A computational fluid dynamics analysis of the effects of size and shape of anterior nasal septal perforations
A computational fluid dynamics analysis of the effects of size and shape of anterior nasal septal perforations
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DOI：
10.4193/rhin18.111
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发表时间：
2019-01-01
期刊：
影响因子：
7.2
通讯作者：
Senior, Bret A.
中科院分区：
文献类型：
--
作者：
Farzal, Zainab;Del Signore, Anthony G.;Senior, Bret A.
背景：鼻中隔穿孔 (NSP) 通常会导致出血、结痂、阻塞和/或啸叫。目的是使用计算流体动力学 (CFD) 分析前 NSP 的大小和形状对鼻生理学的影响。方法：使用成像软件根据放射学正常的 CT 扫描构建鼻腔的 3 维模型。前 NSP（卵形 (ONSP)：前后长 0.5、1、2 和 3 厘米，圆形（RNSP，0.5 和 1 厘米））在模型中虚拟创建，并分为腹侧、背侧、前侧和后侧区域。使用 Fluent (TM) CFD 软件模拟稳态吸气气流、热量和水蒸气传输。分析了通过穿孔的空气透过量、壁面剪切力、热通量、水蒸气通量、阻力和加湿。结果：空气透过量和壁面剪切力随着穿孔尺寸的增加而增加。从区域来看，壁剪切力以及热和水蒸气通量向后最高，向前最低，通常随着这些区域的大小而增加。与相应尺寸的 ONSP 相比，RNSP 具有更大的热量和水蒸气通量。仅在 3 cm ONSP 中，电阻比正常值下降 10% 或更多。在较大的 NSP 鼻腔中，最大含水量在更靠后的位置实现。结论：后穿孔区域的高壁剪切力以及热量和水蒸气通量可以解释 NSP 后边缘最常见的结痂现象。这项初步研究表明，较大的 NSP 对鼻阻力和含水量的影响更大。随着 NSP 尺寸增大，阻力降低可能与报道的 NSP 增大治疗后症状改善有关。
Background: Nasal septal perforations (NSPs) often cause bleeding, crusting, obstruction, and/or whistling. The objective was to analyze the impact of anterior NSP size and shape on nasal physiology using computational fluid dynamics (CFD).Methods: A 3-dimensional model of the nasal cavity was constructed from a radiologically normal CT scan using imaging software. Anterior NSPs (ovoid (ONSP): 0.5, 1, 2, and 3 cm long anterior-to-posteriorly and round (RNSP, 0.5 and 1 cm)) were virtually created in the model and divided into ventral, dorsal, anterior, and posterior regions. Steady-state inspiratory airflow, heat, and water vapor transport were simulated using Fluent (TM) CFD software. Air crossover through the perforation, wall shear, heat flux, water vapor flux, resistance, and humidification were analyzed.Results: Air crossover and wall shear increased with perforation size. Regionally, wall shear and heat and water vapor flux were highest posteriorly and lowest anteriorly, generally increasing with size in those regions. RNSPs had greater heat and water vapor flux compared to corresponding size ONSPs. Resistance decreased by 10% or more from normal only in the 3 cm ONSP. Maximum water content was achieved more posteriorly in larger NSP nasal cavities.Conclusions: High wall shear and heat and water vapor flux in posterior perforation regions may explain the crusting most commonly noted on posterior NSP edges. This preliminary study suggests that larger NSPs have a greater effect on nasal resistance and water content. Decrease in resistance with larger NSP size may be implicated in reported symptomatic improvement following enlargement of NSPs for treatment.