title: Role of virtual surgery in preoperative planning: assessing the individual components of functional nasal airway surgery.
abstract: OBJECTIVE
  To demonstrate the effect of individual components of functional nasal airway surgery in a patient with multifactorial obstruction and to discuss the potential benefit of computational fluid dynamics (CFD)–aided virtual surgery.
  
  
  METHODS
  A 53-year-old woman underwent septoplasty,turbinate reduction, and nasal valve repair. Presurgery and postsurgery digital nasal models were created from computed tomographic images, and nasal resistance was calculated using CFD techniques. The digital models were then manipulated to isolate the effects of the components of the surgery, creating a nasal valverepair alone model and a septoplasty/turbinate reduction alone model.
  
  
  RESULTS
  Bilateral nasal resistance in the postsurgery model was approximately 25% less than presurgery values.Similarly, CFD analysis showed reductions in nasal resistance of the virtual models: 19% reduction with intranasal surgery alone and 6% reduction with nasal valve repair alone.
  
  
  CONCLUSIONS
  Most of the reduction in nasal resistance was accomplished with performance of septoplasty and inferior turbinate reduction. The contribution of nasal valve repair was less in comparison but not insignificant.This pilot study implies that CFD-aided virtual surgery may be useful as part of preoperative planning inpatients with multifactorial anatomical nasal airwayobstruction
authors.affiliation: Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, Milwaukee, Wisconsin 53226, USA.
authors.forename: John S
authors.initials: JS
authors.lastname: Rhee
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Cannon
authors.forename: Dennis O
authors.initials: DO
authors.lastname: Frank
authors.forename: Julia S
authors.initials: JS
authors.lastname: Kimbell
mesh_terms: D003198:Computer Simulation; D005260:Female; D006801:Humans; D008875:Middle Aged; D008953:Models, Anatomic; D015508:Nasal Obstruction / Q000000981:diagnostic imaging / Q000601:surgery*; D009300:Nasal Septum / Q000000981:diagnostic imaging / Q000601:surgery; D011300:Preoperative Care / Q000379:methods*; D012225:Rhinoplasty / Q000379:methods*; D014057:Tomography, X-Ray Computed; D014420:Turbinates / Q000000981:diagnostic imaging / Q000601:surgery; D014584:User-Computer Interface