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Perception of better nasal patency correlates with increased mucosal cooling after surgery for nasal obstruction. Otolaryngol Head Neck Surg 2014 Jan;150(1):139-47



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OBJECTIVES: To (1) quantify mucosal cooling (ie, heat loss) spatially in the nasal passages of nasal airway obstruction (NAO) patients before and after surgery using computational fluid dynamics (CFD) and (2) correlate mucosal cooling with patient-reported symptoms, as measured by the Nasal Obstruction Symptom Evaluation (NOSE) and a visual analog scale (VAS) for sensation of nasal airflow.

STUDY DESIGN: Prospective.

SETTING: Academic tertiary medical center.

SUBJECTS AND METHODS: Computed tomography (CT) scans and NOSE and VAS surveys were obtained from 10 patients before and after surgery to relieve NAO. Three-dimensional models of each patient's nasal anatomy were used to run steady-state CFD simulations of airflow and heat transfer during inspiration. Heat loss across the nasal vestibule and the entire nasal cavity, as well as the surface area of mucosa exposed to heat fluxes >50 W/m(2), were compared pre- and postoperatively.

RESULTS: After surgery, heat loss increased significantly on the preoperative most obstructed side (P < .0002). A larger surface area of nasal mucosa was exposed to heat fluxes >50 W/m(2) after surgery. The best correlation between patient-reported and CFD measures of nasal patency was obtained for NOSE against surface area in which heat fluxes were >50 W/m(2) (Pearson r = -0.76).

CONCLUSION: A significant postoperative increase in mucosal cooling correlates well with patients' perception of better nasal patency after NAO surgery. Computational fluid dynamics-derived heat fluxes may prove to be a valuable predictor of success in NAO surgery.

Author List

Sullivan CD, Garcia GJ, Frank-Ito DO, Kimbell JS, Rhee JS


Guilherme Garcia PhD Assistant Professor in the Biomedical Engineering 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

Airway Resistance
Body Temperature Regulation
Models, Anatomic
Nasal Mucosa
Nasal Obstruction
Postoperative Period
Prospective Studies
Pulmonary Ventilation
Visual Analog Scale
jenkins-FCD Prod-482 91ad8a360b6da540234915ea01ff80e38bfdb40a