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Computed nasal resistance compared with patient-reported symptoms in surgically treated nasal airway passages: a preliminary report. Am J Rhinol Allergy 2012 May-Jun;26(3):e94-8

Date

05/31/2012

Pubmed ID

22643935

Pubmed Central ID

PMC3490502

DOI

10.2500/ajra.2012.26.3766

Scopus ID

2-s2.0-84862167892   40 Citations

Abstract

BACKGROUND: Nasal airway obstruction (NAO) is a common health condition impacting mood, energy, recreation, sleep, and overall quality of life. Nasal surgery often addresses NAO but the results are sometimes unsatisfactory. Evaluating surgical treatment efficacy could be improved if objective tests were available that correlated with patient-reported measures of symptoms. The goal of this study was to develop methods for comparing nasal resistance computed by computational fluid dynamics (CFD) models with patient-reported symptoms of NAO using early data from a 4-year prospective study.

METHODS: Computed tomography (CT) scans and patient-reported scores from the Nasal Obstruction Symptom Evaluation (NOSE) scale and a visual analog scale (VAS) measuring unilateral airflow sensation were obtained pre- and postoperatively in two NAO patients showing no significant mucosal asymmetry who were successfully treated with functional nasal surgery, including septoplasty. Pre- and postsurgery CFD models were created from the CT scans. Numerical simulation of steady-state inspiratory airflow was used to calculate bilateral and unilateral CFD-derived nasal resistance (CFD-NR).

RESULTS: In both subjects, NOSE and VAS scores improved after surgery, bilateral CFD-NR decreased, and unilateral CFD-NR decreased on the affected side. In addition, NOSE and VAS scores tracked with unilateral CFD-NR on the affected side.

CONCLUSION: These preliminary results suggest a possible correlation between unilateral NR and patient-reported symptoms and imply that analysis of unilateral obstruction should focus on the affected side. A formal investigation of unilateral CFD-NR and patient-reported symptoms in a series of NAO patients is needed to determine if these variables are correlated.

Author List

Kimbell JS, Garcia GJ, Frank DO, Cannon DE, Pawar SS, Rhee JS

Authors

Guilherme Garcia PhD Assistant Professor in the Biomedical Engineering department at Medical College of Wisconsin
Sachin S. Pawar MD Chief, Associate Professor in the Otolaryngology department at Medical College of Wisconsin
John S. Rhee MD Chair, Professor in the Otolaryngology department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Adult
Airway Resistance
Computer Simulation
Female
Humans
Hydrodynamics
Male
Models, Biological
Monitoring, Physiologic
Nasal Obstruction
Nasal Septum
Prospective Studies
Self Report
Severity of Illness Index
Surveys and Questionnaires
Tomography, X-Ray Computed
Treatment Outcome
jenkins-FCD Prod-480 9a4deaf152b0b06dd18151814fff2e18f6c05280