Comparative characteristics of the nasal airflow aerodynamic parameters in patients with nasal septum deformation and healthy participants

Surgical treatment of nasal septum deviation or deformity (NSD) is a common method of treatment. The quality of treatment is assessed visually with rhinoscopy, taking into account subjective patient sensations. However, there are still no objective criteria for assessing nasal airflow improvement, which complicates the evaluation of patient breathing after treatment. We used a novel CFD modeling method to create a virtual airflow model and determine flow parameters in the nasal cavity in normal and pathological conditions.

Objective: to compare the aerodynamic characteristics of airflow in patients with NSD and healthy nasal cavities.

Material and methods: the study used electronic files of computed tomography scans of the nasal sinuses of 60 patients with NSD and 21 healthy participants. Specific software (3D slicer, Ansys Fluent) was used to obtain airflow parameters; 3D models of the nasal cavity airflow were created, and CFD flow modeling was conducted.

Results: in patients with NSD, flow velocity ranged from 5.17 to 15.63 m/s, in healthy individuals from 1.1 to 2.0 m/s; pressure force on the nasal walls ranged from 2.20 to 10.20 Pa in patients with NSD, in healthy individuals from 0.60 to 1.00 Pa; flow temperature ranged from 26.45 to 36.80 °C in patients with NSD, in healthy individuals from 20.14 to 24.40 °C; flow partial pressure ranged from –120.60 to –0.01 Pa in patients with NSD, in healthy individuals from 2.00 to –4.80 Pa, p < 0.0001. Conclusion: Aerodynamic characteristics of nasal cavity airflow in patients with nasal septum deviation significantly differ from those in healthy individuals. The application of CFD modeling of nasal airflow will assist clinicians in objectively assessing nasal breathing in NSD, as well as surgical treatment outcomes and quality assessment in otorhinolaryngological practice.

1. Consensus report on acoustic rhinometry and rhinomanometry: The International Standardization Committee on the Objective Assessment of the Nasal Airway in Riga. Rhinology. Clement PAR, Gordt. Riga. 2016:79.

2. Anderson K.R., Anthony T.R. Computational fl uid dy namics investigation of human aspiration in low velocity air: orientation effects on nose-breathing simulations. Ann. Occup. Hyg. 2014;7(7):45–52.

3. Burgos M.A., Sanmiguel-Rojas E., Del Pino C., Sevilla-García M.A., Esteban-Ortega F. New CFD tools to evaluate nasal airflow. Eur. Arch. Otorhinolaryngol. 2017;8:3121 –3128.

4. Bor ojeni A.A., Frank-Ito D.O., Kimbell J.S., Rhee J.S., Garcia G.J.M. Creation of an idealized nasopharynx geometry for accurate computational fl uid dynamics simulations of nasal airflow in patientspecifi c models lacking the nasopharynx anatomy. Int. J. Numer. Meth. Bio. 2017;33(5). DOI: 10.1002/cnm.2825

5. Wen Jian et al. Numerical simulations for detailed airfl ow dynamics in a human nasal cavity. Respiratory physiology & neurobiology. 2008:125–135.

6. Lopatin A.S., Sharojko M.V. Povtornye operacii pri deformacijah peregorodki nosa. Vestnik otorinolaringologii. 2013;5(7):123 –136. (In Russian).

7. Tsarapkin G.Yu., Kunelskaya N.L., Tovmasyan A.S., Kishinevsky A.E., Musaeva M.M., Kochetkova T.A., Vershinina E.A. Complications of surgical treatment of nasal septum curvature. Russian rhinology. 2021;15:145–156. (In Russian).

8. Guyuron B., Uzzo C. D., Scull H. A practical classification of septonasal deviation and an eff ective guide to septal surgery. Plastic and Reconstructive Surgery. 1999;104(7):2202–2209.

9. Jin H.R., Lee J.Y., Jung W.J. New description method and classification system for septal deviation. Journal of Rhinology. 2007;14(1):27–31.

10. Buyukertan M., Keklikoglu N., Kokten G. A morphometric consideration of nasal septal deviations by people with paranasal complaints; a computed tomography study. Rhinology. 2003;41(1):21–24.

11. Clinical protocols of the Ministry of Health of the Republic of Kazakhstan. B.M., National Researh Center for Health Development. 2016. (In Russian) URK: http://www.rcrz.kz

12. Haight J.S., Cole P. The site and function of the nasal valve. Laryngoscope. 1983;1:49–55.

13. Spataro E., Most SP.. Measuring Nasal Obstruction Outcomes. Review. Otolaryngol, Clin. North Am. 2018;5(51):883–895.

14. Yepes-Nuñez J.J., Bartra J., Muñoz-Cano R. et al. Assessment of nasal obstruction: correlation between subjective and objective techniques. Allergol Immunopathol (Madr). 2013;41(6):397–401.

15. Sipila J., Suonpaa J., Silvoniemi P. et al. Correlations between subjective sensation of nasal patency and rhinomanometry in both unilateral and total nasal assessment. ORL J. Otorhinolaryngol. Relat. Spec. 1995;57(5):260–300.

16. Tsang C.L.N., Nguyen T., Sivesind T., Cervin. Long-term patientrelated outcome measures of septoplasty: a systematic review. Eur. Arch. Otorhinolaryngol. 2018;275(5):1039–1048.

17. Quadrio M., Pipolo C., Corti S., Lenzi R., Mes. Review of com putational fluid dynamics in the assessment of nasal air flow and analysis of its limitations. Eur. Arch. Otorhinolaryngol. 2014;271(9):349–354.

18. Mohammadi H., Bahramian F. Boundary conditions in simulation of stenosed coronary arteries. Cardiovasc. Eng. 2009;9(3):83–91.