Correlation of Nasal Mucosal Temperature and Nasal Patency—A Computational Fluid Dynamics Study

Abstract

Objectives Recent evidence suggests that detection of nasal mucosal temperature, rather than direct airflow detection, is the primary determinant of subjective nasal patency. This study examines the role of nasal mucosal temperature in the perception of nasal patency using in vivo and computational fluid dynamics (CFD) measurements. Methods Healthy adult participants completed Nasal Obstruction Symptom Evaluation (NOSE) and Visual Analogue Scale (VAS) questionnaires. A temperature probe measured nasal mucosal temperature at the vestibule, inferior turbinate, middle turbinate, and nasopharynx bilaterally. Participants underwent a CT scan, used to create a 3D nasal anatomy model to perform CFD analysis of nasal mucosal and inspired air temperature and heat flux along with mucosal surface area where heat flux >50 W/m2 (SAHF50). Results Eleven participants with a median age of 27 (IQR 24; 48) were recruited. Probe‐measured temperature values correlated strongly with CFD‐derived values (r = 0.87, p < 0.05). Correlations were seen anteriorly in the vestibule and inferior turbinate regions between nasal mucosal temperature and unilateral VAS (r = 0.42–0.46; p < 0.05), between SAHF50 and unilateral VAS (r = −0.31 to −0.36; p < 0.05) and between nasal mucosal temperature and SAHF50 (r = −0.37 to −0.41; p < 0.05). Subjects with high patency (VAS ≤10) had increased heat flux anteriorly compared with lower patency subjects (VAS >10; p < 0.05). Conclusion Lower nasal mucosal temperature and higher heat flux within the anterior nasal cavity correlates with a perception of improved unilateral nasal patency in healthy individuals. Level of Evidence 4 Laryngoscope, 133:1328–1335, 2023

Effects of Mucosal Decongestion on Nasal Aerodynamics: A Pilot Study

“…Many research studies have shown a lack of correlation between nasal resistance and sensation of nasal airflow. 24,31,32 In fact, today the leading hypothesis is that the primary mechanism of nasal airflow sensation is the stimulation of TRPM8 cold receptors, [3][4][5][6][7][8][9][10][11][12][13][14][15] which was not investigated in past studies of mucosal decongestion.…”

Computational Rhinology: Unraveling Discrepancies between In Silico and In Vivo Nasal Airflow Assessments for Enhanced Clinical Decision Support

“…It can be deduced that the same sensors that cause subjective sensing of nasal patency are responsible for subjective sensing of heat exchange between the nasal airflow and the nasal tissue, and several studies have demonstrated correlations between mucosal cooling and temperature, obtained from CFD simulations, and patients’ subjective evaluation of nasal patency [ 50 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 ].…”

“…This spurs optimism towards predicting subjective sensation of nasal patency through CFD simulations, adding clinical value to virtual surgery. However, it has been pointed out by several authors that the subjective sensing of nasal patency might not be a measure of the objective flow resistance, but rather the cooling effect of the nasal mucosa [ 68 ]. In this case, CFD must be correlated with subjective measures, directly, because no in vivo measurements exist to measure mucosal temperature or heat flux.…”

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“…In principle, the nose flow can be well described by CFD, which is indeed increasingly useful to support ENT doctors in their diagnosis (Moreddu et al. 2019; Tjahjono et al. 2023) and to improve our understanding of the complex physics of the nose flow (Calmet et al.…”