Modeling Nasal Physiology Changes Due to Septal Perforations

Abstract

Objective To use computational fluid dynamics (CFD) technology to help providers understand 1) how septal perforations may alter nasal physiology and 2) how these alterations are influenced by perforation size and location. Study Design Computer simulation study Setting Facial Plastic and Reconstructive Surgery clinic Subjects and Methods With the aid of medical imaging and modeling software, septal perforations of 1 and 2 cm in anterior, posterior, and superior locations were virtually created in a nasal cavity digital model. CFD techniques were used to analyze airflow, nasal resistance, air conditioning, and wall shear stress. Results Bilateral nasal resistance was not significantly altered by a septal perforation. Airflow allocation changed, with more air flowing through the lower-resistance nasal cavity. This effect was greater for anterior and posterior perforations than for the superior location. At the perforation sites, there was less localized heat and moisture flux and wall shear stress in superior perforations compared to those in anterior or posterior locations. For anterior perforations, a larger size produced higher wall shear and velocity, while in posterior perforations a smaller size produced higher wall shear and velocity. Conclusions Septal perforations may alter nasal physiology. In the subject studied, airflow allocation to each side was changed as air was shunted through the perforation to the lower-resistance nasal cavity. Anterior and posterior perforations caused larger effects than those in a superior location. Increasing the size of anterior perforations and decreasing the size of posterior perforations enhanced alterations in wall shear and velocity at the perforation.

Perception of Better Nasal Patency Correlates with Increased Mucosal Cooling after Surgery for Nasal Obstruction

“…30,42–44 The data presented here suggest that CFD may indeed provide nasal physiology variables that correlate with patients’ symptoms. However, it is likely that heat flux will not be the sole determinant, but rather the best indication of success may be a combination of variables, such as heat flux, nasal resistance, and wall shear stress.…”

Creation of an idealized nasopharynx geometry for accurate computational fluid dynamics simulations of nasal airflow in patient‐specific models lacking the nasopharynx anatomy

“…This research is part of a larger study by our group aimed at utilizing CFD modeling techniques to provide important clinical information such as (1) correlating subjective and objective measures of nasal patency [11–15]; (2) using virtual surgery to predict surgical outcomes [16–21]; and (3) effects of nasal deformity on topical drug delivery [22–24]. A cohort of 15 patients underwent nasal surgeries such as septoplasty, functional rhinoplasty, and inferior turbinate reduction to treat NAO (Table 1).…”

Computational technology for nasal cartilage-related clinical research and application

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