Department of Otorhinolaryngology, Hospital Luz Arrabida, Porto, Portugal.
Department of Otorhinolaringology, University Medical Center, Utrecht, The Netherlands.
Facial Plast Surg. 2021 Jun;37(3):306-316. doi: 10.1055/s-0041-1722956. Epub 2021 Feb 8.
Evaluation of the nasal airway is crucial for every patient with symptoms of nasal obstruction as well as for every patient with other nasal symptoms. This assessment of the nasal airway comprises clinical examination together with imaging studies, with the correlation between findings of this evaluation and symptoms reported by the patient being based on the experience of the surgeon. Measuring nasal airway resistance or nasal airflow can provide additional data regarding the nasal airway, but the benefit of these objective measurements is limited due to their lack of correlation with patient-reported evaluation of nasal breathing. Computational fluid dynamics (CFD) has emerged as a valuable tool to assess the nasal airway, as it provides objective measurements that correlate with patient-reported evaluation of nasal breathing. CFD is able to evaluate nasal airflow and measure variables such as heat transfer or nasal wall shear stress, which seem to reflect the activity of the nasal trigeminal sensitive endings that provide sensation of nasal breathing. Furthermore, CFD has the unique capacity of making airway analysis of virtual surgery, predicting airflow changes after trial virtual modifications of the nasal airway. Thereby, CFD can assist the surgeon in deciding surgery and selecting the surgical techniques that better address the features of each specific nose. CFD has thus become a trend in nasal airflow assessment, providing reliable results that have been validated for analyzing airflow in the human nasal cavity. All these features make CFD analysis a mainstay in the armamentarium of the nasal surgeon. CFD analysis may become the gold standard for preoperative assessment of the nasal airway.
评估鼻腔气道对于有鼻塞症状的患者以及有其他鼻腔症状的患者都至关重要。鼻腔气道的评估包括临床检查和影像学研究，评估中发现的结果与患者报告的症状之间的相关性基于外科医生的经验。测量鼻腔气道阻力或鼻腔气流可以提供有关鼻腔气道的额外数据，但这些客观测量的益处有限，因为它们与患者报告的鼻腔呼吸评估缺乏相关性。计算流体动力学 (CFD) 已成为评估鼻腔气道的有价值工具，因为它提供了与患者报告的鼻腔呼吸评估相关的客观测量。CFD 能够评估鼻腔气流并测量热传递或鼻腔壁剪切应力等变量，这些变量似乎反映了提供鼻腔呼吸感觉的鼻三叉神经敏感末梢的活动。此外，CFD 具有气道分析虚拟手术的独特能力，可以预测在尝试虚拟修改鼻腔气道后气流的变化。因此，CFD 可以帮助外科医生决定手术，并选择更能解决每个特定鼻子特征的手术技术。因此，CFD 已成为鼻腔气流评估的趋势，提供了经过验证的可靠结果，可用于分析人类鼻腔中的气流。所有这些特点使 CFD 分析成为鼻外科医生的主要手段。CFD 分析可能成为鼻腔气道术前评估的黄金标准。
