatomy of the skull, such as high-resolution x-ray computed tomography and magnetic resonance imaging. The 17 articles included here represent a broad range of investigators, from paleontologists to engineers, who approach the nose from different perspectives. Key topics include the evolution and development of the nose, its comparative anatomy and function, and airflow through the nasal cavity of individual species. In addition, this special issue includes review articles on anatomical reduction of the olfactory apparatus in both cetaceans and primates (the vomeronasal system), as well as the molecular biology of olfaction in vertebrates. Together these articles provide an expansive summary of our current understanding of vertebrate nasal anatomy and function. In this introduction, we provide background information and an overview of each of the three primary topics, and place each article within the context of previous research and the major challenges that lie ahead. Anat Rec, 297:1975–1984, 2014. © 2014 Wiley Periodicals, Inc.
    The Anatomical Record Advances in Integrative Anatomy and Evolutionary Biology 11/2014; 297(11). DOI:10.1002/ar.23021 · 1.53 Impact Factor
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    ABSTRACT: Although the prevalence of the deviated nasal septum (DNS) is high, the number of asymptomatic person with DNS is higher than that of symptomatic patients. Most of the patients complain nasal discomfort in narrow side. Usually clinical laboratory tests are performed at each side separately; therefore it is very difficult to evaluate the both nasal cavities simultaneously. The purpose of this study is to evaluate the difference in aerodynamic parameters with presence of nasal symptoms, using PIV and CFD methods in asymmetric nasal cavities due to DSN. Aerodynamic parameters, such as velocity, flow rate in both nasal cavities, wall pressure and wall shear stress were evaluated in 2 symptomatic and 2 asymptomatic patients with DSN. Surface-rendered bilateral nasal cavity models were created from CT scans and used for making clear models for investigation with PIV method and for numeric method. Flow rates in both nasal cavities were different in symptomatic patients with PIV method and CFD method. High wall shear stress was noted at the narrow side of the symptomatic patients. These parameters can be used for the evaluation of the patients with nasal discomfort with CFD method.
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    ABSTRACT: This study proposed to apply a computational fluid dynamics (CFD) for treatment success evaluation. Computed Tomography (CT) data obtained from patient with nasal septum deviation were collected before and after surgeries. The computational processes performed in this study are segmentation, meshing, solving, and post-processing. Firstly, Mimic 10.01 software was used to segment the nasal airway, excluded paranasal sinus, automatically and manually. Secondly, Pro-STAR/amm software with Auto-Mesh Classic Module was employed to generate trimmed mesh of 537,160 for pre-operative model and 382,744 for post-operative model. Finally, computational grid model was imported to STAR-CD version 3.24 for solving steady-state Navier-Stoke equations, and visualize the solution by post-processing. The computational results demonstrated as velocity magnitude in coronal cross-sectional planes. The results showed that the velocity magnitude inside the narrowed left side dropped significantly about 22-31% in nasal valve area and 45-50% in inferior and middle meatus due to enlargement and non-deviation of airway. It can be seen that the average velocity for all sections of pre-operative model was greater than post-operative model due to constriction of airway. It is clearly to specify the constricted area should be improved during treatment decision. In summary, combined CT data and CFD analysis is very useful for doctor to evaluate the physiology and phenomena of airflow inside the patient's nose. Thus, treatment success evaluation and prediction could be performed by using CFD simulation, and also applied as a tool for the treatment planning.
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