Impact of posterior septum resection on nasal airflow pattern and warming function

Abstract

Background: The functional significance of the posterior segment of the septum is not fully understood.

Aims/Objectives: The purpose of this study was to evaluate the impact of posterior septum resection with varying extents on nasal airflow pattern and warming function, and to determine the appropriate resection extent on posterior septum without disturbing airflow pattern.

Material and Methods: Three dimensional models were established from the nasal CT scan of a healthy female volunteer without nasal disease. The models included the normal, as well as 1 cm, 2 cm, and 3 cm extent of posterior septum resection by virtual surgery. Using computational fluid dynamics, the airflow characteristics such as average and peak airflow velocity, average wall shear stress, average temperature and turbulence kinetic energy were recorded and compared among the four models.

Results: By comparison with the normal model, the virtual surgeries with varying extents of posterior septum resection (1 cm, 2 cm, and 3 cm), demonstrated little alteration on indices of the average and peak airflow velocity, average wall shear stress, airflow temperature and turbulence kinetic energy. However, a statistical difference of the abovementioned indices existed when compared between varying planes of the nasal cavity (p < .001), although this did not appear to be significantly influenced by the degree of posterior septectomy.

Conclusions and significance: From an aerodynamics perspective, little disturbance on airflow pattern and warming function of nasal cavity could be detected with increasing resection of posterior septum (up to 3 cm). These results may imply that resection of the posterior septum (up to 3 cm) has little impact on nasal function.

Chinese abstract

背景：鼻中隔后部的功能意义尚不完全清楚。

目的：本研究的目的是评估不同程度的后中隔切除对鼻腔气流模式和暖化功能的影响, 并确定不影响气流模式的后中隔适当切除范围。

材料和方法：通过健康的无鼻疾女性志愿者的鼻CT扫描建立三维模型。该模型包括虚拟手术切除后中隔的正常程度以及1 cm、2 cm和3 cm的程度。使用计算流体动力学, 记录并比较了四个模型之间的气流特征, 例如平均和峰值气流速度、平均壁面剪切应力、平均温度和湍流动能。

结果：与正常模型相比, 不同程度的后中隔切除术（1 cm、2 cm和3 cm）的虚拟手术在平均流速和峰值气流速度、平均壁面剪切应力、气流指数、温度和湍流动能的指数上几乎没有变化。然而, 当比较鼻腔的不同平面之间时, 上述指数存在统计学差异（p <0.001）, 尽管这似乎未受到后鼻中隔切除术程度的明显影响。

结论和意义：从空气动力学的角度来看, 随着后中隔切除的增加（最大3 cm）, 几乎没有发现对气流模式和鼻腔升温功能的干扰。这些结果可能暗示切除后中隔（最大3 cm）对鼻功能影响不大。

Keywords:

• Nasal septum
• posterior resection
• virtual surgery
• computational fluid dynamics

Acknowledgments

We thank prof. Liu yingxi at Dalian University of Technology for the help of CFD simulation.

Disclosure statement

N. London holds stock in Navigen Pharmaceuticals which is currently of no value and was a consultant for Cooltech, Inc. The other authors have no relevant conflicts of interest.