Virtual Nasal Surgery - A New Dimension in Rhinological Surgery Planning

Brendan Hanna, John Watterson, Neil Bailie, Jonathan Cole, Geraldine Gallagher, John Cathcart

Research output: Contribution to conferencePaper

1 Citation (Scopus)

Abstract

Objectives: 1. To begin to determine if the results of nasal surgery can be modelled pre-operatively in a computational model of nasal airflow. 2. To commence an investigation of the correlation between nasal airflow and the sensations of nasal patency and olfaction.
Method: Geometrical computational models of the nasal cavities are constructed from multislice CT scans. A hemi-spherical airflow inlet in front of the face is created and the model meshed using ICEM CFD. Airflow analysis is performed with Fluent version 6.1. Prior to nasal surgery the possible results of several surgical procedures are modelled by altering the geometrical model and repeating the airflow analysis, although the final procedure is chosen by the operating surgeon on the basis of clinical experience as virtual surgery is still at the validation stage. After surgery, when healing is complete, the CT scan is repeated and the airflow analysis is compared to the result predicted by the simulation of that procedure. The patient's symptoms are quantified before and after surgery by means of validated questionnaires and olfactory ability is objectively measured. Changes in these variables are correlated with airflow in the olfactory slit and patterns of shear stress distribution in the nasal cavities.
Results: The virtual nasal surgery procedure has been completed for one volunteer patient. Predicted airflow patterns from virtual surgery compared favourably to those obtained following the real operation. Nasopharyngeal pressure was within 10% of that predicted. A reduced sensation of nasal blockage accompanied a posterior shift of median wall shear stress. Olfactory thresholds decreased in both nasal cavities, although olfactory slit airflow improved on one side.
Conclusion: This first report of the use of virtual nasal surgery in a real clinical case demonstrates that it may be a valid means of planning rhinological surgery. Levels of wall shear stress in the posterior aspect of the nasal cavity may be important for the sensation of nasal patency. High olfactory slit airflow appears to decrease olfactory ability just as poor olfactory ventilation is also associated with decreased olfactory ability.
Original languageEnglish
Publication statusPublished - Jun 2005
Event35th AIAA Fluid Dynamics Conference and Exhibit - Toronto, Canada
Duration: 06 Jun 200509 Jun 2005

Conference

Conference35th AIAA Fluid Dynamics Conference and Exhibit
Country/TerritoryCanada
CityToronto
Period06/06/200509/06/2005

Keywords

  • nasal surgery
  • virtual surgery
  • CFD
  • olfactory ability
  • CT scans

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