Investigation of flow characteristics in the maxillary sinus where polypoid changes develop

Flow behavior in the maxillary sinus where polypoid changes develop was investigated using computational fluid dynamics. A nasal cavity model was constructed, after performing a virtual polypectomy based on computed tomography images of a patient, using a computer-aided design software to artificially remove polypoid changes inside the maxillary sinus. Local flow characteristics in the maxillary sinus were examined for one full respiration period. The results showed that the epithelial surfaces where polypoid changes occur are located in the lower part of the maxillary sinus which contains a protruding zone of the sinus and are characterized by stagnation of air during the entire respiration period. Due to the geometric characteristics, a very slow recirculating motion was found to occur in the bulging area for approximately half of the respiration period as a result of interaction with a larger-scale, counter-rotating vortex filling the middle of the maxillary sinus. With a much smaller velocity inside the maxillary sinus compared to that typically found in the airway passage through the middle meatus, both wall shear and pressure changes were found to be vanishingly small along the epithelial surface of the maxillary sinus where polypoid changes were found.

[1]  M. Gurdal,et al.  Antrochoanal polyposis: analysis of 34 cases , 2013, European Archives of Oto-Rhino-Laryngology.

[2]  A. E. Andrews,et al.  Site of origin of nasal polyps: relevance to pathogenesis and management. , 2005, Rhinology.

[3]  Warren H. Finlay,et al.  The effect of unsteady flow rate increase on in vitro mouth-throat deposition of inhaled boluses , 2006 .

[4]  G. Ahmadi,et al.  Phase change and deposition of inhaled droplets in the human nasal cavity under cyclic inspiratory airflow , 2018 .

[5]  W. Fokkens,et al.  Review article: Nasal polyposis: a cellular‐based approach to answering questions , 2007 .

[6]  R. Pawankar.  Nasal polyposis: an update , 2003, Current opinion in allergy and clinical immunology.

[7]  D. Doorly,et al.  Inflow boundary profile prescription for numerical simulation of nasal airflow , 2010, Journal of The Royal Society Interface.

[8]  A. Ceylan,et al.  Analysis of Choanal Polyps , 2014, The Journal of craniofacial surgery.

[9]  H. Stammberger.  2. Surgical treatment of nasal polyps: past, present and future , 1999 .

[10]  Jinxiang Xi,et al.  Effects of the facial interface on inhalation and deposition of micrometer particles in calm air in a child airway model , 2014, Inhalation toxicology.

[11]  M. Tos,et al.  Origin of Nasal Polyps: An Endoscopic Autopsy Study , 2004, The Laryngoscope.

[12]  Jiyuan Tu,et al.  Computational fluid dynamics analysis of wall shear stresses between human and rat nasal cavities , 2017 .

[13]  Andreas Lintermann,et al.  Fluid mechanics based classification of the respiratory efficiency of several nasal cavities , 2013, Comput. Biol. Medicine.

[14]  T Renée Anthony.  Contribution of facial feature dimensions and velocity parameters on particle inhalability. , 2010, The Annals of occupational hygiene.

[15]  M. Kowalski,et al.  Pathogenesis of nasal polyps: An update , 2005, Current allergy and asthma reports.

[16]  J. Mullol,et al.  Nasal polyps in patients with asthma: prevalence, impact, and management challenges , 2016, Journal of asthma and allergy.

[17]  R. C. Schroter,et al.  Mechanics of airflow in the human nasal airways , 2008, Respiratory Physiology & Neurobiology.

[18]  C. Bachert,et al.  Nasal polyposis, eosinophil dominated inflammation, and allergy , 2000, Thorax.

[19]  K. Ah-See,et al.  A review of nasal polyposis , 2008, Therapeutics and clinical risk management.

[20]  Mohammad Faramarzi,et al.  Numerical simulation of airflow and micro-particle deposition in human nasal airway pre- and post-virtual sphenoidotomy surgery , 2015, Comput. Biol. Medicine.

[21]  R. Naclerio,et al.  Medical and surgical management of nasal polyps , 2001 .

[22]  Nicolas Buchmann,et al.  Stereoscopic PIV measurements of flow in the nasal cavity with high flow therapy , 2011 .

[23]  L. Johansson,et al.  Heredity of nasal polyps. , 2015, Rhinology.

[24]  R. Schleimer,et al.  Pathogenesis of nasal polyposis , 2015, Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology.

[25]  Yang Na,et al.  Investigation of flow characteristics in regions of nasal polypoid change , 2016, Comput. Biol. Medicine.

[26]  Goodarz Ahmadi,et al.  Micro and nanoparticle deposition in human nasal passage pre and post virtual maxillary sinus endoscopic surgery , 2012, Respiratory Physiology & Neurobiology.

[27]  H. Stammberger,et al.  Paranasal Sinuses: Anatomic Terminology and Nomenclature , 1995, The Annals of otology, rhinology & laryngology. Supplement.

[28]  M. Tos,et al.  The Estimated Incidence of Symptomatic Nasal Polyps , 2002, Acta oto-laryngologica.

[29]  L. Ertama,et al.  Nasal polyposis: clinical course during 20 years. , 2000, Annals of allergy, asthma & immunology : official publication of the American College of Allergy, Asthma, & Immunology.

[30]  G. Louridas,et al.  Wall pressure gradient in normal left coronary artery tree. , 2005, Medical engineering & physics.

[31]  N. Bateman,et al.  Nasal polyps: Still more questions than answers , 2003, The Journal of Laryngology & Otology.

[32]  J. Patumanond,et al.  Antrochoanal Polyps: How Long Should Follow-Up Be after Surgery? , 2015, International journal of otolaryngology.

[33]  Laura J. White,et al.  Polypoid changes of the middle turbinate as an indicator of atopic disease , 2014, International forum of allergy & rhinology.

[34]  Yang Na,et al.  Numerical study on the effect of uncinectomy on airflow modification and ventilation characteristics of the maxillary sinus , 2016, Respiratory Physiology & Neurobiology.

[35]  David Towey,et al.  Physical and Computational Modeling of Ventilation of the Maxillary Sinus , 2011, Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery.

[36]  R. Weber,et al.  Cysts of the maxillary sinus: a literature review , 2013, International forum of allergy & rhinology.

[37]  R. Chandra,et al.  Relationships between Severity of Chronic Rhinosinusitis and Nasal Polyposis, Asthma, and Atopy , 2009, American journal of rhinology & allergy.

[38]  G. Settipane.  Nasal Polyps: Epidemiology, Pathology, Immunology, and Treatment , 1987, Immunology and Allergy Clinics of North America.

[39]  Seung‐Kyu Chung,et al.  The effect of a middle meatal antrostomy on nitric oxide ventilation in the maxillary sinus , 2014, Respiratory Physiology & Neurobiology.

[40]  Nicolas Buchmann,et al.  Unsteady flow in the nasal cavity with high flow therapy measured by stereoscopic PIV , 2012 .

[41]  R. Schleimer,et al.  Chronic Rhinosinusitis with Nasal Polyps. , 2016, The journal of allergy and clinical immunology. In practice.

[42]  Shabani Shahaboddin,et al.  Medical treatment of nasal polyps: a review , 2015 .

[43]  A. Peters,et al.  Nasal Polyps , 1987, American journal of rhinology & allergy.

[44]  Goodarz Ahmadi,et al.  Numerical investigation of transient transport and deposition of microparticles under unsteady inspiratory flow in human upper airways , 2017, Respiratory Physiology & Neurobiology.