Hostname: page-component-586b7cd67f-t7fkt Total loading time: 0 Render date: 2024-11-24T06:58:21.376Z Has data issue: false hasContentIssue false
  • English
  • Français

Effects of septal perforation on nasal airflow: computer simulation study

Published online by Cambridge University Press:  24 September 2009

H P Lee ,
R R Garlapati ,
V F H Chong  and
D Y Wang
H P Lee*
Affiliation:
Department of Mechanical Engineering, National University of Singapore
R R Garlapati
Affiliation:
Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore
V F H Chong
Affiliation:
Department of Diagnostic Radiology, Yong Loo Lin School of Medicine, National University of Singapore
D Y Wang
Affiliation:
Department of Otolaryngology, Yong Loo Lin School of Medicine, National University of Singapore
*
Address for correspondence: Dr Heow Pueh Lee, Department of Mechanical Engineering, National University of Singapore, 9 Engineering Drive 1, Singapore117576. Fax: 65 67791459 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Nasal septal perforation is a structural or anatomical defect in the septum. The present study focused on the effects of septal perforation on nasal airflow and nasal patency, investigated using a computer simulation model.

Methods:

The effect of nasal septal perforation size on nasal airflow pattern was analysed using computer-generated, three-dimensional nasal models reconstructed using data from magnetic resonance imaging scans of a healthy human subject. Computer-based simulations using computational fluid dynamics were then conducted to determine nasal airflow patterns.

Results:

The maximum velocity and wall shear stress were found always to occur in the downstream region of the septal perforation, and could potentially cause bleeding in that region, as previously reported. During the breathing process, there was flow exchange and flow reversal through the septal perforation, from the higher flow rate to the lower flow rate nostril side, especially for moderate and larger sized perforations.

Conclusion:

In the breathing process of patients with septal perforations, there is airflow exchange from the higher flow rate to the lower flow rate nostril side, especially for moderate and large sized perforations. For relatively small septal perforations, the amount of cross-flow is negligible. This cross-flow may cause the whistling sound typically experienced by patients.

Keywords

Nasal SeptumPerforationRespiratory AirflowComputer Simulation
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 1 , January 2010 , pp. 48 - 54
Copyright
Copyright © JLO (1984) Limited 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Re, M, Paqolucci, L, Romeo, R, Mallardi, V. Surgical treatment of nasal septal perforations: our experience. Acta Otorhinolaryngol Ital 2006;26:102–9Google ScholarPubMed
2 Presutti, L, Ciufelli, MA, Marchioni, D, Villari, D, Marchetti, A, Mattioli, A. Nasal septal perforations: our surgical technique. Otolaryngol Head Neck Surg 2007;136:369–72CrossRefGoogle ScholarPubMed
3 Heller, JB, Gabbay, JS, Trussler, A, Heller, MM, Bradley, JP. Repair of large nasal septal perforations using facial artery musculomucosal (FAMM) flap. Ann Plast Surg 2005;55:456–9CrossRefGoogle ScholarPubMed
4 Metzinger, SE, Guerra, AB, Metairie, LA. Diagnosing and treating nasal septal perforations. Aesthet Surg J 2005;25:524–9CrossRefGoogle ScholarPubMed
5 Mullace, M, Gorini, E, Sbrocca, M, Artesi, L, Mevio, N. Management of nasal septal perforations using silicone nasal septal button. Acta Otorhinolaryngol Ital 2006;26:216–18Google ScholarPubMed
6 Goh, AY, Hussain, SSM. Different surgical treatments for nasal septal perforation and their outcomes. J Laryngol Otol 2007;121:419–26CrossRefGoogle ScholarPubMed
7 Zhao, K, Dalton, P. The way the wind blows: implications of modeling nasal airflow. Curr Allergy Asthma Rep 2007;7:117–25CrossRefGoogle ScholarPubMed
8 Grant, O, Bailie, N, Watterson, J, Cole, J, Gallagher, G, Hanna, B. Numerical model of a nasal septal perforation. Medinfo 2004;11:1352–6Google Scholar
9 Pless, D, Keck, T, Wiesmiller, KM, Lamche, R, Aschoff, AJ, Lindemann, J. Numerical simulation of airflow patterns and air temperature distribution during inspiration in a nose model with septal perforation. Am J Rhinol 2004;18:357–62CrossRefGoogle Scholar
10 Grutzenmacher, S, Lang, C, Saadi, R, Mlynski, G. First findings about the nasal airflow in noses with septal perforation [in German]. Laryngorhinootologie 2002;81:276–9Google ScholarPubMed
11 Grutzenmacher, S, Mlynski, R, Lang, C, Scholz, S, Saadi, R, Mlynski, G. The nasal airflow in noses with septal perforation: a model study. ORL J Otorhinolaryngol Relat Spec 2005;67:142–7CrossRefGoogle ScholarPubMed
12 Eccles, R. Nasal airflow in health and disease. Acta Otolaryngol 2000;120:580–95CrossRefGoogle ScholarPubMed
13 Lindemann, J, Keck, T, Wiesmiller, K, Sander, B, Brambs, HJ, Rettinger, G et al. Nasal air temperature and airflow during respiration in numerical simulation based on multislice computed tomography scan. Am J Rhinol 2006;20:219–23CrossRefGoogle ScholarPubMed