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The relationship between nasal resistance to airflow and the airspace minimal cross-sectional area

机译：鼻对气流的阻力与空域最小横截面积之间的关系

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The relationship between nasal resistance (R) and airspace minimal cross-sectional area (mCSA) remains unclear. After the introduction of acoustic rhinometry, many otolaryngologists believed that mCSA measurements would correlate with subjective perception of nasal airway obstruction (NAO), and thus could provide an objective measure of nasal patency to guide therapy. However, multiple studies reported a low correlation between mCSA and subjective nasal patency, and between mCSA and R. This apparent lack of correlation between nasal form and function has been a long-standing enigma in the field of rhinology. Here we propose that nasal resistance is described by the Bernoulli Obstruction Theory. This theory predicts two flow regimes. For mCSA > A(crit), the constriction is not too severe and there is not a tight coupling between R and mCSA. In contrast, when mCSA < A(crit), nasal resistance is dominated by the severe constriction and it is predicted to be inversely proportional to the minimal cross-sectional area (R proportional to mCSA(-1)). To test this hypothesis, computational fluid dynamics (CFD) simulations were run in 3-dimensional models based on computed tomography scans of 15 NAO patients pre- and post-surgery (i.e., 60 unilateral nasal cavities). Airspace cross-sectional areas were quantified perpendicular to airflow streamlines. Our computational results are consistent with the theory. Given that in most people mCSA > A(crit) (estimated to be 0.37 cm(2)), this theory suggests that airway constrictions are rarely an exclusive contributor to nasal resistance, which may explain the weak correlation between mCSA and subjective nasal patency. (C) 2016 Elsevier Ltd. All rights reserved.
机译：鼻阻力（R）与空域最小横截面积（mCSA）之间的关系仍不清楚。引入声学鼻部测量法后，许多耳鼻喉科医生认为mCSA的测量值与鼻气道阻塞（NAO）的主观感觉相关，因此可以提供客观的鼻腔通畅性测量值来指导治疗。但是，多项研究报告说，mCSA与主观鼻腔通畅之间以及mCSA和R之间的相关性较低。这种鼻腔形式与功能之间的明显缺乏相关性一直是鼻科领域的一个长期谜团。在这里，我们建议用伯努利阻塞理论描述鼻阻力。该理论预测了两种流动状态。对于mCSA> A（暴击），收缩不太严重，R和mCSA之间没有紧密的耦合。相反，当mCSA A（暴击）（估计为0.37 cm（2）），该理论表明，气道收缩很少是引起鼻阻力的唯一原因，这可以解释mCSA与主观鼻腔通畅之间的弱相关性。 （C）2016 Elsevier Ltd.保留所有权利。

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