Computational Fluid Dynamics of the Nasal Cavity
The nose is not a tube, nor can it be regarded as two pipelines transporting air to the lung.
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Ralph Mösges
Core Messages
• Computational fluid dynamics (CFD) is a mature technology used widely in engineering to solve and analyze problems that involve fluid flows. • Computational fluid dynamics has been used to demonstrate physiologic and pathologic conditions of nasal flow and to support preoperative planning and control of postsurgical outcomes. • Using high-definition three-dimensional imaging CFD may offer a chance to study the effects of medication on the tissues lining the surface of the nasal cavity. • CFD may help to design devices for optimal nasal delivery of medications such as nasal spray applicators. • CFD may become a universal tool for research, pharmaceutical development, but also for advanced patient care in rhinology.
R. Mösges Institute of Medical Statistics, Informatics and Epidemiology, University Hospital of Cologne, Lindenburger Allee 42, Köln 50672, Germany e-mail: [email protected]
The nose is not a tube, nor can it be regarded as two pipelines transporting air to the lung. The nose has multiple functions, enabling the exchange of gas between the circulating blood and the environment, humidification, warming and cleaning of the air, and last but not least it supports the sense of smell as an alarm function but also to find the ideal mate. The nasal cavity is optimized for all these tasks and only surgical hybris can lead to the assumption that one could easily ameliorate its structure. It is this “plummer’s mentality” that has transformed human beings with slightly obstructed noses into “nasal wrecks” suffering from the empty nose syndrome. For a long time, otorhinolaryngologists have tried to measure nasal flow under conditions of obstruction, in order to surgically remove what deemed to be the obstacle to normal nasal breathing. But even in cases where the pre-/postcomparison of nasal flow, measured under defined conditions demonstrated significant improvements, patients were sometimes unhappy with the outcome. Septoplasty and turbinectomy are typical interventions with a high rate of “nonresponders” to therapy, at least on the long run. The difference between objective nasal patency and the subjective feeling of obstruction has been very well described in excellent reviews (Baraniuk 2011). One of the reasons for this discrepancy may be that we measure nasal flow in our tests at pressures that are by far higher (150 Pa or 200 Pa) than those produced in a
T.M. Önerci (ed.), Nasal Physiology and Pathophysiology of Nasal Disorders, DOI 10.1007/978-3-642-37250-6_19, © Springer-Verlag Berlin Heidelberg 2013
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R. Mösges
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normal breathing cycle under resting conditions. However, the test equipment we use these days (and have been using over the last 20 years) does not allow for reliable, reproducible measurements at pressures as low as those occurring in real life. Therefore, especially in cases of obstructed anatomy, other methods may be more adequate to calculate nasal flow and the exchange of warmth and humidity at the borderline, the superficial tissue which is the m
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