Abstract
We used a computational fluid dynamics (CFD) model to study the inspiratory airflow profiles of patients with anterior nasal cavity stenosis who underwent curative surgery, by comparing pre- and postoperative airflow characteristics. Twenty patients with severe anterior nasal cavity stenosis, including one case of bilateral stenosis, underwent computed tomography (CT) scans for CFD modelling. The pre- and postoperative airflow characteristics of the nasal cavity were simulated and analyzed. The narrowest area of the nasal cavity in all 20 patients was located within the nasal valve area, and the mean cross-sectional area increased from 0.39 cm2 preoperative to 0.78 cm2 postoperative (P<0.01). Meanwhile, the mean airflow velocity in the nasal valve area decreased from 6.19 m/s to 2.88 m/s (P<0.01). Surgical restoration of the nasal symmetry in the bilateral nasal cavity reduced nasal resistance in the narrow sides from 0.24 Pa.s/mL to 0.11 Pa.s/mL (P<0.01). Numerical simulation of the nasal cavity in patients with anterior nasal cavity stenosis revealed structural changes and the resultant patterns of nasal airflow. Surgery achieved balanced bilateral nasal ventilation and decreased nasal resistance in the narrow region of the nasal cavity. The correction of nasal valve stenosis is not only indispensable for reducing nasal resistance, but also the key to obtain satisfactory curative effect.
Highlights
The nasal cavity, an important passage of the upper respiratory tract, has various functions including cleaning, humidifying and warming the inhaled air
Anterior nasal cavity stenosis features The nasal cavity computational fluid dynamics (CFD) models indicated that the anterior nasal cavity stenoses of the 20 patients were all located in the nasal valve area with a mean crosssectional area of 0.39±0.16 cm2
Lu et al [11] reported that the numerical simulation model provides an accurate reflection of nasal airflow, and results obtained by numerical simulation were consistent with clinical measurements
Summary
The nasal cavity, an important passage of the upper respiratory tract, has various functions including cleaning, humidifying and warming the inhaled air. Anterior nasal cavity stenosis, which occurs in the anterior nostril, nasal valve area or around nasal vestibule, can lead to nasal ventilation dysfunction and structural deformities. Stenosis can occur in the nasal vestibule and postnaris after trauma, infection, or surgery. Ulceration secondary to infection, burns, tumor resection, nasal intubation or radiotherapy may lead to rhinostenosis. Scar stenosis is frequently seen in the nasal valve area due to the weakness of the cartilaginous supporting structures. Surgical treatment methods should be chosen according to the location of stenosis and the thickness of local tissue. The main surgical procedures include: a) scar resection, b) intranasal Z-plasty, and c) nasal stenting (silicone tube) in the anterior nasal cavity to prevent recurrent stenosis
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Schedule a callMore From: Brazilian journal of medical and biological research = Revista brasileira de pesquisas medicas e biologicas
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