Computing and Clinical Research Lab, Department of Otolaryngology/Head and Neck Surgery, University of North Carolina School of Medicine, Chapel Hill, NC 27599, USA.
Division of Head and Neck Surgery & Communication Sciences, Duke University Medical Center, Durham, NC 27710, USA.
Int J Numer Method Biomed Eng. 2018 Apr;34(4):e2946. doi: 10.1002/cnm.2946. Epub 2018 Jan 18.
Generating anatomically realistic 3-dimensional (3D) models of the human sinonasal cavity for numerical investigations of sprayed drug transport presents a host of methodological ambiguities. For example, subject-specific radiographic images used for 3D reconstructions typically exclude spray bottles. Subtracting a bottle contour from the 3D airspace and dilating the anterior nasal vestibule for nozzle placement augment the complexity of model building. So we explored the question: how essential are these steps to adequately simulate nasal airflow and identify the optimal delivery conditions for intranasal sprays? In particular, we focused on particle deposition patterns in the maxillary sinus, a critical target site for chronic rhinosinusitis. The models were reconstructed from postsurgery computed tomography scans for a 39-year-old Caucasian male, with chronic rhinosinusitis history. Inspiratory airflow patterns during resting breathing are reliably tracked through computational fluid dynamics-based steady-state laminar-viscous modeling, and such regimes portray relative lack of sensitivity to inlet perturbations. Consequently, we hypothesized that the posterior airflow transport and the particle deposition trends should not be radically affected by the nozzle subtraction and vestibular dilation. The study involved 1 base model and 2 derived models; the latter 2 with nozzle contours (2 different orientations) subtracted from the dilated anterior segment of the left vestibule. We analyzed spray transport in the left maxillary sinus for multiple release conditions. Similar release points, localized on an approximately 2 mm × 4.5 mm contour, facilitated improved maxillary deposition in all 3 test cases. This suggests functional redundancy of nozzle insertion in a 3D numerical model for identifying the optimal spray release locations.
为了对喷雾药物输送进行数值研究,生成用于人类鼻腔鼻窦的解剖学逼真的三维(3D)模型,提出了许多方法上的模糊性。例如,用于 3D 重建的特定于主体的射线照相图像通常排除喷雾瓶。从 3D 空气空间中减去瓶轮廓并扩张前鼻前庭以放置喷嘴,增加了模型构建的复杂性。因此,我们探讨了一个问题:这些步骤对于充分模拟鼻气流并确定鼻腔喷雾的最佳输送条件有多重要?特别是,我们专注于上颌窦中的颗粒沉积模式,上颌窦是慢性鼻鼻窦炎的关键靶位。该模型是从一位 39 岁的白种男性的手术后计算机断层扫描中重建的,该男性有慢性鼻鼻窦炎病史。通过基于计算流体动力学的稳态层流粘性建模可靠地跟踪休息呼吸期间的吸气气流模式,并且这些模式表现出对入口扰动的相对缺乏敏感性。因此,我们假设,在没有喷嘴和前庭扩张的情况下,后气流输送和颗粒沉积趋势不应受到明显影响。该研究涉及 1 个基础模型和 2 个衍生模型;后两个模型是将喷嘴轮廓(2 种不同的方向)从扩张的左前庭的前部分减去。我们分析了多个释放条件下的喷雾输送情况。在所有 3 个测试案例中,将释放点定位于近似 2mm×4.5mm 的轮廓上,有助于改善左侧上颌窦的沉积。这表明在 3D 数值模型中,喷嘴插入具有功能冗余性,可用于确定最佳喷雾释放位置。