Computational fluid dynamics as surgical planning tool: a pilot study on middle turbinate resection

Area of Science:

• Otorhinolaryngology
• Biomedical Engineering
• Computational Fluid Dynamics

Background:

• The management of the middle turbinate (MT) during functional endoscopic sinus surgery remains controversial.
• Resection of the MT can alter nasal airflow and mucociliary clearance, with current imaging lacking quantitative assessment.
• There is a need for advanced methods to evaluate surgical impacts on nasal airflow dynamics.

Observation:

• This study investigated the use of computational fluid dynamics (CFD) to analyze nasal airflow changes post-partial MT resection.
• Three-dimensional numerical models were created from pre- and postoperative CT scans of a patient undergoing concha bullosa resection.
• CFD simulations were performed to compare airflow patterns before and after surgery.

Findings:

• Partial MT resection shifted airflow towards the resection site, decreasing velocity and wall shear stress while increasing local pressure.
• Overall nasal airflow patterns, flow distribution, and odorant uptake to the olfactory cleft were not significantly affected.
• CFD accurately predicted the patient's lack of perceived improvement in nasal obstruction.

Implications:

• CFD is a feasible technique for predicting nasal airflow dynamics following partial middle turbinate resection.
• This method offers potential for quantitative surgical outcome evaluation and preoperative surgical planning.
• Further clinical studies are needed to correlate CFD findings with functional outcomes.