Impact of inferior turbinate hypertrophy on the aerodynamic pattern and physiological functions of the turbulent airflow - a CFD simulation model.

INTRODUCTION The aim of this study was to investigate the effects of nasal obstruction with enlargement of inferior turbinates on the aerodynamic flow pattern using Computational Fluid Dynamics (CFD) tools including the effects of turbulence. METHODS A high-resolution 3-dimensional model of the nasal cavity was constructed from MRI scans of a healthy human subject using MIMICS 12.0 software. Nasal cavities corresponding to healthy, moderate and severe nasal obstructions were simulated by enlarging the inferior turbinate geometrically. Numerical simulations with turbulent flow models were implemented using FLUENTS for CFD simulations. RESULTS In the healthy nose, the main respiratory air stream occurs mainly in the middle of the airway, accompanied by a diffused pattern of turbulent flow on the surface of the nasal mucosa. The peak value of turbulent flow is found in the functional nasal valve region. However, this aerodynamic flow pattern has partially or completely changed in the models with enlarged inferior turbinate. An inhalation flow rate of 34.8 L/min with a maximum velocity of 5.69 m/s, 7.39 m/s and 11.01 m/s are detected, respectively, in the healthy, moderately and severely obstructed noses. Both total negative pressure and maximum shear stress have increased by more than three and two times, respectively, in severely blocked noses compared to the healthy one. CONCLUSION Data of this study provide quantitative and quantitative information of the impact of inferior turbinate hypertrophy on the aerodynamic pattern and physiological functions of nasal airflow. By including the model of turbulent airflow, the results of this experimental study will be more meaningful and useful in predicting the aerodynamic effects of surgical correction of inferior turbinate hypertrophy.

[1]  P. Cole Acoustic rhinometry and rhinomanometry. , 2000, Rhinology. Supplement.

[2]  C Kleinstreuer,et al.  Laminar airflow and nanoparticle or vapor deposition in a human nasal cavity model. , 2006, Journal of biomechanical engineering.

[3]  K. Englmeier,et al.  Aerodynamics and aerosol particle deaggregation phenomena in model oral-pharyngeal cavities , 1996 .

[4]  Gerhard Rettinger,et al.  Numerical simulation of intranasal airflow after radical sinus surgery. , 2005, American journal of otolaryngology.

[5]  Junjie Gu,et al.  Numerical simulation of aerosol deposition in a 3-D human nasal cavity using RANS, RANS/EIM, and LES , 2007 .

[6]  Jiyuan Tu,et al.  Airflow Patterns in Both Sides of a Realistic Human Nasal Cavity for Laminar and Turbulent Conditions , 2007 .

[7]  R. Hooper,et al.  Forced inspiratory nasal flow-volume curves: a simple test of nasal airflow. , 2001, Mayo Clinic proceedings.

[8]  David Wexler,et al.  Aerodynamic effects of inferior turbinate reduction: computational fluid dynamics simulation. , 2005, Archives of otolaryngology--head & neck surgery.

[9]  Joo-Heon Yoon,et al.  Particle image velocimetry measurements for the study of nasal airflow , 2006, Acta oto-laryngologica.

[10]  J. Piquet Turbulent Flows: Models and Physics , 1999 .

[11]  Heow Pueh Lee,et al.  Changes of Airflow Pattern in Inferior Turbinate Hypertrophy: A Computational Fluid Dynamics Model , 2009, American journal of rhinology & allergy.

[12]  R. Eccles,et al.  Nasal Airflow in Health and Disease , 2000, Acta oto-laryngologica.

[13]  J. Tu,et al.  A Numerical Study of Spray Particle Deposition in a Human Nasal Cavity , 2006 .

[14]  S. Einav,et al.  Analysis of air flow patterns in the human nose , 1993, Medical and Biological Engineering and Computing.

[15]  P. Dalton,et al.  Numerical modeling of turbulent and laminar airflow and odorant transport during sniffing in the human and rat nose. , 2006, Chemical senses.

[16]  Michael T. Black,et al.  Morphological variation and airflow dynamics in the human nose , 2004, American journal of human biology : the official journal of the Human Biology Council.

[17]  M. Lippmann,et al.  Effect of the laryngeal jet on particle deposition in the human trachea and upper bronchial airways , 1980 .

[18]  M. M. Mozell,et al.  Velocity profiles measured for airflow through a large-scale model of the human nasal cavity. , 1993, Journal of applied physiology.

[19]  D. Wang,et al.  Assessment of Nasal Cycle by Acoustic Rhinometry and Rhinomanometry , 2003, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[20]  H. Lee,et al.  Assessment of septal deviation effects on nasal air flow: A computational fluid dynamics model , 2009, The Laryngoscope.

[21]  Gerhard Rettinger,et al.  Numerical simulation of intranasal air flow and temperature after resection of the turbinates. , 2005, Rhinology.

[22]  Soo-Jin Jeong,et al.  Numerical investigation on the flow characteristics and aerodynamic force of the upper airway of patient with obstructive sleep apnea using computational fluid dynamics. , 2007, Medical engineering & physics.

[23]  D. Goh,et al.  Acoustic rhinometry in nasal allergen challenge study: which dimensional measures are meaningful? , 2004, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[24]  Ted B. Martonen,et al.  A numerical study of particle motion within the human larynx and trachea , 1999 .