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首页> 外文期刊>The Laryngoscope: A Medical Journal for Clinical and Research Contributions in Otolaryngology, Head and Neck Medicine and Surgery, Facial Plastic and Reconstructive Surgery .. >Regional peak mucosal cooling predicts the perception of nasal patency
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Regional peak mucosal cooling predicts the perception of nasal patency

机译：局部峰值黏膜降温可预测鼻腔通畅程度

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Objectives/Hypothesis Nasal obstruction is the principal symptom that drives patients with rhinosinus disease to seek medical treatment. However, patient perception of obstruction often bears little relationship to actual measured physical obstruction of airflow. This lack of an objective clinical tool hinders effective diagnosis and treatment. Previous work has suggested that the perception of nasal patency may involve nasal trigeminal activation by cool inspiratory airflow; we attempt to derive clinically relevant variables following this phenomenon. Study Design Prospective healthy cohort. Methods Twenty-two healthy subjects rated unilateral nasal patency in controlled room air using a visual analog scale, followed by rhinomanometry, acoustic rhinometry, and butanol lateralization thresholds (BLTs). Each subject then immediately underwent a computed tomography scan, enabling the construction of a real-time computational fluid dynamics (CFD) nasal airway model, which was used to simulate nasal mucosa heat loss during steady resting breathing. Results Among all measured and computed variables, only CFD-simulated peak heat loss posterior to the nasal vestibule significantly correlated with patency ratings (r = -0.46, P <.01). Linear discriminant analysis predicted patency categories with 89% success rate, with BLT and rhinomanometric nasal resistance being two additional significant variables. As validation, CFD simulated nasal resistance significantly correlated with rhinomanometrically measured resistance (r = 0.41, P <.01). Conclusions These results reveal that our noses are sensing patency via a mechanism involving localized peak nasal mucosal cooling. The analysis provides a strong rationale for combining the individualized CFD with other objective and neurologic measures to create a novel clinical tool to diagnose nasal obstruction and to predict and evaluate treatment outcomes.
机译：目的/假设鼻塞是促使鼻窦疾病患者寻求治疗的主要症状。但是，患者对阻塞的感知通常与实际测量的气流物理阻塞几乎没有关系。缺乏客观的临床工具阻碍了有效的诊断和治疗。先前的研究表明，对鼻腔通畅的感觉可能涉及通过凉爽的吸气气流来激活鼻腔三叉神经。我们尝试根据这种现象得出临床上相关的变量。研究设计预期的健康队列。方法采用视觉模拟量表，然后通过鼻压力计，声学鼻湿度计和丁醇偏侧阈值（BLT），对22名健康受试者在受控室内空气中的单侧鼻腔通畅进行评估。然后，每个受试者立即进行计算机断层扫描，以建立实时计算流体动力学（CFD）鼻气道模型，该模型用于模拟稳定的静息呼吸过程中鼻粘膜的热损失。结果在所有测量和计算的变量中，只有CFD模拟的鼻前庭后部的峰值热量流失与通畅率显着相关（r = -0.46，P <.01）。线性判别分析预测通畅性类别的成功率为89％，而BLT和鼻压鼻阻力是另外两个重要变量。作为验证，CFD模拟的鼻阻力与鼻压力计测得的阻力显着相关（r = 0.41，P <.01）。结论这些结果表明，我们的鼻子通过涉及局部峰值鼻粘膜冷却的机制来感知通畅。该分析为将个性化CFD与其他客观和神经学措施相结合提供了强有力的理由，从而创建了一种新颖的临床工具来诊断鼻塞，预测和评估治疗效果。

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