Computational Fluid Dynamics (CFD) and the Nose: Improving Patient Outcomes in Surgery for Nasal Airway Obstruction
Dr Kimberley Bradshaw, Surgical Registrar, Westmead Hospital, Sydney, Australia
Authors List
Bradshaw, K,; Sacks, R,; Singh, N, Westmead,; University of Sydney, Sydney, Australia
Warfield-McAlpine, P; Vahaji, S,; Emmerling, J,; Salati, H,; Liu, X,; Inthavong, K,; RMIT Melbourne, Australia
Background: Normal nasal airflow is important for the functioning of the airway including filtering and conditioning, mucociliary clearance, defence against pathogens and olfaction. Nasal airway obstruction (NAO) is a common presentation which can reduce quality of life and is usually caused by inferior turbinate hypertrophy, septal deviation and nasal valve collapse, for which various surgical techniques are employed. Our current techniques are based predominantly on experiential evidence.
Aim: This work is the cumulation of a PhD thesis and aims to provide an objective analysis of airflow patterns and conditioning and to assess the effect of NAO on this. Furthermore, to perform virtual surgery to assess which current surgical technique has the best physiological outcome in realistic and detailed computer modelling.
Method: 3D computer models are built from high resolution computer tomography (CT) scans using 3D slicer and geomagic wrap software. Airflow patterns, velocity, temperature, humidity and particle distribution are simulated using Fluent Analyse software.
Results: We present our simulation findings through dynamic images of new airflow, temperature and humidity patterns demonstrated by our novel CFD technique, which are only achieved by looking at the full breathing cycle and including the entire upper airway from the nose to the larynx. This novel approach to computer analysis of nasal physiology has revealed new insights including the laryngeal jet and vortices which greatly contribute to airflow conditioning from the nose amongst other phenomena we will demonstrate visually. We have extended this technique to compare surgical approaches to NAO performed virtually including septoplasty, coblation turbinoplasty, conservative inferior turbinoplasty, radical turbinoplasty and septal swell body reduction. These experiments have provided detail as to the effect of these techniques on nasal airflow and on nasal air conditioning that have been previously supported only by experiential evidence of the surgeon and subjective patient reported outcomes.
Bradshaw, K,; Sacks, R,; Singh, N, Westmead,; University of Sydney, Sydney, Australia
Warfield-McAlpine, P; Vahaji, S,; Emmerling, J,; Salati, H,; Liu, X,; Inthavong, K,; RMIT Melbourne, Australia
Background: Normal nasal airflow is important for the functioning of the airway including filtering and conditioning, mucociliary clearance, defence against pathogens and olfaction. Nasal airway obstruction (NAO) is a common presentation which can reduce quality of life and is usually caused by inferior turbinate hypertrophy, septal deviation and nasal valve collapse, for which various surgical techniques are employed. Our current techniques are based predominantly on experiential evidence.
Aim: This work is the cumulation of a PhD thesis and aims to provide an objective analysis of airflow patterns and conditioning and to assess the effect of NAO on this. Furthermore, to perform virtual surgery to assess which current surgical technique has the best physiological outcome in realistic and detailed computer modelling.
Method: 3D computer models are built from high resolution computer tomography (CT) scans using 3D slicer and geomagic wrap software. Airflow patterns, velocity, temperature, humidity and particle distribution are simulated using Fluent Analyse software.
Results: We present our simulation findings through dynamic images of new airflow, temperature and humidity patterns demonstrated by our novel CFD technique, which are only achieved by looking at the full breathing cycle and including the entire upper airway from the nose to the larynx. This novel approach to computer analysis of nasal physiology has revealed new insights including the laryngeal jet and vortices which greatly contribute to airflow conditioning from the nose amongst other phenomena we will demonstrate visually. We have extended this technique to compare surgical approaches to NAO performed virtually including septoplasty, coblation turbinoplasty, conservative inferior turbinoplasty, radical turbinoplasty and septal swell body reduction. These experiments have provided detail as to the effect of these techniques on nasal airflow and on nasal air conditioning that have been previously supported only by experiential evidence of the surgeon and subjective patient reported outcomes.
