Evaluation of the Intranasal Flow Field through Computational Fluid Dynamics

Abstract

A reliable and comprehensive assessment of nasal breathing is problematic and still a common issue in rhinosurgery. Impairments of nasal breathing need an objective approach. In this regard, currently rhinomanometry is the only standard diagnostic tool available but has various limitations. However, in the last decade, computational fluid dynamics (CFD) has become a promising method in facing the challenge of qualifying nasal breathing. This article presents use of CFD with a symptom-free subject and a symptomatic patient. Thereby, certain flow field features and changes before and after surgery were investigated. Moreover, the study outlines suggestions for concrete rhinologic CFD applications.

Keywords

nasal resistance - pressure drop - nasal breathing - flow field - wall shear stress

• References

• 1 Bermüller C, Kirsche H, Rettinger G, Riechelmann H. Diagnostic accuracy of peak nasal inspiratory flow and rhinomanometry in functional rhinosurgery. Laryngoscope 2008; 118: 605-610
• 2 Mlynski G, Beule A. Diagnostik der respiratorischen Funktion der Nase [Diagnostic methods of nasal respiratory function]. HNO 2008; 56: 81-99
• 3 Kimbell JS, Garcia GJM, Frank DO, Cannon DE, Pawar SS, Rhee JS. Computed nasal resistance compared with patient-reported symptoms in surgically treated nasal airway passages: a preliminary report. Am J Rhinol Allergy 2012; 26: e94-e98
• 4 Doorly DJ, Taylor DJ, Gambaruto AM, Schroter RC, Tolley N. Nasal architecture: form and flow. Philos Transact A Math Phys Eng Sci 2008; 366: 3225-3246
• 5 Doorly DJ, Taylor DJ, Schroter RC. Mechanics of airflow in the human nasal airways. Respir Physiol Neurobiol 2008; 163: 100-110
• 6 Elad D, Naftali S, Rosenfeld M, Wolf M. Physical stresses at the air-wall interface of the human nasal cavity during breathing. J Appl Physiol 2006; 100: 1003-1010
• 7 Goubergrits L, Schaller L, Kertzscher U , et al. Statistically wall shear stress maps of ruptured and unruptured middle cerebral artery aneurysms. J R Soc Interface 2012; 69: 677-688
• 8 Goubergrits L, Wellnhofer E, Kertzscher U, Affeld K, Petz C, Hege H-C. Coronary artery WSS profiling using a geometry reconstruction based on biplane angiography. Ann Biomed Eng 2009; 37: 682-691
• 9 Zachow S, Steinmann A, Hildebrandt T, Weber R, Heppt W. CFD simulation of nasal airflow: towards treatment planning for functional rhinosurgery. Int J Comput Assist Radiol Surg 2006; 1 (S1) 165-167
• 10 Zachow S, Muigg P, Hildebrandt T, Doleisch H, Hege H-C. Visual exploration of nasal airflow. IEEE Trans Vis Comput Graph 2009; 15: 1407-1414
• 11 Zachow S, Steinmann A, Hildebrandt T, Heppt W. Understanding nasal airflow via CFD simulation and visualization. In: Proc Computer Aided Surgery around the Head. Berlin: Pro Business Verlag; 2007: 173-176
• 12 Gubisch W. Twenty-five years experience with extracorporeal septoplasty. Facial Plast Surg 2006; 22: 230-239
• 13 Zhu JH, Lee HP, Lim KM, Lee SJ, Teo Li San L, Wang DY. Inspirational airflow patterns in deviated noses: a numerical study. Comput Methods Biomech Biomed Engin 2012;
• 14 Doorly DJ, Taylor DJ, Gambaruto AM, Schroter RC, Tolley N. Nasal architecture: form and flow. Philos Transact A Math Phys Eng Sci 2008; 366: 3225-3246
• 15 Taylor DJ, Doorly DJ, Schroter RC. Inflow boundary profile prescription for numerical simulation of nasal airflow. J R Soc Interface 2010; 7: 515-527
• 16 Sommer F, Kröger R, Lindemann J. Numerical simulation of humidification and heating during inspiration within an adult nose. Rhinology 2012; 50: 157-164
• 17 Delank KW. Aerodynamik im Bereich des Riechorgans. In: Stoll W, , ed. Klinik der menschlichen Sinne. Wien, Austria: Springer Verlag; 2008: 50-58
• 18 Keyhani K, Scherer PW, Mozell MM. Numerical simulation of airflow in the human nasal cavity. J Biomech Eng 1995; 117: 429-441
• 19 Hahn I, Scherer PW, Mozell MM. Velocity profiles measured for airflow through a large-scale model of the human nasal cavity. J Appl Physiol 1993; 75: 2273-2287
• 20 Proctor DF. The upper airway. In: Proctor DF, Anderson IB, , eds. The Nose. Upper Airway Physiology and the Atmospheric Environment. New York, NY: Elsevier, Urban & Fischer; 1982: 23-43
• 21 Wen J, Inthavong K, Tian ZF, Tu JY, Xue CL, Li CG. Airflow Patterns in Both Sides of a Realistic Human Nasal Cavity for Laminar and Turbulent Conditions. Paper presented at: 16th Australasian Fluid Mechanics Conference; December 3–7, 2007; Gold Coast, Australia
• 22 Wexler DB, Davidson TM. The nasal valve: a review of the anatomy, imaging, and physiology. Am J Rhinol 2004; 18: 143-150
• 23 Huizing EH, De Groot JAM. Functional Reconstructive Nasal Surgery. 1st ed. Stuttgart, Germany: Thieme; 2003: 47-50
• 24 Bloching MB. Disorders of the nasal valve area. GMS Curr Top Otorhinolaryngol Head Neck Surg 2007; 6: Doc07
• 25 Tesla N. Valvular Conduid. US-Patent 1329559 (1920)
• 26 Hildebrandt T. Das Konzept der Rhinorespiratorischen Homöostase—ein neuer theoretischer Ansatz für die Diskussion physiologischer und physikalischer Zusammenhänge bei der Nasenatmung [PhD dissertation]. Freiburg im Breisgau, Germany: Albert-Ludwigs-Universität; 2011
• 27 Fiedler G. Retrospektive Analyse sinunasaler Erkrankungen bei 104 Patienten nach Laryngektomie [PhD dissertation]. Marburg, Germany: Phillips-Universität; 2008
• 28 Maniscalo M, Lundberg JO. Nasal nitric oxide. Eur Respir Mon 2010; 49: 71-81
• 29 Heppt W, Gubisch W. Septal surgery in rhinoplasty. Facial Plast Surg 2011; 27: 167-178