Numerical modeling of nasal obstruction and endoscopic surgical intervention: outcome to airflow and olfaction.
BACKGROUND
Mechanical obstruction of odorant flow to the olfactory neuroepithelium may be a primary cause of olfactory loss in nasal-sinus disease patients. Surgical removal of nasal obstruction may facilitate the recovery of olfactory ability. Unfortunately, quantifying the functional impact of nasal obstruction and subsequent surgical outcomes using acoustic rhinometry, rhinomanometry, or CT scans is inadequate.


METHODS
Using computational fluid dynamics (CFD) techniques, we can convert patient CT scans into anatomically accurate 3D numerical nasal models that can be used to predict nasal airflow and odorant delivery rates. These models also can be rapidly modified to reflect anatomic changes, e.g., surgical removal of polyps.


RESULTS
CFD modeling of one patient's nose pre- and postsurgery showed significant improvement in postsurgical ortho- and retronasal airflow and odorant delivery rate to olfactory neuroepithelium (> 1000 times), which correlated well with olfactory recovery.


CONCLUSIONS
This study has introduced a novel technique (CFD) to calculate nasal airflow dynamics and its effects on olfaction, nasal obstruction, and sinus disease. In the future, such techniques may provide a quantitative evaluation of surgical outcome and an important preoperative guide to optimize nasal airflow and odorant delivery.
Zhao
Kai
K
Monell Chemical Senses Center, 3500 Market Street, Philadelphia, Pennsylvania, USA.
Pribitkin
Edmund A
EA
Cowart
Beverly J
BJ
Rosen
David
D
Scherer
Peter W
PW
Dalton
Pamela
P
D004724:Endoscopy; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D008875:Middle Aged; D008953:Models, Anatomic; D015508:Nasal Obstruction / Q000503:physiopathology* / Q000601:surgery*; D009666:Nose / Q000503:physiopathology*; D013517:Otorhinolaryngologic Surgical Procedures; D020127:Recovery of Function; D012903:Smell; D014057:Tomography, X-Ray Computed