Computed nasal resistance compared with patient-reported symptoms in surgically treated nasal airway passages: a preliminary report.
BACKGROUND
Nasal airway obstruction (NAO) is a common health condition impacting mood, energy, recreation, sleep, and overall quality of life. Nasal surgery often addresses NAO but the results are sometimes unsatisfactory. Evaluating surgical treatment efficacy could be improved if objective tests were available that correlated with patient-reported measures of symptoms. The goal of this study was to develop methods for comparing nasal resistance computed by computational fluid dynamics (CFD) models with patient-reported symptoms of NAO using early data from a 4-year prospective study.


METHODS
Computed tomography (CT) scans and patient-reported scores from the Nasal Obstruction Symptom Evaluation (NOSE) scale and a visual analog scale (VAS) measuring unilateral airflow sensation were obtained pre- and postoperatively in two NAO patients showing no significant mucosal asymmetry who were successfully treated with functional nasal surgery, including septoplasty. Pre- and postsurgery CFD models were created from the CT scans. Numerical simulation of steady-state inspiratory airflow was used to calculate bilateral and unilateral CFD-derived nasal resistance (CFD-NR).


RESULTS
In both subjects, NOSE and VAS scores improved after surgery, bilateral CFD-NR decreased, and unilateral CFD-NR decreased on the affected side. In addition, NOSE and VAS scores tracked with unilateral CFD-NR on the affected side.


CONCLUSIONS
These preliminary results suggest a possible correlation between unilateral NR and patient-reported symptoms and imply that analysis of unilateral obstruction should focus on the affected side. A formal investigation of unilateral CFD-NR and patient-reported symptoms in a series of NAO patients is needed to determine if these variables are correlated.
Department of Otolaryngology/Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, 27599, USA.
Julia S
JS
Kimbell
Guilherme J M
GJ
Garcia
Dennis O
DO
Frank
Daniel E
DE
Cannon
Sachin S
SS
Pawar
John S
JS
Rhee
D000328:Adult; D000403:Airway Resistance; D003198:Computer Simulation; D005260:Female; D006801:Humans; D057446:Hydrodynamics; D008297:Male; D008954:Models, Biological; D008991:Monitoring, Physiologic / Q000592:standards; D015508:Nasal Obstruction / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery*; D009300:Nasal Septum / Q000601:surgery*; D011446:Prospective Studies; D057566:Self Report / Q000592:standards; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome