Zhu Jian Hua, Lim Kian Meng, Thong Kim Thye Mark, Wang De Yun, Lee Heow Pueh
Department of Mechanical Engineering, National University of Singapore, Singapore, Singapore.
Department of Otolaryngology, National University Health System, Singapore, Singapore.
Respir Physiol Neurobiol. 2014 Apr 1;194:29-36. doi: 10.1016/j.resp.2014.01.004. Epub 2014 Jan 10.
In this study, we evaluated the effects of targeted sinonasal surgery on nasal and maxillary sinus airflow patterns. A patient, who underwent right balloon sinuplasty and left uncinectomy for recurrent maxillary sinus barometric pressure, and concomitant septoplasty and bilateral inferior turbinate reduction for deviated nasal septum and inferior turbinate hypertrophy, was selected. Two 3D models representing both pre- and post-operative sinonasal morphology were constructed. The models were then used to evaluate nasal and maxillary sinus airflow patterns during respiration at ventilation rates of 7.5 L/min, 15 L/min and 30 L/min using computational fluid dynamics. The results showed that septoplasty and inferior turbinate reduction increased the nasal volume by 13.6%. The airflow patterns in the nasal cavity showed reasonably decreased resistance and slightly more even flow partitioning after the operation. Maxillary sinus ventilation significantly increased during inspiration in the left sinus after uncinectomy, and during expiration in right sinus after balloon sinuplasty. This study demonstrates computational fluid dynamics simulation is a tool in the investigation of outcomes after targeted, minimally invasive sinonasal surgery.
在本研究中，我们评估了针对性鼻窦手术对鼻腔和上颌窦气流模式的影响。选取了一名患者，该患者因复发性上颌窦气压问题接受了右侧球囊鼻窦成形术和左侧钩突切除术，并因鼻中隔偏曲和下鼻甲肥大同时接受了鼻中隔成形术和双侧下鼻甲切除术。构建了两个代表术前和术后鼻窦形态的三维模型。然后使用计算流体动力学，在通气率为7.5升/分钟、15升/分钟和30升/分钟的呼吸过程中，利用这些模型评估鼻腔和上颌窦的气流模式。结果显示，鼻中隔成形术和下鼻甲切除术使鼻腔容积增加了13.6%。术后鼻腔内的气流模式显示阻力适度降低，气流分配略微更加均匀。钩突切除术后左侧鼻窦在吸气时上颌窦通气显著增加，球囊鼻窦成形术后右侧鼻窦在呼气时上颌窦通气显著增加。本研究表明，计算流体动力学模拟是一种用于研究针对性微创鼻窦手术后结果的工具。
