An effective simulation- and measurement-based workflow for enhanced diagnostics in rhinology

Abstract

Physics-based analyses have the potential to consolidate and substantiate medical diagnoses in rhinology. Such methods are frequently subject to intense investigations in research. However, they are not used in clinical applications, yet. One issue preventing their direct integration is that these methods are commonly developed as isolated solutions which do not consider the whole chain of data processing from initial medical to higher valued data. This manuscript presents a workflow that incorporates the whole data processing pipeline based on a environment. Therefore, medical image data are fully automatically pre-processed by machine learning algorithms. The resulting geometries employed for the simulations on high-performance computing systems reach an accuracy of up to 99.5% compared to manually segmented geometries. Additionally, the user is enabled to upload and visualize 4-phase rhinomanometry data. Subsequent analysis and visualization of the simulation outcome extend the results of standardized diagnostic methods by a physically sound interpretation. Along with a detailed presentation of the methodologies, the capabilities of the workflow are demonstrated by evaluating an exemplary medical case. The pipeline output is compared to 4-phase rhinomanometry data. The comparison underlines the functionality of the pipeline. However, it also illustrates the influence of mucosa swelling on the simulation.

A Scoping Review of Artificial Intelligence Research in Rhinology

“…Articles were published in journals of otolaryngology (n = 19), 17,18,23,26,28,30,36,38,39,42,46,52,57,65,72,77,86,87,94 radiology (n = 21), 19,22,25,29,31,33,34,45,48,51,54,55,58,67,73,74,81,83–85,95 medical sciences (n = 19), 32,41,44,47,53,61,63,66,68–70,76,78–80,89–91,93 or other areas of medicine (n = 20). 20,21,24,27,35,37,…”

“…Radiology Diagnostics There were 42 articles that used an application of AI for radiology/imaging diagnostics in rhinology. 19,21,22,25,26,29,31,38–43,45,46,48–51,54,55,58,59,62–64,67,69,75,78,80–86,89,91–93,95 Imaging tools used include CT (n = 25), 21,22,25,26,38–43,45,46,55,58,59,63,69,75,81–83,89,91,92,…”

“…Of the 79 articles identified, 3 were published in 2017, [17][18][19] 5 were published in 2018, [20][21][22][23][24] 9 were published in 2019, [25][26][27][28][29][30][31][32][33] 15 were published in 2020, [34][35][36][37][38][39][40][41][42][43][44][45][46][47][48] 31 were published in 2021, and 16 were published in 2022 [80][81][82][83][84][85][86][87][88][89][90][91][92][93][94][95] until May 14th (Figure 3). Study designs of the included articles were either cross-sectional (n = 61) 1...…”

“…Of the 42 articles total, 15 aimed to identify or characterize anatomical structures 21,22,25,38,41,43,45,50,51,59,78,[91][92][93]95 including the location of the anterior ethmoid artery (n = 1), 38 the maxillary sinus (n = 4), 21,41,43,45 the inferior turbinate (n = 1), 41 the nasal cavity (n = 4), 25,59,91,93 the olfactory bulb (n = 3), 50,51,78 the depth of the olfactory fossa (n = 1), 95 the sphenoid sinus (n = 2), 22,92 and the entire upper airway (n = 1). 93 Diagnostic accuracy was rated as excellent (n = 5), 21,45,59,91,92 very good (n = 5), 38,41,51,93,95 good (n = 1), 50 or was not applicable/not reported (n = 4) 22,25,43,78 (see Appendix 2).…”

Measurement of Nasal Obstruction: Rhinomanometry as Basic Method in Functional Rhinology

“…PNIF is a valuable tool in diagnosing and monitoring nasal obstruction, such as in cases of allergic rhinitis or nasal polyps. The results are good repeatable but are completely neglecting the important influence of the nasal valve, and lacks the flow and pressurization necessary to determine the effort of nasal breathing as seen in the tracings of rhinomanometry [11] After the determination of the degree of obstruction in a nasal cavity or on both sides a second anatomical analysis must follow to identify the locations in the nasal cavity, which are causing the obstruction because there is a big variety of one or multiple locations, where we find a remarkable increased pressure resp. minor flow.…”