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快速上颌扩弓对鼻中隔偏曲儿童的通气有有益影响:一项计算流体动力学研究。

Rapid Maxillary Expansion Has a Beneficial Effect on the Ventilation in Children With Nasal Septal Deviation: A Computational Fluid Dynamics Study.

作者信息

Chen Shuai, Wang Jingying, Xi Xun, Zhao Yi, Liu Hong, Liu Dongxu

机构信息

Department of Orthodontics, School and Hospital of Stomatology, Cheeloo College of Medicine, Shandong University & Shandong Key Laboratory of Oral Tissue Regeneration & Shandong Engineering Laboratory for Dental Materials and Oral Tissue Regeneration, Jinan, China.

Institute of Thermodynamics and Fluid Mechanics, School of Energy and Power Engineering, Shandong University, Jinan, China.

出版信息

Front Pediatr. 2022 Feb 10;9:718735. doi: 10.3389/fped.2021.718735. eCollection 2021.

Abstract

Nasal septal deviation (NSD) is one of the most common nasal diseases. Different from common clinical examination methods, computational fluid dynamics (CFD) can provide visual flow information of the nasal cavity. The dimension and volume of the nasal cavity are easily affected by rapid maxillary expansion (RME). The purpose of this study was to use CFD to evaluate the effect of RME on the aerodynamics of the nasal cavity in children with maxillary transverse deficiency and NSD. Computational fluid dynamics was implemented after 3D reconstruction based on the CBCT of 15 children who have completed RME treatment. After treatment, the volume increases in the nasal cavity, nasopharynx, oropharynx, and pharynx were not statistically significant. The wall shear stress of the nasal cavity after RME, 1.749 ± 0.673 Pa, was significantly lower than that before RME, 2.684 ± 0.919 Pa. Meanwhile, the maximal negative pressure in the pharyngeal airway during inspiration was smaller after RME (-31.058 Pa) than before (-48.204 Pa). This study suggests that RME has a beneficial effect on nasal ventilation. The nasal airflow became more symmetrical in the bilateral nasal cavity after RME. Pharyngeal resistance decreased with the reduction in nasal resistance and the increase in the volume of oropharynx after RME.

摘要

鼻中隔偏曲(NSD)是最常见的鼻部疾病之一。与普通临床检查方法不同,计算流体动力学(CFD)能够提供鼻腔可视化的气流信息。鼻腔的尺寸和容积很容易受到快速上颌扩弓(RME)的影响。本研究的目的是利用CFD评估RME对患有上颌横向发育不足和NSD的儿童鼻腔空气动力学的影响。基于15名完成RME治疗的儿童的CBCT进行三维重建后实施计算流体动力学分析。治疗后,鼻腔、鼻咽、口咽和咽部的容积增加无统计学意义。RME后鼻腔的壁面剪应力为1.749±0.673帕,显著低于RME前的2.684±0.919帕。同时,吸气时咽气道的最大负压在RME后(-31.058帕)比之前(-48.204帕)更小。本研究表明,RME对鼻腔通气有有益作用。RME后双侧鼻腔内的鼻气流变得更加对称。随着鼻腔阻力降低以及RME后口咽容积增加,咽阻力减小。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6279/8866691/049c62991e77/fped-09-718735-g0001.jpg

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