The Combination of Acoustic Rhinometry, Rhinoresistometry and Flow Simulation in Noses before and after Turbinate Surgery: A Model Study

Abstract

Background: Especially to young examiners, the interpretation of rhinometric findings seems to be difficult. In order to understand rhinometric assessments precisely, knowledge of airflow behavior in the nose is necessary. We therefore investigated the influence of nasal concha surgery on acoustic rhinometry and rhinoresistometry in a model. Method: Six nose models were examined with acoustic rhinometry and rhinoresistometry, each of these models with its lateral wall altered to represent various conditions after nasal concha surgery. Besides, all models were rinsed with water and the flow was visualized for observation. Results and Conclusions: The normal nose presented an even flow distribution over the entire nasal cavity. After nasal concha resection, though, an unfavorable flow course and a strong increase in turbulence were seen. Additionally, flow resistance decreased considerably. In the model with general lateral wall hyperplasia, reduction of the inferior and even of the middle nasal concha showed good functional results. The model revealed a good correlation between the result of flow observation and findings in acoustic rhinometry and rhinoresistometry. Both methods complement one another in their diagnostic outcome.

Surgical Treatment for Empty Nose Syndrome

“…18 In the healthy nose, the air flows across the entire body of nasal mucosa; thus, there is vast trigeminal feedback sent from the receptors of the entire cavity. Proetz 2 and Grü tzenmacher et al 18 have shown that when, for example, an IT is removed, almost the entire airflow will converge into this enlarged empty cavity, along the nasal floor, and will not become elevated or deflected into Abbreviations: ENS, empty nose syndrome; ET, eustachian tube; improv, improvement; IT, inferior turbinate; MT, middle turbinate; PT, partial turbinectomy; SNOT-20, 20-item Sino-Nasal Outcome Test; SP, surgical procedure; TS, turbinate surgery. a ENS-type indicates patients who have lost relatively little of their turbinate tissues and whose turbinates appear to be almost normal in size; ENS-both, patients in whom both the IT and MT were at least partially resected.…”

“…The IT directs airflow toward the middle meatus. 3,18 The turbinates themselves are bony structures with mucosal and submucosal covering. The IT has a great deal of capacitance vessels to alter its size and thus alter airflow.…”

Study of inferior turbinate reconstruction with Medpor for the treatment of empty nose syndrome

“…Loss of turbinate tissue ultimately disrupts and destroys the meatal structure, causing turbulent, less efficient, and less sensate airflow. 15,16 The meati that are formed by turbinates, septum, and nasal floor walls are very narrow, offering a mechanism of resistance and thereby limiting the total amount of airflow, while in turbinates lacking ENS patients the nasal airflow resistance is substantially decreased. We found a lower mean NAR score (1.03) in our study cohort before operation, and the findings derived from acoustic rhinometry were similar to previous ENS studies.…”

Numerical simulation for nasal flow with partial inferior turbinatomy-a turbulent model

“…It was found that simulated inferior turbinate reduction would result in a broad reduction of pressure along the nasal airway, including the regions distant from the inferior turbinate vicinity. Grutzenmacher et al [4] created six polymer models of nasal cavity including models with turbinate resection. Unfavorable flow course and strong turbulence were observed after nasal turbinate resection.…”