Division of Plastic, Reconstructive and Aesthetic Surgery, National University Hospital, Singapore.
Laryngoscope. 2010 Oct;120(10):1931-9. doi: 10.1002/lary.21072.
Injury to the nasal septum is commonly found in most nasal fractures. The nasal septum deforms and crumples, leading to nasal deviation and internal nasal obstruction.
This study aims to identify the main areas of high stress concentration when a dynamic anteroposterior load is applied to the nasal tip, simulating nasal trauma. We wish to determine if the nasal septum acts as a crumpled zone, and deforms significantly during nasal trauma.
An idealized and a patient-specified finite element model have been generated for the present study. Several models with various combinations of narrower angle at the Vomer Ethmoidal Junction (VEJ) are also constructed from this septum model. Finite element analyses are carried out to determine the deformation and stress distribution in the nasal septum when a dynamic anteroposterior load is applied to the nasal tip.
The maximum stress areas in the nasal septum are in the vicinity of the bony-cartilaginous (BC) junction and the anterior nasal spine (ANS), which are consistent with clinical experience. A larger anteroposterior load, a longer loading duration, and a more acute VEJ angle would result in higher maximum stresses. The observations were identical in both idealized and patient-specific models. The findings of this analysis also suggest that the septum does function as a crumpled zone, absorbing a significant amount of stress before it is transmitted to the skull.
鼻中隔损伤在大多数鼻骨骨折中较为常见。鼻中隔变形、卷曲,导致鼻偏曲和鼻腔内部阻塞。
本研究旨在确定在模拟鼻外伤时,从前向后施加动态负荷于鼻尖时,鼻中隔高应力集中的主要区域。我们希望确定鼻中隔是否作为一个皱缩区,并在鼻外伤期间显著变形。
为目前的研究生成了一个理想化的和一个患者特定的有限元模型。还从这个鼻中隔模型中构建了几个具有各种更窄的筛骨垂直板-犁骨结合部(VEJ)角度组合的模型。进行有限元分析以确定在从前向后施加于鼻尖的动态负荷时,鼻中隔的变形和应力分布。
鼻中隔的最大应力区域位于骨软骨(BC)交界处和前鼻棘(ANS)附近,这与临床经验一致。更大的前后向负荷、更长的加载持续时间和更陡的 VEJ 角度会导致更高的最大应力。在理想化和患者特定的模型中均观察到相同的结果。该分析的结果还表明,鼻中隔确实作为一个皱缩区,在其传递到颅骨之前吸收了大量的应力。