鼻腔粘连对气流和粘膜冷却的影响--计算流体动力学分析
The impact of nasal adhesions on airflow and mucosal cooling -- a computational fluid dynamics analysis
摘要：
鼻粘连是鼻气道阻塞（NAO）外科手术后的一种已知术后并发症;也是手术失败的常见原因，尽管粘连尺寸相对较小，但患者经常报告严重NAO。基于与粘连相关的横截面积的最小减少，这种鼻粘连的分离通常提供比预期大得多的缓解。关于鼻粘连的现有文献提供的证据很少，使用客观的措施来检查其对鼻气流的定量和定性影响。本研究使用计算流体动力学（CFD）检查了不同解剖部位的鼻粘连对鼻气流和粘膜冷却的影响。对一名25岁健康女性患者的副鼻窦进行高分辨率CT扫描，以创建三维鼻气道模型。在NAO术后常见部位的鼻腔内不同部位添加直径为2.5~mm的虚拟鼻粘连。建立了一系列具有单一粘连的模型。对每个模型进行CFD分析，并与基线无粘附模型进行比较，比较气流和传热传质。鼻腔粘连导致通过鼻腔的整体气流模式无显著变化。然而，在鼻粘连周围和紧邻鼻粘连下游的局部气流和粘膜冷却方面观察到显著变化。这些在内瓣和前下鼻甲的前鼻粘连中最为明显。
英文摘要：
Nasal adhesions are a known postoperative complication following surgical procedures for nasal airway obstruction (NAO); and are a common cause of surgical failure, with patients often reporting significant NAO, despite relatively minor adhesion size. Division of such nasal adhesions often provides much greater relief than anticipated, based on the minimal reduction in cross-sectional area associated with the adhesion. The available literature regarding nasal adhesions provides little evidence examining their quantitative and qualitative effects on nasal airflow using objective measures. This study examined the impact of nasal adhesions at various anatomical sites on nasal airflow and mucosal cooling using computational fluid dynamics (CFD). A high-resolution CT scan of the paranasal sinuses of a 25-year-old, healthy female patient was segmented to create a three-dimensional nasal airway model. Virtual nasal adhesions of 2.5~mm diameter were added to various locations within the nasal cavity, representing common sites seen following NAO surgery. A series of models with single adhesions were created. CFD analysis was performed on each model and compared with a baseline no-adhesion model, comparing airflow and heat and mass transfer. The nasal adhesions resulted in no significant change in bulk airflow patterns through the nasal cavity. However, significant changes were observed in local airflow and mucosal cooling around and immediately downstream to the nasal adhesions. These were most evident with anterior nasal adhesions at the internal valve and anterior inferior turbinate.
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