Tirth R Patel1, Chengyu Li2, Jillian Krebs3, Kai Zhao4, Prashant Malhotra5. 1. College of Medicine, The Ohio State University, 370 West 9th Avenue, Columbus, OH 43210, USA. Electronic address: tirth.patel@osumc.edu. 2. Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, 915 Olentangy River Road Suite 4000, Columbus, OH 43212, USA. Electronic address: chengyu.li@osumc.edu. 3. Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, 915 Olentangy River Road Suite 4000, Columbus, OH 43212, USA. 4. Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, 915 Olentangy River Road Suite 4000, Columbus, OH 43212, USA. Electronic address: kai.zhao@osumc.edu. 5. Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, 915 Olentangy River Road Suite 4000, Columbus, OH 43212, USA; Department of Otolaryngology, Nationwide Children's Hospital, 700 Children's Drive, Columbus, OH 43205, USA. Electronic address: prashant.malhotra@nationwidechildrens.org.
Abstract
OBJECTIVES: Congenital nasal pyriform aperture stenosis (CNPAS) is a rare cause of airway obstruction in the neonate. Computational airway modeling has not been done in neonates and young infants to understand the impact of stenosis on functional nasal airflow. In this study, we 1) applied computational fluid dynamics (CFD) model to the airway of a neonate with CNPAS and 2) compare airflow dynamics of a normal and CNPAS airway. METHODS: Three-dimensional models of the nasal airway of a normal neonate and a neonate with CNPAS were created using computed tomography scans of the facial bones. Measured anatomic parameters included volume, surface area, and cross-sectional area. CFD simulation was then performed. Simulated flow parameters included pressure, average velocity, and resistance. RESULTS: The neonate with CNPAS had a lesser volume (2.74 cm3 vs. 4.50 cm3) and surface area (18.8 cm2 vs. 45.5 cm2) than the normal airway. The CNPAS airway had a lesser bilateral cross-sectional area and average cross-sectional velocity throughout the length of the model. While there is a large pressure drop in the normal airway immediately after the entry point, the pressure drop in the CNPAS airway occurs more posteriorly. The total nasal resistance was approximately eight-fold greater in the CNPAS airway than the normal. CONCLUSIONS: CFD analysis can be performed on airways of neonates with nasal obstruction, such as in CNPAS. A CFD model may help characterize severity of airway obstruction as it can predict the three-dimensional pattern of airflow. Determining the role of CFD in clinical management of CNPAS requires further investigation.
OBJECTIVES:Congenital nasal pyriform aperture stenosis (CNPAS) is a rare cause of airway obstruction in the neonate. Computational airway modeling has not been done in neonates and young infants to understand the impact of stenosis on functional nasal airflow. In this study, we 1) applied computational fluid dynamics (CFD) model to the airway of a neonate with CNPAS and 2) compare airflow dynamics of a normal and CNPAS airway. METHODS: Three-dimensional models of the nasal airway of a normal neonate and a neonate with CNPAS were created using computed tomography scans of the facial bones. Measured anatomic parameters included volume, surface area, and cross-sectional area. CFD simulation was then performed. Simulated flow parameters included pressure, average velocity, and resistance. RESULTS: The neonate with CNPAS had a lesser volume (2.74 cm3 vs. 4.50 cm3) and surface area (18.8 cm2 vs. 45.5 cm2) than the normal airway. The CNPAS airway had a lesser bilateral cross-sectional area and average cross-sectional velocity throughout the length of the model. While there is a large pressure drop in the normal airway immediately after the entry point, the pressure drop in the CNPAS airway occurs more posteriorly. The total nasal resistance was approximately eight-fold greater in the CNPAS airway than the normal. CONCLUSIONS:CFD analysis can be performed on airways of neonates with nasal obstruction, such as in CNPAS. A CFD model may help characterize severity of airway obstruction as it can predict the three-dimensional pattern of airflow. Determining the role of CFD in clinical management of CNPAS requires further investigation.
Authors: Haiyan Luo; Sanghun Sin; Joseph M McDonough; Carmen R Isasi; Raanan Arens; David M Wootton Journal: J Biomech Date: 2014-03-24 Impact factor: 2.712
Authors: W M Faizal; N N N Ghazali; C Y Khor; Irfan Anjum Badruddin; M Z Zainon; Aznijar Ahmad Yazid; Norliza Binti Ibrahim; Roziana Mohd Razi Journal: Comput Methods Programs Biomed Date: 2020-06-26 Impact factor: 5.428