The clinical implications of computerised fluid dynamic modelling in rhinology

Leite, S H P; Jain, Ravi; Douglas, Richard

doi:10.4193/rhin18.035

Cited by 15 publications

(22 citation statements)

References 59 publications

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“…Although there are many others, all have cultural bias and there have been recent advances to overcome this with culturally unbiased, universally usable smell tests (95) . Nasal obstruction is the most significant of the cardinal symptoms of rhinosinusitis and nasal patency may be objectively evaluated with peak nasal inspiratory flow (PNIF), (active anterior) rhinomanometry (AAR), and acoustic rhinometry (AR) Newer methods such as computational fluid dynamics (96) are presently mainly used for research purposes (97,98) but may be of value in the future. In addition to confirming diagnosis, histopathology is becoming more important to assist in endotyping of inflammatory disease, thereby directing potential therapies, e.g.…”

Section: Diagnostic Toolsmentioning

confidence: 99%

Executive Summary of EPOS 2020 Including Integrated Care Pathways

Fokkens

Lund

Hopkins

et al. 2020

Rhin

360

254

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The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012 (1-3). The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an update on the literature published and studies undertaken in the eight years since the EPOS2012 position paper was published and addresses areas not extensively covered in EPOS2012 such as paediatric CRS and sinus surgery. EPOS2020 also involves new stakeholders, including pharmacists and patients, and addresses new target users who have become more involved in the management and treatment of rhinosinusitis since the publication of the last EPOS document, including pharmacists, nurses, specialised care givers and indeed patients themselves, who employ increasing self-management of their condition using over the counter treatments. The document provides suggestions for future research in this area and offers updated guidance for definitions and outcome measurements in research in different settings. EPOS2020 contains chapters on definitions and classification where we have defined a large number of terms and indicated preferred terms. A new classification of CRS into primary and secondary CRS and further division into localized and diffuse disease, based on anatomic distribution is proposed. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, allergic rhinitis, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. All available evidence

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Section: Diagnostic Toolsmentioning

confidence: 99%

Executive Summary of EPOS 2020 Including Integrated Care Pathways

Fokkens

Lund

Hopkins

et al. 2020

Rhin

360

254

View full text Add to dashboard Cite

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“…The correlation between clinical evaluation of nasal breathing and CFD is a key to improving interpretation of the latter. In the published literature, there is a dearth of comparative studies analysing correlations between patient nasal breathing perception and CFD, as reported by Leite et al in their recent literature review …”

Section: Introductionmentioning

confidence: 99%

Functional relevance of computational fluid dynamics in the field of nasal obstruction: A literature review

Radulesco

Meister

Bouchet

et al. 2019

Clinical Otolaryngology

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Background: Nasal airway obstruction (nasal obstruction) is a common symptom affecting the quality of life of patients. It can be estimated by patient perception or physical measurements. Computational fluid dynamics (CFD) can be used to analyse nasal ventilation modalities. There is a lack of comparative studies investigating the correlations between CFD variables and patient perception or physical measurements.Objective of the review: Our goal was to define correlations between CFD variables and patient perception and physical measurements. We also aimed to identify the most reliable CFD variable (heat flux, WSS, total pressure, temperature…) characterising nasal breathing perception.Type of review: Systematic literature review using PRISMA guidelines. Search strategy:The selected studies were obtained from the US National Library of Medicine (PubMed) online database, MEDLINE (Ovid), Google Scholar and the Cochrane Library using a combination of MeSH terms (nose, paranasal sinus, fluid dynamics, rhinology) and non-MeSH terms (CFD, nasal airway, nasal airflow, numerical, nasal symptoms). Studies that did not incorporate objective or subjective clinical assessment were excluded. Evaluation method:We compared all results obtained by authors regarding CFD variables and assessment of nasal airway obstruction (clinical or physical). Results:To compare nasal obstruction with CFD variables, most authors use CFD-calculated nasal resistances, airflow, heat flux, wall shear stress, total pressure, velocities and streamlines. We found that heat flux appears to be the CFD variable most closely correlated with patient perception. Total pressure, wall shear stress and velocities are also useful and show good correlations. Correlations between CFD-calculated nasal resistances and patient perception are stronger after correction of the nasal cycle. Conclusions:The growing number of CFD studies on the nose has led to a better understanding of nasal obstruction. The clinical interpretation of previously unknown data, such as WSS and heat flux, is opening up new horizons in the understanding of this symptom. Heat fluxes are among the best CFD values correlated with patient perception. More studies need to be performed including temperature and humidity exchanges.

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“…Computational fluid dynamics (CFD) is a useful tool to examine nasal physiology and has advantages over conventional methods (4,5) . A recent study has used CFD to demonstrate different airflow, wall shear stress (WSS), heat flux and humidifying efficiencies in patients following the TA compared to controls (6) .…”

Section: To the Editormentioning

confidence: 99%