Wang T, Wang P H, Chen D, Xu Z, Deng J
Department of Otorhinolaryngology Head and Neck Surgery, Shanghai 9th People's Hospital, Shanghai JiaoTong University School of Medicine; Ear Institute, Shanghai JiaoTong University School of Medicine; Shanghai Key Laboratory of Translational Medicine on Ear and Nose Diseases, Shanghai 200011, China.
Institute of Aeronautics and Astronautics, Zhejiang University, Hangzhou 310027, China.
Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2020 Mar 7;55(3):209-216. doi: 10.3760/cma.j.issn.1673-0860.2020.03.005.
To investigate the effect of nasal septum perforation (SP) with different locations and sizes on nasal airflow by means of numerical simulation. Two healthy persons with normal nasal anatomy were enrolled in this study, including a 45 years old male (case 1) and a 36 years old female (case 2). Nasal CT data was used as the basis to create nasal airway numerical models of nasal SP with different locations (anterior caudal, central caudal, posterior caudal and anterior cranial) and sizes (diameter of 10 mm and 5 mm respectively). The inspiratory airflow characteristics (nasal cavity volume, nasal cavity wall area, pressure, nasal resistance, temperature, airflow velocity, wall shear stress, airflow-rate partitioning and vortex) of these nasal airway numerical models were simulated and analyzed. correlation analysis was performed between nasal resistances, airflow temperature and nasal cavity wall area. In terms of pressure and nose resistance, the anterior caudal and larger size SP lead to more obvious variation of pressure distribution, and increased nasal resistance was especially found in the nasal cavity with anterior and medium caudal SP. In terms of temperature, the anterior (caudal and cranial) and larger size SP had significant effect on local temperature gradient as same as the anterior cranial and smaller size SP. Nasal heating efficiency was lower in nasal model with the anterior and larger size SP than that in the normal model. The temperature difference from the nostril to the end of nasal septum had positive correlation with nasal cavity wall area ((2) value of case 1 and case 2 was 0.69, 0.41, respectively, all 0.01). In terms of airflow velocity, the anterior caudal and cranial SP had more significant effect on the average airflow velocity in the nasal cavity. The anterior and medium caudal SP could make the airflow distribution in the asymmetric bilateral nasal cavity more unbalanced compared to the bilateral symmetrical nasal models. The anterior and medium SP resulted in a more pronounced vortex distribution than the posterior SP. The effect of SP on nasal cavity is related to its location and size. The anterior and larger size SP shows more negative influence on intranasal pressure, nasal resistance, heat transmission efficiency, airflow-rate partitioning than the posterior and smaller size SP.
通过数值模拟研究不同位置和大小的鼻中隔穿孔（SP）对鼻腔气流的影响。本研究纳入两名鼻腔解剖结构正常的健康受试者，包括一名45岁男性（病例1）和一名36岁女性（病例2）。以鼻CT数据为基础，创建不同位置（前尾、中央尾、后尾和前颅）和大小（直径分别为10 mm和5 mm）的鼻中隔穿孔鼻腔气道数值模型。对这些鼻腔气道数值模型的吸气气流特性（鼻腔容积、鼻腔壁面积、压力、鼻阻力、温度、气流速度、壁面剪应力、气流量分配和涡流）进行模拟分析。对鼻阻力、气流温度和鼻腔壁面积进行相关性分析。在压力和鼻阻力方面，前尾及较大尺寸的鼻中隔穿孔导致压力分布变化更明显，尤其是在前尾和中尾鼻中隔穿孔的鼻腔中鼻阻力增加。在温度方面，前（尾和颅）及较大尺寸的鼻中隔穿孔与前颅及较小尺寸的鼻中隔穿孔一样，对局部温度梯度有显著影响。前及较大尺寸鼻中隔穿孔的鼻腔模型的鼻加热效率低于正常模型。从鼻孔到鼻中隔末端的温差与鼻腔壁面积呈正相关（病例1和病例2的（2）值分别为0.69、0.41，均0.01）。在气流速度方面，前尾和前颅鼻中隔穿孔对鼻腔平均气流速度的影响更显著。与双侧对称鼻腔模型相比，前和中尾鼻中隔穿孔可使不对称双侧鼻腔的气流分布更不均衡。前和中鼻中隔穿孔比后鼻中隔穿孔导致更明显的涡流分布。鼻中隔穿孔对鼻腔的影响与其位置和大小有关。前及较大尺寸的鼻中隔穿孔比后及较小尺寸的鼻中隔穿孔对鼻内压力、鼻阻力、热传递效率、气流量分配的负面影响更大。
