A CFD approach to understand nasoseptal perforations

Area of Science:

• Otorhinolaryngology
• Biomedical Engineering
• Computational Fluid Dynamics

Background:

• Nasoseptal perforations (NSP) are increasingly common, causing diverse symptoms like obstruction, epistaxis, and pain.
• Current surgical outcomes for NSP are inconsistent, potentially due to limited understanding of their impact on nasal airflow dynamics.
• Computational fluid dynamics (CFD) offers a valuable tool for investigating nasal function and airflow.

Purpose of the Study:

• To investigate the impact of induced nasoseptal perforations (NSP) on nasal airflow using computational fluid dynamics (CFD).
• To analyze how the location and pre-existing nasal conditions influence airflow alterations caused by NSP.

Main Methods:

• CFD software (MECOMLAND®, Digbody®) was employed to simulate virtual surgery on four subjects (two healthy, two with nasal obstruction).
• Septal perforations (anterior and posterior) were virtually induced, and CFD analysis was performed before and after the intervention.
• Key airflow parameters were evaluated to assess the functional impact of the induced NSP.

Main Results:

• Posterior septal perforations did not significantly alter volumetric airflow between nasal passages in any analyzed case.
• Anterior septal perforations led to significant airflow changes only in nasal cavities with pre-existing obstruction.
• Healthy nasal cavities showed no significant airflow differences between sides after NSP induction.

Conclusions:

• Induced NSP primarily cause significant airflow alterations in noses already compromised by nasal airway obstruction.
• The absence of significant airflow changes in healthy noses suggests NSP may be asymptomatic in these cases.
• These findings help explain the wide spectrum of symptoms and the presence of asymptomatic patients with NSP.