The numerical simulations demonstrate significantly disturbed intranasal airflow patterns due to SPs. This fact may contribute to crusting and nosebleed due to dehydration of the nasal mucosa. The location and size of the SP are crucial for the impact on disturbed airflow pattern and therefore the patients' complaints. Anterior caudal SPs seem to be the worst. Surgical closure of SPs or simply changes in the site and size of the SP if a complete closure is surgically impossible makes sense.
Nasal septum perforations (SP) are characterized by nasal obstruction, bleeding and crusting. The disturbed heating and humidification of the inhaled air are important factors, which cause these symptoms due to a disturbed airflow. Numerical simulations offer a great potential to avoid these limitations and to provide valid data. The aim of the study was to simulate the humidification and heating of the inhaled air in digital nose models with three different SPs and without SP. Four realistic bilateral nose models based on a multi-slice CT scan were created. The SP were located anterior caudal, anterior cranial and posterior caudal. One model was without SP. A numerical simulation was performed. Boundary conditions were based on previous in vivo measurements. Heating and humidification of the inhaled air were displayed, analyzed in each model and compared to each other. Anterior caudal SPs cause a disturbed decrease of temperature and humidity of the inhaled air. The reduced temperature and humidity values can still be shown in the posterior nose. The anterior cranial and the posterior caudal perforation have only a minor influence on heating and humidification. A reduced humidification and heating of the air can be shown by numerical simulations due to SP depending on their localization. The anterior caudal SP representing a typical localization after previous surgery has the biggest influence on heating and humidification. The results explain the typical symptoms such as crusting by drying-out the nasal mucosa. The size and the localization of the SP are essential for the symptoms.
The changes after performing a pyriform turbinoplasty seem to be an improvement when compared to the changes after inferior turbinate surgery that can misdirect the airflow largely through the inferior meatus.
Background: The temperature of inhaled air is highly relevant for the humidification process. Narrow anatomical conditions limit possibilities for in vivo measurements. Numerical simulations offer a great potential to examine the function of the human nose. Objective: In the present study, the nasal humidification of inhaled air was simulated simultaneously with temperature distribution during a respiratory cycle. Methods: A realistic nose model based on a multislice CT scan was created. The simulation was performed by the Software Fluent(r). Boundary conditions were based on previous in vivo measurements. Inhaled air had a temperature of 20(deg)C and relative humidity of 30%. The wall temperature was assumed to be variable from 34(deg)C to 30(deg)C with constant humidity saturation of 100% during the respiratory cycle. Results: A substantial increase in temperature and humidity can be observed after passing the nasal valve area. Areas with high speed air flow, e.g. the space around the turbinates, show an intensive humidification and heating potential. Inspired air reaches 95% humidity and 28(deg)C within the nasopharynx. Conclusion: The human nose features an enormous humidification and heating capability. Warming and humidification are dependent on each other and show a similar spacial pattern. Concerning the climatisation function, the middle turbinate is of high importance. In contrast to in vivo measurements, numerical simulations can explore the impact of airflow distribution on nasal air conditioning. They are an effective method to investigate nasal pathologies and impacts of surgical procedures.
The human nose takes primary responsibility for preconditioning inhaled air. Numerous pathologies can affect the physiology of the nose. The beginnings of flow analyzes were carried out with three-dimensional casting models and differently colored liquids. Temperature and humidity could not be taken into account. Today, much more complex analyzes are possible using computational fluid dynamics (CFD), which are based on three-dimensional models generated from computed tomography (CT) or magnetic resonance imaging (MRI) datasets. Here, flow velocities, temperature, humidity, and pressure differences can be simulated and displayed in high-resolution videos as a function of multiple boundary conditions. The analysis of pathological changes or surgical interventions is thereby possible.
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