The Healthy Nasal Cavity—Characteristics of Morphology and Related Airflow Based on a Statistical Shape Model Viewed from a Surgeon's Perspective

Abstract

Functional surgery on the nasal framework requires referential criteria to objectively assess nasal breathing for indication and follow-up. This motivated us to generate a mean geometry of the nasal cavity based on a statistical shape model. In this study, the authors could demonstrate that the introduced nasal cavity's mean geometry features characteristics of the inner shape and airflow, which are commonly observed in symptom-free subjects. Therefore, the mean geometry might serve as a reference-like model when one considers qualitative aspects. However, to facilitate quantitative considerations and statistical inference, further research is necessary. Additionally, the authors were able to obtain details about the importance of the isthmus nasi and the inferior turbinate for the intranasal airstream.

Keywords

statistical shape model - nasal cavity - nasal breathing - nasal airflow - isthmus nasi - inferior turbinate

• References

• 1 Fischer R. Die Physik der Atemströmung in der Nase. Berlin, Germany: Habilitationsschrift, Freie Universität Berlin; 1969
• 2 Mlynski G. Physiology and pathophysiology of nasal breathing. In: Önerci TM. , ed. Nasal Physiology and Pathophysiology of Nasal Disorders. Heidelberg, Germany: Springer; 2013: 76-87
• 3 Vogt K, Wernecke KD, Behrbohm H, Gubisch W, Argale M. Four-phase rhinomanometry: a multicentric retrospective analysis of 36,563 clinical measurements. Eur Arch Otorhinolaryngol 2016; 273 (05) 1185-1198
• 4 Brüning JJ, Goubergrits L, Heppt W, Zachow S, Hildebrandt T. Numerical analysis of nasal breathing: a pilot study. Facial Plast Surg 2017; 33 (04) 388-395
• 5 Zachow S, Muigg P, Hildebrandt T, Doleisch H, Hege HC. Visual exploration of nasal airflow. IEEE Trans Vis Comput Graph 2009; 15 (06) 1407-1414
• 6 Li C, Jiang J, Kim K. , et al. Nasal structural and aerodynamic features that may benefit normal olfactory sensitivity. Chem Senses 2018; 43 (04) 229-237
• 7 Inthavong K, Shang Y, Tu J. Surface mapping for visualization of wall stresses during inhalation in a human nasal cavity. Respir Physiol Neurobiol 2014; 190: 54-61
• 8 Doorly DJ, Taylor DJ, Schroter RC. Mechanics of airflow in the human nasal airways. Respir Physiol Neurobiol 2008; 163 (1-3): 100-110
• 9 Taylor DJ, Doorly DJ, Schroter RC. Inflow boundary profile prescription for numerical simulation of nasal airflow. J R Soc Interface 2010; 7 (44) 515-527
• 10 Zhao K, Jiang J, Blacker K. , et al. Regional peak mucosal cooling predicts the perception of nasal patency. Laryngoscope 2014; 124 (03) 589-595
• 11 Lamecker H, Zachow S. Statistical shape modeling of musculoskeletal structures and its applications. In: Zheng G, Li S. , eds. Computational Radiology for Orthopaedic Interventions. Cham, Switzerland: Springer; 2016: 1-23
• 12 Wilson DAJ, Anglin C, Ambellan F. , et al. Validation of three-dimensional models of the distal femur created from surgical navigation point cloud data for intraoperative and postoperative analysis of total knee arthroplasty. Int J CARS 2017; 12 (12) 2097-2105
• 13 Park CS. Role of nose in sleep-disordered breathing. Sleep Med Res 2014; 5 (01) 1-4
• 14 Fodil R, Brugel-Ribere L, Croce C. , et al. Inspiratory flow in the nose: a model coupling flow and vasoerectile tissue distensibility. J Appl Physiol (1985) 2005; 98 (01) 288-295
• 15 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 (1985) 2006; 100 (03) 1003-1010
• 16 Liu Y, Johnson MR, Matida EA, Kherani S, Marsan J. Creation of a standardized geometry of the human nasal cavity. J Appl Physiol (1985) 2009; 106 (03) 784-795
• 17 Gambaruto AM, Taylor DJ, Doorly DJ. Decomposition and description of the nasal cavity form. Ann Biomed Eng 2012; 40 (05) 1142-1159
• 18 Bruening J, Hildebrandt T, Bindernagel M. , et al. A Statistical Shape Model of the Human Nasal Cavity. Poster presented at: 8th World Congress of Biomechanics; 2018. Available via Figshare (doi: 10.6084/m9.figshare.7339577)
• 19 Bloching MB. Disorders of the nasal valve area. GMS Curr Top Otorhinolaryngol Head Neck Surg 2007; 6: Doc07
• 20 Nigro CE, Nigro JF, Mion O, Mello Jr JF, Mello Jr JF. Nasal valve: anatomy and physiology. Rev Bras Otorrinolaringol (Engl Ed) 2009; 75 (02) 305-310
• 21 Matthias C. Surgery of the nasal septum and turbinates. GMS Curr Top Otorhinolaryngol Head Neck Surg 2007; 6: Doc10
• 22 Huizing EH, De Groot JAM. Functional Reconstructive Nasal Surgery. 1st ed. Stuttgart, Germany: Thieme; 2003: 47-50