鼻中隔偏曲患者中鼻甲海绵体对鼻腔气流特征的影响：计算流体动力学分析。
Impact of a Concha Bullosa on Nasal Airflow Characteristics in the Setting of Nasal Septal Deviation: A Computational Fluid Dynamics Analysis.
机构信息
Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China.
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland.
出版信息
Am J Rhinol Allergy. 2020 Jul;34(4):456-462. doi: 10.1177/1945892420905186. Epub 2020 Feb 11.
BACKGROUND
A concha bullosa (CB) of the middle turbinate is frequently observed on the nondeviated side of patients with a nasal septal deviation (NSD). However, the impact of the CB on nasal airflow characteristics in patients with NSD has been incompletely defined.
OBJECTIVE
The purpose of this study was to evaluate the impact of a CB in patients with NSD on nasal airflow characteristics using a computational fluid dynamics (CFD) approach.
METHODS
Twenty patients with NSD and a unilateral CB of the middle turbinate on the nondeviated side (study group) were recruited. Another 20 patients with NSD without the formation of a CB (control group) were also enrolled. Using CFD, the maximal airflow velocity, nasal resistance, maximal wall shear stress, and minimal temperature in the bilateral nostrils of each group were assessed. Moreover, the volume of the nasal tract, surface area-to-volume ratio, and the total nasal resistance were compared between the study and control groups.
RESULTS
In the study group, no significant differences of airflow dynamics between the bilateral nasal cavities were observed. In the control group, however, there were statistically significant differences for maximal airflow velocity, nasal resistance, maximal wall shear stress, and minimal airflow temperature between the bilateral nostrils. The surface area-to-volume ratio and total nasal resistance in the study group was significantly higher and the nasal volume was significantly decreased than that in the control group.
CONCLUSION
CB of the middle turbinate on the nondeviated side of patients with NSD rendered airflow characteristics more evenly distributed between the bilateral nostrils as assessed by CFD. From an aerodynamics perspective, a CB may represent a compensatory action to normalize airflow dynamics. However, a CB may also result in constriction of the ipsilateral nasal cavity.
背景
中鼻甲泡（CB）在鼻中隔偏曲（NSD）患者的未偏曲侧经常被观察到。然而，CB 对 NSD 患者鼻腔气流特征的影响尚未完全确定。
目的
本研究旨在通过计算流体动力学（CFD）方法评估 NSD 患者中鼻甲 CB 对鼻腔气流特征的影响。
方法
招募了 20 例 NSD 患者和未偏曲侧单侧中鼻甲 CB（研究组），并招募了 20 例 NSD 且未形成 CB（对照组）的患者。使用 CFD 评估了两组双侧鼻孔的最大气流速度、鼻腔阻力、最大壁切应力和最小气流温度。此外，比较了研究组和对照组的鼻腔容积、表面积-容积比和总鼻腔阻力。
结果
在研究组，双侧鼻腔的气流动力学无明显差异。然而，在对照组，双侧鼻孔的最大气流速度、鼻腔阻力、最大壁切应力和最小气流温度存在统计学差异。研究组的表面积-容积比和总鼻腔阻力明显较高，鼻腔容积明显较小，与对照组相比。
结论
NSD 患者未偏曲侧的中鼻甲 CB 通过 CFD 评估使双侧鼻孔的气流特征分布更加均匀。从空气动力学的角度来看，CB 可能代表一种代偿性动作，以使气流动力学正常化。然而，CB 也可能导致同侧鼻腔的狭窄。
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