Aerodynamic impact of total inferior turbinectomy versus inferior turbinoplasty – a computational fluid dynamics study

Siu, Joey; Inthavong, Kiao; Shang, Yidan; Vahaji, Sara; Douglas, Rg.

doi:10.4193/rhin20.011

Cited by 8 publications

(19 citation statements)

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“…Representative healthy nasal models were reconstructed as described previously from two normal subjects without any sinonasal complaints. (Siu et al, 2020a) Nasal cavity mucosal health was confirmed with endoscopy. Written informed consent was obtained from all patients.…”

Section: Subjectsmentioning

confidence: 98%

“…A total of ten subjects were included in this study. The subject demographics, clinical history, and surgical intervention of this cohort are described in our previous study (Siu et al, 2020a) and in Table 1. This included eight patients with nasal obstruction listed for surgery (inferior turbinate surgery with or without septoplasty) for turbinate hypertrophy resistant to medical treatment.…”

Section: Subjectsmentioning

confidence: 99%

“…Some studies suggest that total inferior turbinate resection (ITR) produces a significant drop in nasal resistance compared to more conservative turbinate reduction methods, while simultaneously creating disrupted flow patterns. (Chen et al, 2010;Dayal et al, 2016;Li et al, 2017a;Lindemann et al, 2002b;Lindemann et al, 2005a;Na et al, 2012;Rhee J et al, 2011;Siu et al, 2020a;Sullivan et al, 2013) The resulting impact on air-conditioning capacity is understudied. Turbinoplasty has been suggested to have a minor effect on nasal conditioning, (Lindemann et al, 2005a;Tsakiropoulou et al, 2015) while a deterioration of climatization following ITR characterized by reduced heat and moisture exchange is supported by other studies.…”

Section: Introductionmentioning

confidence: 99%

“…A recent study of virtual surgery by our group compared the aerodynamic impact of bilateral ITR and turbinoplasty in eight patients with NAO due to inferior turbinate swelling. (Siu et al, 2020a) Although nasal flow patterns were significantly altered following surgery, the differences between the techniques were small and hypothesized to bear little influence on nasal conditioning under ambient conditions. Specifically, a greater change in airflow distribution and air-mucosa contact, and more prominent jet-like course of the main flow stream was observed following ITR.…”

Section: Introductionmentioning

confidence: 99%

“…Specifically, a greater change in airflow distribution and air-mucosa contact, and more prominent jet-like course of the main flow stream was observed following ITR. The aim of this computational study was to investigate using CFD the effects of two different techniques for reducing the inferior turbinate on nasal warming and humidification in different climatic conditions in the same group of eight NAO patients (Siu et al, 2020a) undergoing surgery, with two healthy subjects for comparison. Virtual models of turbinoplasty by resection of the lower bulk of the inferior turbinate and ITR were compared with pre-operative NAO and healthy models.…”

Section: Introductionmentioning

confidence: 99%

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Nasal air conditioning following total inferior turbinectomy compared to inferior turbinoplasty – A computational fluid dynamics study

Siu

Inthavong

Dong

et al. 2021

Clinical Biomechanics

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Background: The aim of this study was to use computational fluid dynamics (CFD) to investigate the effects on nasal heat exchange and humidification of two different surgical techniques for reducing the inferior turbinate under different environmental conditions. Methods: Virtual surgery using two techniques of turbinate reduction was performed in eight nasal airway obstruction patients. Bilateral nasal airway models for each patient were compared: 1) Pre-operative 2) Post inferior turbinoplasty 3) Post total inferior turbinate resection (ITR). Two representative healthy models were included. Three different environmental conditions were investigated 1) ambient air 2) cold, dry air 3) hot, humid air. CFD modelling of airflow and conditioning was performed under steady-state, laminar, inspiratory conditions. Findings: Nasal conditioning is significantly altered following inferior turbinate reduction surgery, particularly with ITR under cold, dry inspired air (CDA). The degree of impairment is minor under the simulated range of environmental conditions (temperature = 12-40 • C; relative humidity = 13-80%). Streams of significantly colder air are found in the nasopharynx and more prevalent under CDA in ITR. These are related to high velocity flow streams, which remain cool in their centre throughout the widened inferior nasal cavity. Interpretation: Reduced air-mucosal heat exchange and moisture carrying capacity occurs under cooler temperatures in patients following inferior turbinate surgery. The clinical impact in extremely cold and dry conditions in groups with poor baseline respiratory function, respiratory illness, or endurance athletes is of special interest.

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Section: Subjectsmentioning

confidence: 98%

Section: Subjectsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Nasal air conditioning following total inferior turbinectomy compared to inferior turbinoplasty – A computational fluid dynamics study

Siu

Inthavong

Dong

et al. 2021

Clinical Biomechanics

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Computational Fluid Dynamics and Its Potential Applications for the ENT Clinician

Root,

Schneller,

Lepley

et al. 2024

Facial Plast Surg

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This article is an examination of computational fluid dynamics in the field of otolaryngology, specifically rhinology. The historical development and subsequent application of computational fluid dynamics continues to enhance our understanding of various sinonasal conditions and surgical planning in the field today. This article aims to provide a description of computational fluid dynamics, the methods for its application, and the clinical relevance of its results. Consideration of recent research and data in computational fluid dynamics demonstrates its use in nonhistological disease pathology exploration, accompanied by a large potential for surgical guidance applications. Additionally, this article defines in lay terms the variables analyzed in the computational fluid dynamic process, including velocity, wall shear stress, area, resistance, and heat flux.

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Empty Nose Syndrome Pathophysiology: A Systematic Review

Kanjanawasee

Campbell

Rimmer

et al. 2021

Otolaryngol.--head neck surg.

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Objective The pathophysiology of empty nose syndrome (ENS) remains unclear despite significant research. The pathophysiologic mechanism of ENS was systematically reviewed. Data Sources MEDLINE and Embase. Review Methods Data were systematically reviewed for studies that provided original data on pathophysiology. Results A total of 2476 studies were screened, and 19 met the inclusion criteria: 13 case-control and 6 cross-sectional. Nine pathophysiologic themes were identified. • Demographics: ENS symptoms had no relationship with climatic factors. • Symptomatology: ENS patients demonstrated high symptom severity. • Mental health: Anxiety and depression including hyperventilation were reported in >50% of ENS patients and correlated with ENS symptom severity. • Anatomic features: Structural changes in response to turbinate surgery were similar between ENS and non-ENS patients. • Airflow analysis: Airflow parameters were similar between ENS and non-ENS patients after turbinate surgery. On computational fluid dynamic analysis, differences were found on multiple outcomes. • Diagnostic testing: The menthol detection test was impaired in ENS, and cotton placement in the airway improved ENS symptoms. • Cognitive function: Functional magnetic resonance imaging showed activation in emotional processing area during breathing. • Olfactory function: Subjective impairment was reported in ENS, but quantitative measures were similar to non-ENS patients. • Mucosal physiology/innate immunity: Turbinate histopathology in ENS showed a tissue-remodeling pattern. Nasal nitric oxide level was lower in ENS patients. Conclusion There is evidence of high comorbid mental health disorders in ENS patients. An abnormal trigeminal-thermoreceptor response may be present in some patients. The influence of altered airflow and the evidence of surgery as the cause for ENS are unclear.

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Aerodynamic impact of total inferior turbinectomy versus inferior turbinoplasty – a computational fluid dynamics study

Cited by 8 publications

References 0 publications

Nasal air conditioning following total inferior turbinectomy compared to inferior turbinoplasty – A computational fluid dynamics study

Nasal air conditioning following total inferior turbinectomy compared to inferior turbinoplasty – A computational fluid dynamics study

Computational Fluid Dynamics and Its Potential Applications for the ENT Clinician

Empty Nose Syndrome Pathophysiology: A Systematic Review

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