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Agreement between rhinomanometry and computed tomography-based computational fluid dynamics.

Manuel Berger1,2, Aris I Giotakis3, Martin Pillei1,4

  • 1Department of Environmental, Process and Energy Engineering, MCI, The Entrepreneurial School, Innsbruck, Austria.

International Journal of Computer Assisted Radiology and Surgery
|March 7, 2021
PubMed
Summary

This study found that CT-based CFD simulations correlate well with active anterior rhinomanometry (AAR) pressure, especially in less obstructed nasal passages. However, significant discrepancies in resistance were noted in more obstructed areas.

Keywords:
Agreement analysisComputational fluid dynamicsMethod comparisonNasal obstructionRhinomanometrySimulation

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Area of Science:

  • Otolaryngology
  • Medical Imaging
  • Computational Fluid Dynamics

Background:

  • Active anterior rhinomanometry (AAR) and computed tomography (CT) are standard for nasal obstruction assessment.
  • Previous attempts to correlate AAR with CT-based computational fluid dynamics (CFD) have yielded controversial results.

Purpose of the Study:

  • To investigate the correlation and agreement between AAR and CT-based CFD using an in-house developed procedure.
  • To evaluate the feasibility of simulating rhinomanometry pressure and resistance via CT-based CFD.

Main Methods:

  • A pilot study retrospectively analyzed five subjects undergoing septoplasty.
  • Preoperative digital volume tomography and AAR data were used for CFD simulations with a lattice Boltzmann code (Sailfish CFD).
  • Correlation and agreement of pressure (RhinoPress vs. SimPress) and resistance (RhinoRes150 vs. SimRes150) were assessed using univariate analysis of variance, Pearson's correlation, and the Bland-Altman method.

Main Results:

  • A strong correlation was observed between AAR-derived and CFD-simulated pressures (r=0.93, p<0.001).
  • Pressure agreement was good in less obstructed nasal sides but showed a two-fold difference in more obstructed sides.
  • Moderate correlation was found for resistance (r=0.65, p=0.041).

Conclusions:

  • CT-based CFD simulation of rhinomanometry pressure is feasible, particularly in less obstructed nasal passages.
  • Higher error rates (up to 100%) were observed in simulating resistance in more obstructed nasal sides.
  • While CT-based CFD and AAR-derived pressure and resistance show similarity, they are not identical, indicating potential limitations in obstructed nasal conditions.