Computational Analysis of the Mature Unilateral Cleft Lip Nasal Deformity on Nasal Patency
Computational Analysis of the Mature Unilateral Cleft Lip Nasal Deformity on Nasal Patency
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DOI：
10.1097/gox.0000000000002244
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发表时间：
2019-05-01
影响因子：
1.5
通讯作者：
Marcus, Jeffrey R.
中科院分区：
文献类型：
--
作者：
Frank-Ito, Dennis O.;Carpenter, David J.;Marcus, Jeffrey R.
背景：鼻解剖畸形引起的鼻气道阻塞（NAO）在唇腭裂患者中比在普通人群中更为常见，但相对于其他导致NAO的情况，唇腭裂相关鼻塞的严重程度和变异性的信息缺乏。本初步研究比较了单侧唇裂鼻畸形（uCLND）与非唇裂鼻畸形（NAO）的差异。方法：采用基于患者特异性计算机断层扫描图像的计算建模技术，量化21例受试者的鼻气道解剖和气流动力学：5例健康正常受试者；非裂NAO受试者8例；8名uCLND科目。报道的结果包括鼻塞症状评估（NOSE）评分、横截面积和鼻阻力。结果：与正常和NAO受试者相比，uCLND受试者的左右鼻腔在多个横截面上的横截面积差异显著较大。NAO和uCLND的鼻鼻翼评分中位数和四分位间距（IQR）分别为75 （IQR= 22.5）和67.5 （IQR= 30）。两腔间气流隔断差值：中位数= 9.4%,IQR = 10.9%（正常）；中位数= 31.9%，IQR= 25.0% (NAO)；中位数= 29.9%,IQR = 44.1% （uCLND）。左右鼻腔阻力中值差为0.01 pa。(IQR= 0.03 pa。S /ml)，正常值为0.09 pa。(IQR= 0.16 pa。s/ml), 0.08 pa。(IQR = 0.25 pa。（s/ml）。结论：uCLND受试者表现出明显的两侧鼻腔不对称。此外，在uCLND受试者中，裂侧和非裂侧的血流分配差异和阻力差异存在显著的不相称性，表明两侧可能都存在功能障碍。
Background: Nasal airway obstruction (NAO) due to nasal anatomic deformities is known to be more common among cleft patients than the general population, yet information is lacking regarding severity and variability of cleft-associated nasal obstruction relative to other conditions causing NAO. This preliminary study compares differences in NAO experienced by unilateral cleft lip nasal deformity (uCLND) subjects with noncleft subjects experiencing NAO.Methods: Computational modeling techniques based on patient-specific computed tomography images were used to quantify the nasal airway anatomy and airflow dynamics in 21 subjects: 5 healthy normal subjects; 8 noncleft NAO subjects; and 8 uCLND subjects. Outcomes reported include Nasal Obstruction Symptom Evaluation (NOSE) scores, cross-sectional area, and nasal resistance.Results: uCLND subjects had significantly larger cross-sectional area differences between the left and right nasal cavities at multiple cross sections compared with normal and NAO subjects. Median and interquartile range (IQR) NOSE scores between NAO and uCLND were 75 (IQR= 22.5) and 67.5 (IQR= 30), respectively. Airflow partition difference between both cavities were: median = 9.4%, IQR = 10.9% (normal); median = 31.9%, IQR= 25.0% (NAO) ; and median = 29.9%, IQR = 44.1% (uCLND). Median nasal resistance difference between left and right nasal cavities were 0.01 pa.s/ml (IQR= 0.03 pa.s/ml) for normal, 0.09 pa.s/ml (IQR= 0.16 pa.s/ml) for NAO and 0.08 pa.s/ml (IQR = 0.25 pa.s/ml) for uCLND subjects.Conclusions: uCLND subjects demonstrated significant asymmetry between both sides of the nasal cavity. Furthermore, there exists substantial disproportionality in flow partition difference and resistance difference between cleft and noncleft sides among uCLND subjects, suggesting that both sides may be dysfunctional.