Background

The aim of this study was to use computational fluid dynamics (CFD) to investigate the effects on nasal heat exchange and humidification of two different surgical techniques for reducing the inferior turbinate under different environmental conditions.

Methods

Virtual surgery using two techniques of turbinate reduction was performed in eight nasal airway obstruction patients. Bilateral nasal airway models for each patient were compared: 1) Pre-operative 2) Post inferior turbinoplasty 3) Post total inferior turbinate resection (ITR). Two representative healthy models were included. Three different environmental conditions were investigated 1) ambient air 2) cold, dry air 3) hot, humid air. CFD modelling of airflow and conditioning was performed under steady-state, laminar, inspiratory conditions.

Findings

Nasal conditioning is significantly altered following inferior turbinate reduction surgery, particularly with ITR under cold, dry inspired air (CDA). The degree of impairment is minor under the simulated range of environmental conditions (temperature = 12–40 °C; relative humidity = 13–80%). Streams of significantly colder air are found in the nasopharynx and more prevalent under CDA in ITR. These are related to high velocity flow streams, which remain cool in their centre throughout the widened inferior nasal cavity.

Interpretation

Reduced air-mucosal heat exchange and moisture carrying capacity occurs under cooler temperatures in patients following inferior turbinate surgery. The clinical impact in extremely cold and dry conditions in groups with poor baseline respiratory function, respiratory illness, or endurance athletes is of special interest.

中文翻译：

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与下鼻甲成形术相比，全下鼻甲切除术后的鼻腔空调–计算流体力学研究

背景

这项研究的目的是使用计算流体力学（CFD）来研究两种不同的手术技术在不同环境条件下减少鼻甲的鼻腔热交换和加湿的影响。

方法

对八名鼻气道阻塞患者进行了使用两种减少鼻甲技术的虚拟手术。比较每位患者的双侧鼻气道模型：1）术前2）下鼻甲成形术后3）全鼻甲下切除术后（ITR）。包括两个代表性的健康模型。研究了三种不同的环境条件：1）环境空气2）冷干空气3）热湿空气。在稳态，层流，吸气条件下进行气流和空调的CFD建模。

发现

降低鼻甲手术后，鼻部条件明显改变，尤其是在冷，干燥的吸入空气（CDA）下进行ITR时。在模拟环境条件范围内（温度= 12–40°C；相对湿度= 13–80％），损伤程度很小。在鼻咽中发现明显更冷的空气流，在ITR的CDA中更为普遍。这些与高速流相关，高速流在整个下鼻腔中部保持凉爽。

解释

在下鼻甲手术后，患者在较低的温度下会降低空气-粘膜的热交换和水分吸收能力。对于基线呼吸功能差，呼吸系统疾病或耐力运动员较弱的群体，在极冷和极干的条件下产生的临床影响尤其令人关注。