E Moreddu1, L Meister2, C Philip-Alliez2, J-M Triglia3, M Medale2, R Nicollas4. 1. IUSTI, UMR 7343, CNRS, Aix-Marseille university, 13005 Marseille, France; Department of pediatric otolaryngology, Aix-Marseille university, La Timone Children's hospital, 13005 Marseille, France. Electronic address: eric.moreddu@ap-hm.fr. 2. IUSTI, UMR 7343, CNRS, Aix-Marseille university, 13005 Marseille, France. 3. Department of pediatric otolaryngology, Aix-Marseille university, La Timone Children's hospital, 13005 Marseille, France. 4. IUSTI, UMR 7343, CNRS, Aix-Marseille university, 13005 Marseille, France; Department of pediatric otolaryngology, Aix-Marseille university, La Timone Children's hospital, 13005 Marseille, France.
Abstract
OBJECTIVES: Nasal obstruction is a highly subjective symptom. It can be evaluated by combining clinical examination, imaging and functional measurements such as active anterior rhinomanometry (AAR). In pediatrics, AAR is often impossible because it requires the participation of the child. Airflow modeling by Computational Fluid Dynamics (CFD) has been developed since the early 1990s, mostly in adults. This study is the first to describe a methodology of "numerical rhinomanometry" in children using CFD and to evaluate the feasibility and the clinical interest of this new tool. MATERIALS AND METHODS: Five children aged from 8 to 15 years, complaining of nasal obstruction, underwent routine management including clinical evaluation, AAR, and CT-scanning. CT acquisitions were used for CFD calculations and numerical rhinomanometry. RESULTS AND CONCLUSIONS: In the 5 children, the results of CFD were concordant with clinical complaints and examination. In 3 children, AAR and CFD were concordant. In one patient, CFD corrected the results of AAR. In one patient, AAR was not feasible, unlike CFD, which contributed to diagnosis. This study highlighted the feasibility of CFD in children and that it can support or refute diagnosis of nasal obstruction with good reliability. These results indicate that CFD modeling could be widely used for functional exploration in pediatric rhinology.
OBJECTIVES:Nasal obstruction is a highly subjective symptom. It can be evaluated by combining clinical examination, imaging and functional measurements such as active anterior rhinomanometry (AAR). In pediatrics, AAR is often impossible because it requires the participation of the child. Airflow modeling by Computational Fluid Dynamics (CFD) has been developed since the early 1990s, mostly in adults. This study is the first to describe a methodology of "numerical rhinomanometry" in children using CFD and to evaluate the feasibility and the clinical interest of this new tool. MATERIALS AND METHODS: Five children aged from 8 to 15 years, complaining of nasal obstruction, underwent routine management including clinical evaluation, AAR, and CT-scanning. CT acquisitions were used for CFD calculations and numerical rhinomanometry. RESULTS AND CONCLUSIONS: In the 5 children, the results of CFD were concordant with clinical complaints and examination. In 3 children, AAR and CFD were concordant. In one patient, CFD corrected the results of AAR. In one patient, AAR was not feasible, unlike CFD, which contributed to diagnosis. This study highlighted the feasibility of CFD in children and that it can support or refute diagnosis of nasal obstruction with good reliability. These results indicate that CFD modeling could be widely used for functional exploration in pediatric rhinology.
Authors: Eric Moreddu; Lionel Meister; Alexia Dabadie; Jean-Michel Triglia; Marc Médale; Richard Nicollas Journal: Med Biol Eng Comput Date: 2019-12-17 Impact factor: 2.602
Authors: Hans J Welkoborsky; Christina Rose-Diekmann; Anja Pähler Vor der Holte; Hagen Ott Journal: Eur Arch Otorhinolaryngol Date: 2022-01-18 Impact factor: 2.503