Wang Tao, Mu Xiongzhen, Deng Jian, Wang Peihua, Chen Dong, Cai Weiyu
Department of Otorhinolaryngology, Ninth People's Hospital, Ninth People's Hospital, Shanghai Jiao Tong University Medical College, Shanghai, China.
J Craniofac Surg. 2011 Jan;22(1):166-72. doi: 10.1097/SCS.0b013e3181f752e9.
Setup computational fluid dynamics (CFD) model of the nasal cavity in patients with Crouzon syndrome analyze inspiratory airflow hydrokinetics of its nasal cavity. After changing the morphosis structure of the nasal cavity by operation, compare the preoperative and postoperative alteration of the airflow field of the nasal cavity and evaluate the effect of operation on the physiological function of nasal ventilation.
Eleven patients with Crouzon syndrome were underwent spiral computed tomographic laminar scanning to obtain DICOM data and establish the CFD model. The field features of the nasal cavity with inspiratory static state phase were simulated and analyzed by the Fluent software. The changed data on preoperative and postoperative flow field in the nasal cavity in 5 of 11 patients were compared and analyzed.
The nasal cavity of a patient with Crouzon syndrome reflected the structural features of relatively short and high-vaulted anteroposterior diameter. The nasal valve was the narrowest region in the nasal cavity and was the key region of producing obvious pressure drop. The inspiratory static state phase reflected comparatively high local airflow rate (approximately 2.469 m/s) and sheer force of the nasal wall. With the distance increasing from the anterior naris, the pressure inside the nasal cavity was decreased gradually. The pressure drop in the nasal cavity before the front end of the concha nasalis inferior (approximately 2 cm from anterior naris) accounted for most of the pressure of the whole nasal cavity (69%-88% of the overall pressure in nasal cavity and 79.24% on average). Osteotomy advancement and distraction osteogenesis increased the anteroposterior diameter of the nasal cavity and the changed nasal resistance.
By analyzing the structure of the nasal cavity of patients with Crouzon syndrome and the CFD numerical simulation of patients after the procedure, airflow distribution in patients' nasal cavity and the effect of the surgery on the structure of the nasal cavity and airflow field were realized. Nasal valve played a pivotal role in the airflow field distribution of the nasal cavity. Operation changed the nasal resistance, improved the ventilation of nasal cavity, but did not affect the airflow field distribution of nasal cavity.
建立克鲁宗综合征患者鼻腔的计算流体动力学（CFD）模型，分析其鼻腔吸气气流流体动力学。通过手术改变鼻腔形态结构后，比较鼻腔气流场术前和术后的变化，评估手术对鼻腔通气生理功能的影响。
对11例克鲁宗综合征患者进行螺旋计算机断层扫描层扫以获取DICOM数据并建立CFD模型。采用Fluent软件模拟分析吸气静态相时鼻腔的场特征。对11例患者中5例鼻腔术前和术后流场的变化数据进行比较分析。
克鲁宗综合征患者鼻腔呈现出前后径相对短且穹顶高的结构特征。鼻瓣膜是鼻腔中最狭窄的区域，是产生明显压降的关键区域。吸气静态相显示鼻腔局部气流速度相对较高（约2.469 m/s）以及鼻壁的剪切力。随着距前鼻孔距离增加，鼻腔内压力逐渐降低。在下鼻甲前端之前的鼻腔压降（距前鼻孔约2 cm处）占整个鼻腔压力的大部分（占鼻腔总压力的69%-88%，平均为79.24%）。截骨前移和牵张成骨增加了鼻腔的前后径并改变了鼻阻力。
通过分析克鲁宗综合征患者鼻腔结构及术后患者的CFD数值模拟，了解了患者鼻腔内气流分布以及手术对鼻腔结构和气流场的影响。鼻瓣膜在鼻腔气流场分布中起关键作用。手术改变了鼻阻力，改善了鼻腔通气，但未影响鼻腔气流场分布。
