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首页> 外文期刊>American journal of rhinology & allergy >Partial Preservation of the Inferior Turbinate in Endoscopic Medial Maxillectomy: A Computational Fluid Dynamics Study
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Partial Preservation of the Inferior Turbinate in Endoscopic Medial Maxillectomy: A Computational Fluid Dynamics Study

机译：内窥镜内镜颌骨切除术中次鼻甲的部分保存：计算流体动力学研究

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Background Endoscopic medial maxillectomy (EMM) is a workhorse for multiple sinonasal conditions. To reduce its burden on the sinonasal physiology, several modified EMM (M-EMM) have been proposed. Objective: In order to provide a theoretical basis for EMM and its modifications, this study introduces a computational fluid dynamics (CFD) model, based on a time-resolved direct numerical simulation, describing EMM and assessing the role of the M-EMM in preserving the overall fluid dynamics of the sinonasal cavities. Methods A normal sinonasal CT scan was converted into a geometrical model and used as a reference; 2 anatomies were then created by virtual surgery, mimicking EMM and M-EMM, with the latter sparing the anterior portion of inferior turbinate and medial maxillary sinus wall. The airflow was simulated in the models via the OpenFOAM CFD software and compared in terms of flow rate, mean and fluctuating velocity, vorticity, and turbulent structures. Results The analysis shows that EMM induces a massive flow rate increase in the operated side, which becomes less obvious in the M-EMM model. In contrast to M-EMM, EMM induces higher velocity fields that reach the maxillary sinus. Velocity and vorticity fluctuations are negligible in the baseline model, but become increasingly evident and widespread in the M-EMM and EMM models. Conclusions A significant disruption of the nasal fluid dynamics is observed in EMM, while M-EMM minimizes variations and reduces interference with nasal air conditioning. Our analysis provides insights into the pathophysiology of radical sinus surgery and provides a theoretical basis for the ability of M-EMM to reduce the temporary surgery-related changes on both healthy and operated sides.
机译：背景技术内窥镜内窥镜内颌骨菌切除术（EMM）是用于多个Sinonasal条件的主力。为减少对Sinonasal生理学的负担，提出了几种修改的EMM（M-EMM）。目的：为了为EMM提供理论依据及其修改，本研究介绍了基于时间解决的直接数值模拟的计算流体动力学（CFD）模型，描述了EMM并评估了M-EMM在保存中的作用Sinonasal腔的整体流体动力学。方法将正常的Sinonasal CT扫描转换成几何模型并用作参考;然后通过虚拟手术，模仿EMM和M-EMM来创建2个解剖，后者施加下鼻甲和内侧上颌窦壁的前部。通过OpenFoam CFD软件在模型中模拟了气流，并在流速，平均值和波动速度，涡流和湍流结构方面进行比较。结果分析表明，EMM在M-EMM模型中诱导操作侧的大量流量增加，这在M-EMM模型中变得不那么明显。与M-EMM相比，EMM诱导到达上颌窦的更高速度场。基线模型中的速度和涡流波动可忽略不计，但在M-EMM和EMM模型中越来越明显和广泛普及。结论在EMM中观察到鼻流体动力学的显着破坏，而M-EMM最小化变化并减少对鼻空调的干扰。我们的分析提供了激进窦手术的病理生理学的见解，为M-EMM减少健康和经营方面的临时手术相关变化提供了理论依据。

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