Normative ranges of nasal airflow variables in healthy adults
Normative ranges of nasal airflow variables in healthy adults
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DOI：
10.1007/s11548-019-02023-y
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发表时间：
2020-01-01
影响因子：
3
通讯作者：
Rhee, John S.
中科院分区：
文献类型：
--
作者：
Borojeni, Azadeh A. T.;Garcia, Guilherme J. M.;Rhee, John S.
目的基于计算流体动力学（CFD）模拟鼻腔气流的虚拟手术计划有可能改善鼻气道阻塞（NAO）患者的手术效果。虚拟手术计划需要气流变量的标准范围，但迄今为止很少有研究量化健康受试者的鼻气流个体间的变异性。本研究报告了47名健康成年人鼻气流的CFD模拟。方法利用锥形束CT扫描重建鼻的三维模型，模拟双侧250 ml/s的稳态吸气气流。采用鼻塞症状评估和视觉模拟评分确认鼻腔通畅的主观感觉正常。计算了已知与主观鼻通畅性相关的几个CFD变量的健康范围，包括单侧气流、鼻阻力、空气空间最小横截面积（mCSA）、热通量（HF）和粘膜冷却刺激的表面积（定义为HF> 50 W/m2的面积）。标准范围的目标是包含95%的健康人群，并使用基于顺序统计量的非参数方法进行计算。结果健康受试者鼻气流存在较大的个体差异。单侧气流变化范围为60 - 191 ml/s，气流分配范围为23.8 - 76.2%，单侧mCSA变化范围为0.24 - 1.21 cm（2）。这些范围与文献中的测压和声学测压数据吻合良好。这项研究的一个关键创新是与粘膜冷却相关的流量变量的标准范围，最近的研究表明这是鼻气流感觉的主要生理机制。单侧HF范围为94至281 W/m2，而冷却刺激的表面积范围为27.4至64.3 cm 2。结论这些正常范围可以作为NAO患者未来虚拟手术计划的目标。
Purpose Virtual surgery planning based on computational fluid dynamics (CFD) simulations of nasal airflow has the potential to improve surgical outcomes for patients with nasal airway obstruction (NAO). Virtual surgery planning requires normative ranges of airflow variables, but few studies to date have quantified inter-individual variability of nasal airflow among healthy subjects. This study reports CFD simulations of nasal airflow in 47 healthy adults. Methods Anatomically accurate three-dimensional nasal models were reconstructed from cone beam computed tomography scans and used for steady-state inspiratory airflow simulations with a bilateral flowrate of 250 ml/s. Normal subjective sensation of nasal patency was confirmed using the nasal obstruction symptom evaluation and visual analog scale. Healthy ranges for several CFD variables known to correlate with subjective nasal patency were computed, including unilateral airflow, nasal resistance, airspace minimal cross-sectional area (mCSA), heat flux (HF), and surface area stimulated by mucosal cooling (defined as the area where HF > 50 W/m(2)). The normative ranges were targeted to contain 95% of the healthy population and computed using a nonparametric method based on order statistics. Results A wide range of inter-individual variability in nasal airflow was observed among healthy subjects. Unilateral airflow varied from 60 to 191 ml/s, airflow partitioning ranged from 23.8 to 76.2%, and unilateral mCSA varied from 0.24 to 1.21 cm(2). These ranges are in good agreement with rhinomanometry and acoustic rhinometry data from the literature. A key innovation of this study are the normative ranges of flow variables associated with mucosal cooling, which recent research suggests is the primary physiological mechanism of nasal airflow sensation. Unilateral HF ranged from 94 to 281 W/m(2), while the surface area stimulated by cooling ranged from 27.4 to 64.3 cm(2). Conclusions These normative ranges may serve as targets in future virtual surgery planning for patients with NAO.