Nasal airflow diagnosis--comparison of experimental studies and computer simulations.

The lack of suited diagnostic tools providing insight into patient specific flow characteristics of the nasal airflow is one of the main problems in functional diagnosis. Diagnostic methods currently used do not provide the necessary information for flow analysis. But the flow distribution is essential for a physiological respiration, in particular for cleaning, moistening and tempering of the inhaled air as well as for the olfactory function of the nose. To overcome this current situation a cooperation project of the ENT surgeons and computer graphic engineers was established to develop the computer assisted planning system STAN (Simulation Tool for Airflow in the human Nose) combining Computer Fluid Dynamics (CFD) with advanced Computer Graphic Technology. The idea of the STAN system is to perform patient specific airflow simulations in the patient's nasal cavities. Therefore a geometrical model of the nasal airways is derived from the patient's tomography scans. A discretization of the surrounded flow volume is made by a computational grid. To establish the flow simulation Finite Element Methods are performed on the grid. A tailored visualization is offered to the surgeon that overlaps the flow pattern to the patient's tomography data shown in the coronal, sagittal and transversal plane. The surgeon can not only analyze the patient's current respiratory situation he has also the possibility to describe the planned surgical intervention. The goal is to simulate the flow distribution that can be expected after the surgical intervention and to offer a possibility to validate various surgical strategies. To verify the simulation results experimental investigations and measurements are made in nasal models. Silicon Models of patient's nose channels are made to analyze flow characteristics. The CT or MR scans of the same patients are used as input data for the simulation. The experimental outcome is compared to the simulation results to validate this diagnostic approach.

Numerical simulation of airflow in the human nose.

Unobstructed air passageways as well as sufficient contact of the air stream with the mucous membrane are essential for the correct function of the nose. For that, local flow phenomena, which often cannot be captured by standard diagnostic methods, are important. We developed and validated a method for the numerical simulation of the nasal airflow. Two anatomically correct, transparent resin models of human nasal cavities, manufactured by a special casting technology, and the nasal cavities of two patients were reconstructed as Computer Aided Design models based on computed tomography (CT) scans. One of the nasal models and one clinical case represented a normal nasal anatomy, while the others were examples of pathological alterations. The velocity and pressure fields in these reconstructed cavities were calculated for the entire range of physiological nasal inspiration using commercially available computational fluid dynamics software. To validate the results rhinoresistometric data were measured and characteristic streamlines were videotaped for the resin models. The numerical results were in good agreement with the experimental data for the investigated cases. An example of a complex clinical case demonstrates the potential benefit of the developed simulation method for rhinosurgical planning. The results support the assumption that even under the specific conditions of the clinical practice the application of numerical simulation of nasal airflow phenomena may become realistic in the near future. However, important technical issues such as a completely automated reconstruction of the nasal cavity still need to be resolved before such simulations are efficient and cost effective enough to become a standard tool for the rhinologist.