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鼻中隔成形术对鼻腔气流分布和颗粒沉积增强作用的数值研究

Septoplasty Effect on the Enhancement of Airflow Distribution and Particle Deposition in Nasal Cavity: A Numerical Study.

作者信息

Tao Feng, Feng Yu, Sun Baobin, Wang Jianwei, Chen Xiaole, Gong Jiarui

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Zhongda Hospital, Southeast University, Nanjing 210009, China.

School of Chemical Engineering, Oklahoma State University, Stillwater, OK 74078, USA.

出版信息

Healthcare (Basel). 2022 Sep 5;10(9):1702. doi: 10.3390/healthcare10091702.

Abstract

The surgery outcomes after fixing nasal airway obstruction (NAO) are sometimes not satisfactory in improving ventilations of airflow. A case study is presented in this paper with computational fluid dynamics applied to determine the key factors for successful septoplasty plans for a patient with a deviated nasal septum. Specifically, airflow, as well as particle transport and deposition were predicted in a pre-surgery nasal cavity model reconstructed from patient-specific Computer Tomography (CT) images and two post-surgery nasal cavity models (i.e., VS1 and VS2) with different virtual surgery plans A and B. Plan A corrected the deviated septal cartilage, the perpendicular plate of the ethmoid bone, vomer, and nasal crest of the maxilla. Plan B further corrected the obstruction in the nasal vestibule and caudal nasal septal deviation based on Plan A. Simulations were performed in the three nose-to-throat airway models to compare the airflow velocity distributions and local particle depositions. Numerical results indicate that the VS2 model has a better improvement in airflow allocation between the two sides than the VS1 model. In addition, the deposition fractions in the VS2 model are lower than that in both the original and VS1 models, up to 25.32%. The better surgical plan (i.e., Plan B) reduces the particle deposition on the convex side, but slightly increases the deposition on the concave side. However, the overall deposition in the nasal cavity is reduced.

摘要

修复鼻气道阻塞(NAO)后的手术效果在改善气流通气方面有时并不理想。本文介绍了一个案例研究,应用计算流体动力学来确定一名鼻中隔偏曲患者成功进行鼻中隔成形术方案的关键因素。具体而言,在根据患者特定的计算机断层扫描(CT)图像重建的术前鼻腔模型以及具有不同虚拟手术方案A和B的两个术后鼻腔模型(即VS1和VS2)中预测了气流以及颗粒传输和沉积情况。方案A矫正了偏曲的鼻中隔软骨、筛骨垂直板、犁骨和上颌骨鼻嵴。方案B在方案A的基础上进一步矫正了鼻前庭阻塞和鼻中隔尾端偏曲。在这三个鼻咽喉气道模型中进行了模拟,以比较气流速度分布和局部颗粒沉积情况。数值结果表明,VS2模型在两侧气流分配方面比VS1模型有更好的改善。此外,VS2模型中的沉积分数低于原始模型和VS1模型,高达25.32%。更好的手术方案(即方案B)减少了凸侧的颗粒沉积,但略微增加了凹侧的沉积。然而,鼻腔内的总体沉积减少了。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/41f2/9498368/453e63b4c295/healthcare-10-01702-g001.jpg

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