title: Effect of accessory ostia on maxillary sinus ventilation: a computational fluid dynamics (CFD) study.
abstract: We evaluated, by CFD simulation, effects of accessory ostium (AO) on maxillary sinus ventilation. A three-dimensional nasal model was constructed from an adult CT scan with two left maxillary AOs (sinus I) and one right AO (sinus II), then compared to an identical control model with all AOs sealed (sinuses III and IV). Transient simulations of quiet inspiration and expiration at 15 L/min, and nasal blow at 48 L/min, were calculated for both models using low-Reynolds-number turbulent analysis. At low flows, ventilation rates in sinuses with AOs (I ≈ 0.46 L/min, II ≈ 0.54 L/min), were both more than a magnitude higher than sinuses without AOs (II I ≈ 0.019 L/min, IV ≈ 0.020 L/min). Absence of AO almost completely prevented sinus ventilation. Increased ventilation of sinuses with AOs is complex. Under high flow conditions mimicking nose blowing, in sinuses II, III, and IV, the sinus flow rate increased. In contrast, the airflow direction through sinus I reversed between inspiration and expiration, while it remained almost constant throughout the respiration cycle in sinus II. CFD simulation demonstrated that AOs markedly increase maxillary sinus airflow rates and alter sinus air circulation patterns. Whether these airflow changes impact maxillary sinus physiology or pathophysiology is unknown.
authors: Department of Mechanical Engineering, National University of Singapore, Singapore. jhzhu.me@gmail.com
authors: Jian Hua
authors: JH
authors: Zhu
authors: Heow Pueh
authors: HP
authors: Lee
authors: Kian Meng
authors: KM
authors: Lim
authors: Bruce R
authors: BR
authors: Gordon
authors: De Yun
authors: de Y
authors: Wang
mesh_terms: D000328:Adult; D000388:Air; D005260:Female; D006801:Humans; D057446:Hydrodynamics; D021621:Imaging, Three-Dimensional; D008443:Maxillary Sinus / Q000000981:diagnostic imaging / Q000503:physiopathology*; D008954:Models, Biological; D065631:Rhinitis, Allergic; D012221:Rhinitis, Allergic, Perennial / Q000000981:diagnostic imaging / Q000503:physiopathology; D012852:Sinusitis / Q000000981:diagnostic imaging / Q000503:physiopathology; D014057:Tomography, X-Ray Computed