A systematic analysis of surgical interventions for the airway in the mature unilateral cleft lip nasal deformity: a single case study.
A systematic analysis of surgical interventions for the airway in the mature unilateral cleft lip nasal deformity: a single case study.
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DOI：
10.1007/s11548-021-02396-z
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发表时间：
2022-01
影响因子：
3
通讯作者：
Frank-Ito DO
中科院分区：
文献类型：
--
作者：
Tillis RT;Shah R;Martin HL;Allori AC;Marcus JR;Frank-Ito DO
患有单侧唇裂鼻畸形（uCLND）的人通常需要在青春期进行鼻整形术以纠正鼻塞。本研究的目的是确定最严重的鼻塞部位，并使用计算流体动力学（CFD）评估模拟手术程序对这些部位的单独和组合的影响。将患有uCLND的青少年受试者的计算机断层扫描成像转换为解剖学上精确的三维鼻气道模型。根据CFD计算的阻力值进行初步分析，以确定梗阻的解剖部位。模拟了与常见uCLND手术干预相对应的虚拟手术程序。在进行气流和传热模拟后，对所得到的空域模型进行了分析。术前模型有21个阻塞部位，鼻阻力为0.075 Pa s/mL。在模拟手术程序与功能干预单独和组合后，三个虚拟手术模型的鼻气流改善最多的是下鼻甲缩小术（ITR）和后鼻中隔成形术（阻力= 0.054 Pa s/ml，21个阻塞部位中的14个减少），ITR伴前房间隔成形术（阻力= 0.058 Pa s/ml，21个阻塞部位中的8个减少），以及前后鼻中隔成形术的ITR（阻力= 0.052 Pa s/ml，21个阻塞部位中的17个减少）。本研究介绍了一种新技术，用于分析不同模拟手术干预对uCLND引起的鼻塞的影响。在该受试者中，在非裂隙侧使用ITR进行模拟鼻中隔成形术，最大限度地缓解了鼻塞。可以进一步研究所提出的技术，以分析潜在的手术干预，以最佳缓解uCLND患者的鼻塞可能的效用。
Individuals with unilateral cleft lip nasal deformity (uCLND) often require rhinoplasty in adolescence to correct nasal obstruction. The intent of this study is to identify sites of greatest nasal obstruction and evaluate the effects of isolated and combinations of simulated surgical procedures on these sites using computational fluid dynamics (CFD). Computed tomography imaging of an adolescent subject with uCLND was converted to an anatomically accurate three-dimensional nasal airway model. Initial analysis was performed to identify anatomic sites of obstruction based on CFD computed resistance values. Virtual surgery procedures corresponding to common uCLND surgical interventions were simulated. Resulting airspace models were then analyzed after conducting airflow and heat transfer simulations. The preoperative model had 21 obstructed sites with a nasal resistance of 0.075 Pa s/mL. Following simulated surgical procedures with functional interventions alone and in combinations, the three virtual surgery models with most improved nasal airflow were inferior turbinate reduction (ITR) with posterior septoplasty (resistance = 0.054 Pa s/ml, reduction in 14 of 21 obstructed sites), ITR with anterior septoplasty (resistance = 0.058 Pa s/ml, reduction in 8 of 21 obstructed sites), and ITR with both anterior and posterior septoplasty (resistance = 0.052 Pa s/ml, reduction in 17 of 21 obstructed sites). This study introduces a new technique for analysis of the impact of different simulated surgical interventions on uCLND-induced nasal obstruction. In this subject, simulated septoplasty with ITR on the non-cleft side provided maximal relief of nasal obstruction. The proposed technique can be further studied for possible utility in analyzing potential surgical interventions for optimal relief of nasal obstruction in patients with uCLND.
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DOI：
10.1177/0194599813509776
发表时间：
2014-01
期刊：
Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
影响因子：
--
作者：
Sullivan CD;Garcia GJ;Frank-Ito DO;Kimbell JS;Rhee JS
通讯作者：
Rhee JS
DOI：
10.1097/gox.0000000000001373
发表时间：
2017-06
期刊：
Plastic and reconstructive surgery. Global open
影响因子：
--
作者：
Glener AD;Allori AC;Shammas RL;Carlson AR;Pien IJ;Aylsworth AS;Meyer R;Pimenta L;Strauss R;Watkins S;Marcus JR
通讯作者：
Marcus JR
影响因子：
2
作者：
Kaufman, Yoav;Buchanan, Edward P;Stal, Samuel
通讯作者：
Stal, Samuel
影响因子：
3.6
作者：
Byrd, HS;Salomon, J
通讯作者：
Salomon, J
DOI：
10.1097/gox.0000000000002244
发表时间：
2019-05-01
影响因子：
1.5
作者：
Frank-Ito, Dennis O.;Carpenter, David J.;Marcus, Jeffrey R.
通讯作者：
Marcus, Jeffrey R.