Impact of Airflow Communication between Nasal Cavities on Nasal Ventilation

Abstract

Objective: To investigate the impact of airflow communication between bilateral nostril sides on nasal ventilation. In addition, we try to validate the efficacy of the Draf III procedure from the aerodynamics perspective. Methods: One health model and two disease models were constructed. These included 2 patients with nasal septum perforation and 1 patient who received the Draf III procedure. With the computational fluid dynamics method, indices such as airflow velocity and wall shear stress in the nasal cavity were detected and compared among the 3 subjects. Results: The main pathway for airflow in the nasal cavity is the common meatus. Little airflow exchange occurred in the patient who underwent the Draf III procedure, and the wall shear stress around the communication site was as low as in the adjacent areas. However, when airflow communication occurred in the lower part of the nasal cavity, the airflow velocity and wall shear stress were obviously altered, and the ventilation function of the nasal cavity was impaired. Conclusion: Airflow communication in the upper part of the nasal cavity has little impact on nasal ventilation. Nonetheless, airflow communication occurring in the lower part of the nasal cavity disturbs the overall airflow distribution and a repair procedure is necessary.

A computational fluid dynamics analysis of the effects of size and shape of anterior nasal septal perforations

“…However, this highlights the previously demonstrated importance of providing subject sex and race data so that the applicability (external validity) of the findings can be assessed by the reader (28)(29)(30) . The findings presented here do agree with those of prior studies in different individuals (16)(17)(18)(19)(20) . Second, the models did not account for other adaptations that may occur in the nasal cavity such as mucosal and turbinate hypertrophy.…”

“…However, as a result, we were able to demonstrate the isolated effects of perforations without confounding effects from such adaptations. Four recent studies have analyzed true NSPs and have compared physiologic parameters to post-virtual repair (19,20,22,23) . However, additional studies analyzing true NSPs are needed to provide a similar data library on physiologic alterations as we currently have for virtual NSPs.…”

“…Several CFD studies have focused on the nasal alterations and symptoms observed with NSPs (15)(16)(17)(18)(19)(20)(21)(22)(23) . However, most of these studies analyzed changes either in single-sized perforations (15,16,19,20,22) or purely circular perforations (17,18,21) , but anecdotally perforations are more commonly ovoid in shape. The objective of this study was to analyze the impact of size and shape (ovoid versus round) of anterior NSPs on nasal physiology using CFD simulations.…”

Radical versus Functional Endoscopic Sinus Surgery for Osteitis in Chronic Rhinosinusitis

“…From our study, RESS should be a better choice for the patient with osteitis and inflammatory load, through the eradication of pro-inflammatory factors (eosinophils in the mucosa, superantigen, bacterial load, biofilm, and osteitic bony lamella) that contribute to the local persistent inflammation. On the other hand, RESS is based on the traditional FESS, which is further expanded to open sinus ostium, and also emphasizes the protection of normal mucosa, resulting in improvement of the nasal ventilation, olfactory function, and other physiological functions [19,20].…”

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“…Airflow patterns in nasal cavities have been well reported [7][8][9][10], but sinus physiology and the effects of ESS interventions are still quite limited due to the poorly accessible location of the sinuses and the lack of noninvasive techniques for studying sinus physiology in living persons. For example, during ESS, uncinectomy is usually performed when the ostiomeatal complex is affected by disease, and anterior ethmoidectomy is frequently added to optimally decompress the ostiomeatal complex [11].…”