title: Estimates of nasal airflow at the nasal cycle mid-point improve the correlation between objective and subjective measures of nasal patency.
abstract: The nasal cycle represents a significant challenge when comparing pre- and post-surgery objective measures of nasal airflow.
  
  
  
  Computational fluid dynamics (CFD) simulations of nasal airflow were conducted in 12 nasal airway obstruction patients showing significant nasal cycling between pre- and post-surgery computed tomography scans. To correct for the nasal cycle, mid-cycle models were created virtually. Subjective scores of nasal patency were obtained via the Nasal Obstruction Symptom Evaluation (NOSE) and unilateral visual analog scale (VAS).
  
  
  
  The correlation between objective and subjective measures of nasal patency increased after correcting for the nasal cycle. In contrast to biophysical variables in individual patients, cohort averages were not significantly affected by the nasal cycle correction.
  
  
  
  The ability to correct for the confounding effect of the nasal cycle is a key element that future virtual surgery planning software for nasal airway obstruction will need to account for when using anatomic models based on single instantaneous imaging.
authors.affiliation: Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, United States; Department of Biomedical Engineering, Marquette University & the Medical College of Wisconsin, United States. Electronic address: cgaberino@mcw.edu.
authors.forename: Courtney
authors.initials: C
authors.lastname: Gaberino
authors.affiliation: Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, United States. Electronic address: jrhee@mcw.edu.
authors.forename: John S
authors.initials: JS
authors.lastname: Rhee
authors.affiliation: Department of Otolaryngology and Communication Sciences, Medical College of Wisconsin, United States; Department of Biomedical Engineering, Marquette University & the Medical College of Wisconsin, United States. Electronic address: ggarcia@mcw.edu.
authors.forename: Guilherme J M
authors.initials: GJ
authors.lastname: Garcia
mesh_terms: D000403:Airway Resistance / Q000502:physiology*; D001703:Biophysics; D019295:Computational Biology; D003198:Computer Simulation; D005260:Female; D006801:Humans; D057446:Hydrodynamics; D021621:Imaging, Three-Dimensional; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D008954:Models, Biological; D009297:Nasal Mucosa / Q000000981:diagnostic imaging / Q000601:surgery; D015508:Nasal Obstruction / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology* / Q000601:surgery; D012123:Pulmonary Ventilation / Q000502:physiology*; D013223:Statistics as Topic; D015898:Tomography Scanners, X-Ray Computed; D016896:Treatment Outcome; D064232:Visual Analog Scale
keywords: Computational fluid dynamics (CFD) simulations; Mucosal cooling; Nasal airway obstruction; Nasal cycle correction; Nasal resistance; Virtual surgery planning