RESUMEN
Objectives: This study aims to delineate the specific impact of using computational fluid dynamics (CFD) and 3D virtual surgery techniques in otolaryngology surgery, focusing on their roles in enhancing the precision of nasal surgery and optimizing future patient outcomes. The central objective was to assess whether these advanced technologies could reduce variability in surgical approaches and decision-making among specialists, thereby improving the consistency and efficacy of patient care in cases of nasal obstruction. Methods and results: Our methodology involved a detailed analysis of pre- and post-operative scenarios using CFD feedback. Six otolaryngologists participated, employing virtual surgery techniques on two patients with diagnosed nasal obstruction. The CFD analysis focused on quantifying key airflow parameters: right nasal flow rate (QR), left nasal flow rate (QL), flow symmetry (Ф), and bilateral nasal resistance (R). These parameters were meticulously compared before and after the application of CFD feedback to evaluate changes in surgical planning and outcomes. Quantitative analysis revealed a notable decrease in the standard deviation of the measured parameters among the specialists post-CFD feedback, indicating reduced variability in surgical approaches. Specifically, for Patient #1 the standard deviation for QR values dropped from 0.694 L/min to 0.602 L/min, and for QL values from 0.676 L/min to 0.584 L/min, and for Patient #2, the standard deviation for QR values decreased from 2.204 L/min to 0.958 L/min, and for QL values from 2.295 L/min to 1.014 L/min. Moreover, the variability range, represented by the differences between the maximum and minimum values for Ф and R, diminished significantly. Post-operative average values for all parameters showed a convergence towards ideal basal levels, suggesting a more uniform and effective surgical strategy across different surgeons. Conclusions: Both integration of CFD and 3D virtual surgery techniques in otolaryngology can substantially reduce variability in surgical planning and decision-making, ultimately leading to improved patient outcomes. These advanced tools have the potential to standardize the diagnosis and treatment of nasal pathologies, contributing to more effective and consistent care. Future research in this area should focus on larger patient cohorts and further exploration of the potential benefits and applications of CFD and virtual surgery in otolaryngology.
RESUMEN
El condrosarcoma laríngeo es un raro tumor no epitelialde lento crecimiento derivado del sistema cartilaginoso de la laringe. Aunque es el tumor mesenquimatoso más frecuente en la laringe 1 tan sólo representa entre un 0,5 yun 1% de los procesos neoplásicos de la laringe 2,3. Elcricoides es el lugar más común de aparición en la laringe 4. Debido a su baja frecuencia, en la literatura tan sólo existen entre 250 y 300 publicaciones sobre él 1,5-8. Su pronóstico está muy relacionado con su histología y su tratamiento quirúrgico precisa un seguimiento y control estrechos tras la cirugía. Presentamos el caso de un condrosarcoma laríngeo de localización subglótica, de lenta evolución que cursó con disfonía y disnea y que fue tratado mediante cirugía
Larynx chondrosarcoma is a rare non epithelial slow growing tumor derivated from the cartilaginous system of the larynx. Although its the most common mesenchimal tumor in larinx only represents between a 0.5 and a 1 %of all the larinx tumors. Due to its low frecuency there are only between 250 and 300 cases reported in the literature about it. Its prognostic is related to it´s histopathology and its surgical treatment needs a close follow up and control after surgery for the detection of recurrences and metastases. We present the case of a larynx chondrosarcoma of subglotic localitation, slow growing that cursed with hoarness and dysnea and was treated by surgery
