Dmitrii Shcherbakov
All Russian Academy for Opthalmic and Plastic Surgery, Russia
Title: Aerodynamics of the Empty Nose Syndrome and Nasal Septum Performation
Biography
Biography: Dmitrii Shcherbakov
Abstract
Introduction: Surgical treatment of the empty nose syndrome is a complex, poorly developed, general medical problem.
The aim of the study: to determine the aerodynamics disorders of the nasal cavity in patients with the empty nose syndrome and to develop the principles of surgical treatment
Materials and methods: Two groups were formed for the study. Group 1 - patients with empty nose syndrome after resection of the lower nasal concha (32 people), group 2 - patients with perforation of the nasal septum (31 people). Based on the obtained CT in the Slicer program (BSD license, Open Source Initiative OSI), three-dimensional models of the nasal cavity were constructed in both groups. Modeling of the air flow in the nasal cavity was carried out using the ANSYS software system (certified No.10000741 QM15, ISO 9001: 2015).
Results and discussion: After performing CFD modeling in group 1, it was found that air is distributed mainly in the lower nasal passage, the speed varies 5.5 ± 1.5 m / s, which is significantly lower than with the physiological norm of 15 ± 3.1 m / s. Pressure indicators reach from + 5 ± 2 Pa, which shows a reduced "suction" force of the nose. The air temperature practically does not change, varying 26.8 ± 0.3 Celsius, which indicates violation of heating. Humidity decreased to 88 ± 4.3%. In group 2, it was found that the speed pattern varies from 20 ± 4 m / s, which exceeds the physiological parameters. The presence of perforation creates a shunt between both nasal cavities, which negatively affects the air heating and pressure. The air temperature throughout the nasal cavity during perforation varies 30.4 ± 0.5 Celsius, while in the perforation area it decreases to 25.6 ± 0.2. The pressure indicators slightly deteriorate, varying from -35 ± 5 Pa throughout the nasal cavity and to -50 ± 5 Pa in the nasopharynx. The relative humidity index decreased and amounted to 97 ± 0.34%.
Conclusions. Using the results obtained, the tactics of surgery in Group 1 is the thickening of the nasal septum and augmentation of the lower nasal concha in order to narrow the lower nasal passage so that air can rush into the upper sections. In group 2, the tactic is surgical closure of the perforation of the nasal septum with the mucosal flap on the ethmoid arteries.