Nomura Tsutomu, Ushio Munetaka, Kondo Kenji, Kikuchi Shigeru
Department of Otolaryngology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe-shi, Saitama, 380-8550, Japan.
Department of Otolaryngology and Head and Neck Surgery, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, Japan.
Auris Nasus Larynx. 2018 Oct;45(5):1020-1026. doi: 10.1016/j.anl.2018.02.006. Epub 2018 Mar 13.
The purpose of this research is to examine the changes in nasal airflow dynamics before and after the nasal perforation repair.
Three dimensional (3D) models of the nasal cavity before and after septal perforation repair was reconstructed using preoperative and postoperative computed tomography (CT) images of a patient. The numerical simulation was carried out using ANSYS CFX V15.0. Pre- and post-operative models were compared by their velocity, pressure (P), pressure gradient (PG), wall shear (WS), shear strain rate (SSR) and turbulence kinetic energy (TKE) in three plains.
In the post-operative state, the cross flows disappeared. In preoperative state, there were areas showing high PG, WS, SSR at the posterior border of the perforation, which exactly correspond to the area showing erosive mucosa on endoscopic inspection of the patient. In postoperative state, such high PG, WS and SSR areas disappeared. High TKEs also disappeared after surgery.
The effects of septal perforation repair on airflow dynamics were evaluated using computer fluid dynamics (CFD). High WS, PG and SSR observed at the edge of the septal perforation may be related to the clinical symptom such as nasal bleeding and pain. TKE was considered to cause nasal symptom.
本研究旨在探讨鼻中隔穿孔修复前后鼻腔气流动力学的变化。
利用一名患者术前和术后的计算机断层扫描(CT)图像,重建鼻中隔穿孔修复前后鼻腔的三维(3D)模型。使用ANSYS CFX V15.0进行数值模拟。通过比较术前和术后模型在三个平面上的速度、压力(P)、压力梯度(PG)、壁面切应力(WS)、切应变率(SSR)和湍动能(TKE)来进行分析。
术后状态下,交叉流消失。在术前状态下,穿孔后缘存在高PG、WS、SSR区域,这与患者内镜检查中显示糜烂黏膜的区域完全对应。术后状态下,此类高PG、WS和SSR区域消失。术后高湍动能也消失。
利用计算流体动力学(CFD)评估了鼻中隔穿孔修复对气流动力学的影响。在鼻中隔穿孔边缘观察到的高WS、PG和SSR可能与鼻出血和疼痛等临床症状有关。湍动能被认为会导致鼻腔症状。