Nasal function in patients with maxillectomy using various obturator designs

Area of Science:

• Biomedical Engineering
• Computational Fluid Dynamics
• Otorhinolaryngology

Background:

• Maxillary obturators restore oral tissues after maxillectomy, improving quality of life.
• The impact of maxillectomy and obturators on nasal function remains under-investigated.
• Nasal physiology is crucial for respiratory health and requires thorough evaluation post-surgery.

Purpose of the Study:

• To computationally evaluate the effects of maxillectomy on nasal function.
• To assess the influence of obturator designs on nasal airflow, temperature, and humidity.
• To understand the physiological changes in nasal function after cancer-related maxillectomy.

Main Methods:

• Computational fluid dynamics (CFD) simulations were used to model nasal airflow.
• Computed tomography data from 10 maxillectomy patients created models: maxillectomy-without-obturator (MWO), maxillectomy-with-closed-bulb-obturator (MCO), and maxillectomy-with-open-bulb-obturator (MOO).
• Control models from 10 healthy individuals were used for comparison; simulations covered a 1.9-second inspiration cycle.

Main Results:

• Maxillectomy significantly decreased nasopharyngeal temperature and relative humidity.
• Obturators reduced tidal volume and airflow velocity but increased inspired air temperature.
• Obturator use altered wall-shear stress, with humidity levels not fully normalized compared to controls.

Conclusions:

• Maxillectomy disrupts nasal airflow dynamics, affecting temperature, humidity, and wall-shear stress.
• Obturators partially restore airflow but do not normalize nasal humidity.
• Optimizing obturator design is crucial for improving nasal function after maxillectomy.