Nasal Septal Perforations: A Computational Fluid Dynamics Comparison of Symptomatic and Asymptomatic Patients

نویسندگان

1 Department of Otorhinolaryngology, Lisbon Central University Hospital, Lisbon, Portugal

2 Department of Mechanical Engineering, University of Oporto, Oporto, Portugal

3 Department of Otorhinolaryngology, Lisbon Central University Hospital, Lisbon, Portugal

4 Department of Otorhinolaryngology, Lisbon Central University Hospital, Lisbon, Portugal

doi
10.22037/orlfps.v10i1.46113
چکیده

Background: Computational fluid dynamics (CFD) technology has emerged as a valuable tool for studying nasal physiology. Aim: The objective of this study was to establish a CFD analysis comparing patients with asymptomatic and symptomatic nasal septal perforations (NSP). Methods: We applied CFD technology to examine the nasal airflow differences between 10 asymptomatic and 10 symptomatic NSP adult patients. Questionnaires (22-item Sino-Nasal Outcome Test and Nasal Obstruction Symptom Evaluation) were obtained to confirm patients' symptoms. Results: The asymptomatic NSP group consisted of 4 males and 6 females with a mean age of 46.2 years. The symptomatic group consisted of 5 males and 5 females with a mean age of 42.1 years. The NSP etiology was before nasal surgery in most of the patients (11 cases, 55%). NSPs were considered idiopathic in 3 cases (15%). No statistically significant differences were found between groups regarding sex, age, or etiology of perforation. No statistical differences were found in perforation shape, location, axial diameters, area, nasal resistance, or volumetric flow rate shunting across the perforation between asymptomatic and symptomatic patients. Symptomatic patients had higher wall shear stress along the posterior perforation margins, although the difference was not statistically significant.  Conclusion: NSP altered the physiology of the nasal cavity both in symptomatic and asymptomatic patients. High wall shear stress in posterior perforation regions may explain the crusting most commonly found on posterior NSP margins.