In this study we utilized computational fluid dynamic (CFD) techniques to construct a numerical simulation of nasal cavity airflow pre and post virtual functional endoscopic surgery (FESS). A healthy subject was selected, and CFD techniques were then applied to construct an anatomically and proportionally accurate three-dimensional nasal model based on nasal CT scans. A virtual FESS intervention was performed numerically on the normal nasal model using Fluent software. Navier-Stokes and continuity equations were used to calculate and compare airflow, velocity, distribution and pressure in both the pre and post FESS models. In the post-FESS model, there was an increase in airflow distribution in the maxillary, ethmoid and sphenoid sinuses, and a 13% increase through the area connecting the middle meatus and the surgically opened ethmoid. There was a gradual decrease in nasal resistance in the posterior ethmoid sinus region following FESS. These findings highlight the potential of this technique as a powerful preoperative assessment tool to aid clinical decision-making.

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The major airflow forms are straight (lower common and inferior meatus) and parabolic (middle and upper common meatus and middle superior). Flow force is strongest at the front end of the inferior and middle turbinate and uncinate process. There is very little exchange between the paranasal sinus and the nasal cavity during stable airflow.

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