Changes in nasal airflow and heat transfer correlate with symptom improvement after surgery for nasal obstruction. J Biomech 2013 Oct 18;46(15):2634-43
Date
09/26/2013Pubmed ID
24063885Pubmed Central ID
PMC3959863DOI
10.1016/j.jbiomech.2013.08.007Scopus ID
2-s2.0-84884979625 (requires institutional sign-in at Scopus site) 93 CitationsAbstract
Surgeries to correct nasal airway obstruction (NAO) often have less than desirable outcomes, partly due to the absence of an objective tool to select the most appropriate surgical approach for each patient. Computational fluid dynamics (CFD) models can be used to investigate nasal airflow, but variables need to be identified that can detect surgical changes and correlate with patient symptoms. CFD models were constructed from pre- and post-surgery computed tomography scans for 10 NAO patients showing no evidence of nasal cycling. Steady-state inspiratory airflow, nasal resistance, wall shear stress, and heat flux were computed for the main nasal cavity from nostrils to posterior nasal septum both bilaterally and unilaterally. Paired t-tests indicated that all CFD variables were significantly changed by surgery when calculated on the most obstructed side, and that airflow, nasal resistance, and heat flux were significantly changed bilaterally as well. Moderate linear correlations with patient-reported symptoms were found for airflow, heat flux, unilateral allocation of airflow, and unilateral nasal resistance as a fraction of bilateral nasal resistance when calculated on the most obstructed nasal side, suggesting that these variables may be useful for evaluating the efficacy of nasal surgery objectively. Similarity in the strengths of these correlations suggests that patient-reported symptoms may represent a constellation of effects and that these variables should be tracked concurrently during future virtual surgery planning.
Author List
Kimbell JS, Frank DO, Laud P, Garcia GJ, Rhee JSAuthors
Guilherme Garcia PhD Assistant Professor in the Biomedical Engineering department at Medical College of WisconsinPurushottam W. Laud PhD Professor in the Institute for Health and Equity 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
AdolescentAdult
Female
Hot Temperature
Humans
Male
Models, Biological
Nasal Obstruction
Pulmonary Ventilation
Recovery of Function
Tomography, X-Ray Computed