title: Cadaveric validation study of computational fluid dynamics model of sinus irrigations before and after sinus surgery.
abstract: BACKGROUND
  Investigations into the distribution of sinus irrigations have been limited by labor-intensive methodologies that do not capture the full dynamics of irrigation flow. The purpose of this study was to validate the accuracy of a computational fluid dynamics (CFD) model for sinonasal irrigations through a cadaveric experiment.
  
  
  METHODS
  Endoscopic sinus surgery was performed on 2 fresh cadavers to open all 8 sinuses, including a Draf III procedure for cadaver 1, and Draf IIb frontal sinusotomies for cadaver 2. Computed tomography maxillofacial scans were obtained preoperatively and postoperatively, from which CFD models were created. Blue-dyed saline in a 240-mL squeeze bottle was used to irrigate cadaver sinuses at 60 mL/second (120 mL per side, over 2 seconds). These parameters were replicated in CFD simulations. Endoscopes were placed through trephinations drilled through the anterior walls of the maxillary and frontal sinuses, and sphenoid roofs. Irrigation flow into the maxillary, frontal, and sphenoid sinuses was graded both ipsilateral and contralateral to the side of nasal irrigation, and then compared with the CFD simulations.
  
  
  RESULTS
  In both cadavers, preoperative and postoperative irrigation flow into maxillary, frontal, and sphenoid sinuses matched extremely well when comparing the CFD models and cadaver endoscopic videos. For cadaver 1, there was 100% concordance between the CFD model and cadaver videos, and 83% concordance for cadaver 2.
  
  
  CONCLUSIONS
  This cadaveric experiment provided potential validation of the CFD model for simulating saline irrigation flow into the maxillary, frontal, and sphenoid sinuses before and after sinus surgery.
authors.affiliation: Department of Otolaryngology, Henry Ford Health System, Detroit, MI.
authors.forename: John R
authors.initials: JR
authors.lastname: Craig
authors.affiliation: Department of Otolaryngology, Ohio State University, Columbus, OH.
authors.forename: Kai
authors.initials: K
authors.lastname: Zhao
authors.affiliation: Department of Engineering, Drexel University, Philadelphia, PA.
authors.forename: Ngoc
authors.initials: N
authors.lastname: Doan
authors.affiliation: Department of Otolaryngology, University of Pennsylvania, Philadelphia, PA.
authors.forename: Sammy
authors.initials: S
authors.lastname: Khalili
authors.affiliation: Department of Otolaryngology, University of Pennsylvania, Philadelphia, PA.
authors.forename: John Y K
authors.initials: JY
authors.lastname: Lee
authors.affiliation: Department of Otolaryngology, University of Pennsylvania, Philadelphia, PA.
authors.forename: Nithin D
authors.initials: ND
authors.lastname: Adappa
authors.affiliation: Department of Otolaryngology, University of Pennsylvania, Philadelphia, PA.
authors.forename: James N
authors.initials: JN
authors.lastname: Palmer
mesh_terms: D002102:Cadaver; D006801:Humans; D057446:Hydrodynamics; D008962:Models, Theoretical; D010256:Paranasal Sinuses / Q000601:surgery*; D011184:Postoperative Period; D057234:Preoperative Period; D007507:Therapeutic Irrigation
keywords: Draf III; computational fluid dynamics; endoscopic sinus surgery; frontal sinus; sinus irrigation; sphenoid sinus