Department of Otolaryngology Head and Neck Surgery, The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710000, China.
School of Engineering - Mechanical and Automotive, RMIT University, Bundoora, VIC, Australia.
Sci Total Environ. 2024 Jan 10;907:168156. doi: 10.1016/j.scitotenv.2023.168156. Epub 2023 Oct 26.
Middle turbinectomy (MT) has always been controversial. MT significantly alters the anatomy and redistributes the inhaled air. The current study is designed to quantify the effect of MT with varying resection volumes on airflow and associated pollen inhalation exposure characteristics in the nasal airways.
Six realistic models following bilateral comprehensive Functional Endoscopic Sinus Surgery (FESS) deriving from CT images were constructed and their corresponding post-MT models with four types of MT procedures were virtually conducted. Inhalation exposure to pollen particles was simulated by the Computational Fluid-Particle Dynamics (CFPD) approach and validated through in vitro experiments.
Following the excision of the middle turbinate, a significant escalation in airflow was observed within the upper-middle region of the nasal cavities. Pollen deposition was observed to be more prominent in the nasal septum, laryngopharynx, and maxillary sinus, varying with the types of MT procedures. Notably, particles with diameters smaller than 50 μm exhibited two distinct "high peaks" and three "small peaks" within the nasal airways.
MT resulted in increased airflow volume within the upper-middle region of the nasal cavities. Following MT, notable shifts in pollen particle deposition hot spots were observed, transitioning from the nasal vestibule, nasal septum, and middle meatus to the nasal septum and laryngopharynx. These findings are anticipated to contribute valuable perspectives on pollen inhalation exposure risk assessments following diverse MT surgical interventions.
中鼻甲切除术（MT）一直存在争议。MT 显著改变了解剖结构，并重新分配了吸入的空气。本研究旨在定量评估不同切除体积的 MT 对鼻气道气流以及相关花粉吸入暴露特征的影响。
根据双侧全面功能性内窥镜鼻窦手术（FESS）的 CT 图像构建了六个真实模型，并对其进行了四种类型的 MT 手术的虚拟 MT 后模型构建。通过计算流体-颗粒动力学（CFPD）方法模拟花粉颗粒的吸入暴露，并通过体外实验进行验证。
中鼻甲切除后，鼻腔中上区域的气流明显增加。花粉沉积在鼻中隔、喉咽和上颌窦中更为明显，这取决于 MT 手术的类型。值得注意的是，直径小于 50μm 的颗粒在鼻气道内呈现出两个明显的“高峰”和三个“小高峰”。
MT 导致鼻腔中上区域的气流体积增加。MT 后，花粉颗粒沉积热点明显转移，从鼻前庭、鼻中隔和中鼻甲转移到鼻中隔和喉咽。这些发现有望为不同 MT 手术干预后花粉吸入暴露风险评估提供有价值的视角。
