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Nasal function in patients with maxillectomy using various obturator designs.

Ahmed Sameir Mohamed Ali1, Yuka I Sumita2, Masako Akiyama3

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Maxillectomy significantly alters nasal airflow, temperature, and humidity. While obturators improve some nasal functions, they do not fully restore humidity levels, indicating a need for optimized designs.

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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.