Effects of partial middle turbinectomy with varying resection volume and location on nasal functions and airflow characteristics by CFD

Lee, Kyun Bum; Jeon, Young Jin; Chung, Seung‐Kyu; Kim, Sung Kyun

doi:10.1016/j.compbiomed.2016.08.014

Cited by 32 publications

(14 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Specifically, middle turbinate reduction may result in increased airflow to and deposition of aeroallergens in the nasal septum. 26–28 This is consistent with the findings that middle turbinate resection may lead to progression of central compartment involvement in patients with AERD. 28 It is also possible that damage to olfactory epithelium during ESS may induce an inflammatory response that induces proliferation of respiratory epithelium via an olfactory epithelium repair process, predisposing patients to the development of REAH.…”

Section: Discussionsupporting

confidence: 90%

Is Respiratory Epithelial Adenomatoid Hamartoma Related to Central Compartment Atopic Disease?

Schertzer

Levy

Wise

et al. 2020

Am J Rhinol�Allergy

View full text Add to dashboard Cite

Background Respiratory epithelial adenomatoid hamartoma (REAH) is a benign lesion of the sinonasal tract that may mimic more concerning pathology. Clinical factors associated with REAH have not been well characterized. Objective To report our findings on patients with this pathologic diagnosis. Methods A retrospective chart review of patients with REAH between September 2006 and November 2019 was conducted. Data collected included clinical allergic rhinitis and asthma history, additional sinonasal diagnoses, prior sinus surgery, and the location of the REAH within the sinonasal cavity. Results Twenty-six patients were identified (53.8% male, mean age 62 years [range, 29–93]). Bilateral REAH occurred in 50%. REAH was located at the superior nasal septum in 84.6% cases, with the remainder identified in sinus contents submitted for pathology, making definitive site uncertain. Concurrent sinonasal inflammatory disorders were identified in 18 patients (69.2%), including chronic rhinosinusitis with nasal polyps—not otherwise specified (6), chronic rhinosinusitis without nasal polyps (4), aspirin-exacerbated respiratory disease (2), allergic fungal rhinosinusitis (1), central compartment atopic disease (5), and IgG4-related sclerosing disease (1). Eight patients had isolated REAH. Adequate allergy records were available for 19 patients, of which 18 of 19 (94.7%) had clinical allergic rhinitis. Conclusions REAH is a benign sinonasal lesion commonly located within the central compartment of the nasal cavity, a site of significant allergen exposure. Affected patients have a high incidence of allergy along with chronic inflammatory conditions. The coexistence of REAH within inflammatory nasal mucosa in a consistent anatomic location, suggests REAH may have a similar etiology to central compartment atopic disease, with resultant respiratory glandular ingrowth within long-standing reactive changes of mucosa derived from ethmoid embryologic origin.

show abstract

Section: Discussionsupporting

confidence: 90%

Is Respiratory Epithelial Adenomatoid Hamartoma Related to Central Compartment Atopic Disease?

Schertzer

Levy

Wise

et al. 2020

Am J Rhinol�Allergy

View full text Add to dashboard Cite

show abstract

“…5, it can be seen that in the case of patient 2, the local pressure distributions reach much higher values than in the case of patient 1. The series of studies from other authors presented similar findings in patients with nasal congestion [16,34,35].…”

Section: Discussionsupporting

confidence: 70%

Three-dimensional modeling and automatic analysis of the human nasal cavity and paranasal sinuses using the computational fluid dynamics method

Tretiakow

Tesch

Meyer-Szary

et al. 2020

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

Purpose The goal of this study was to develop a complete workflow allowing for conducting computational fluid dynamics (CFD) simulation of airflow through the upper airways based on computed tomography (CT) and cone-beam computed tomography (CBCT) studies of individual adult patients. Methods This study is based on CT images of 16 patients. Image processing and model generation of the human nasal cavity and paranasal sinuses were performed using open-source and freeware software. 3-D Slicer was used primarily for segmentation and new surface model generation. Further processing was done using Autodesk® Meshmixer TM. The governing equations are discretized by means of the finite volume method. Subsequently, the corresponding algebraic equation systems were solved by OpenFOAM software. Results We described the protocol for the preparation of a 3-D model of the nasal cavity and paranasal sinuses and highlighted several problems that the future researcher may encounter. The CFD results were presented based on examples of 3-D models of the patient 1 (norm) and patient 2 (pathological changes). Conclusion The short training time for new user without a prior experience in image segmentation and 3-D mesh editing is an important advantage of this type of research. Both CBCT and CT are useful for model building. However, CBCT may have limitations. The Q criterion in CFD illustrates the considerable complication of the nasal flow and allows for direct evaluation and quantitative comparison of various flows and can be used for the assessment of nasal airflow.

show abstract

“…6 Similarly, Lee et al examined the effects of varying degrees of resection of the middle turbinate on nasal airflow and olfaction and found a progressive decrease in flow to the olfactory region as the volume of middle turbinectomy increased. 21 However, in our particle flow pathway analysis, MTR led to an increase in airflow to the space created by MTR and also increased airflow to the olfactory region in 4 of our 5 patients (Figure 1). Interestingly, Damm et al identified the nasal segment in the upper meatus below the cribriform plate as 1 of the 2 nasal segments that contributes to individual differences in odor thresholds.…”

Section: Discussionmentioning

confidence: 63%

Impact of Middle Turbinectomy on Airflow to the Olfactory Cleft: A Computational Fluid Dynamics Study

Alam

Bradburn

et al. 2018

Am J Rhinol�Allergy

View full text Add to dashboard Cite

Background The impact of middle turbinate resection (MTR) on olfaction remains a point of debate in the current literature. Few studies have objectively evaluated olfactory cleft airflow following MTR; thus, the mechanism by which MTR may impact olfaction is poorly understood. It is not known whether the postsurgical changes in airway volume, flow, and resistance increase odorant transport or disrupt the patterns of normal airflow. Computational fluid dynamics can be used to study the nasal airway and predict responses to surgical intervention. Objective To evaluate the functional impact of MTR on nasal airflow, resistance, and olfaction. Methods Five maxillofacial computed tomography scans of patients without signs of significant sinusitis or nasal polyposis were used. Control models for each patient were compared to their corresponding model after virtual total MTR. For each model, nasal airway volume, nasal resistance, and air flow rate were determined. Odorant transport of 3 different odorants in the nasal cavity was simulated based on the computed steady airflow field. Results Total airflow significantly increased following bilateral MTR in all patient models ( P < .05). Consistent with our airflow results, we found a decrease in nasal resistance following MTR. MTR significantly increased area averaged flux to the olfactory cleft when compared to controls for phenylethyl alcohol (high-sorptive odorant). Results for carvone (medium sorptive) were similarly elevated. MTR impact on limonene, a low flux odorant, was equivocal. Conclusion MTR increases nasal airflow while decreasing the nasal resistance. Overall, olfactory flux increased for high sorptive (phenylethyl alcohol) and medium sorpitve (l-carvone) odorants. However, the significant variation observed in one of our models suggests that the effects of MTR on the nasal airflow and the resultant olfaction can vary between individuals based on individual anatomic differences.

show abstract

Effects of partial middle turbinectomy with varying resection volume and location on nasal functions and airflow characteristics by CFD

Cited by 32 publications

References 23 publications

Is Respiratory Epithelial Adenomatoid Hamartoma Related to Central Compartment Atopic Disease?

Is Respiratory Epithelial Adenomatoid Hamartoma Related to Central Compartment Atopic Disease?

Three-dimensional modeling and automatic analysis of the human nasal cavity and paranasal sinuses using the computational fluid dynamics method

Impact of Middle Turbinectomy on Airflow to the Olfactory Cleft: A Computational Fluid Dynamics Study

Contact Info

Product

Resources

About