Guilherme J. M. Garcia,Neil Bailie ,Dário A. Martins, and Julia S. Kimbell.
The Hamner Institutes for Health Sciences, Research Triangle Park, North Carolina;Queens University, Belfast,United Kingdom; and Hospital Santa Casa, Belo Horizonte, MG, Brazil.
Garcia GJ, Bailie N, Martins DA, Kimbell JS. Atrophicrhinitis: a CFD study of air conditioning in the nasal cavity.JAppl Physiol103: 1082–1092, 2007. First published June 14, 2007;doi:10.1152/japplphysiol.01118.2006.—Atrophic rhinitis is a chronicdisease of the nasal mucosa.
The disease is characterized by abnor-mally wide nasal cavities, and its main symptoms are dryness, crust-ing, atrophy, fetor, and a paradoxical sensation of nasal congestion.The etiology of the disease remains unknown. Here, we propose thatexcessive evaporation of the mucous layer is the basis for the relent-less nature of this disease. Airflow and water and heat transport weresimulated using computational fluid dynamics (CFD) techniques. Thenasal geometry of an atrophic rhinitis patient was acquired fromcomputed tomography scans before and after a procedure to narrowthe nasal cavity. Simulations of air conditioning in the atrophic nosewere compared with similar computations performed within the nasalgeometries of four healthy humans. The excessively wide cavity of thepatient generated abnormal flow patterns, which led to abnormalpatterns of water fluxes across the wall. Geometrically, the atrophicnose had a much lower surface area than the healthy nasal passages,which increased water fluxes per unit area. Nevertheless, the simula-tions indicated that the atrophic nose did not condition inspired air aseffectively as the healthy geometries. These simulations of watertransport in the nasal cavity are consistent with the hypothesis thatexcessive evaporation of mucus plays a key role in the pathophysiol-ogy of atrophic rhinitis. We conclude that the main goals of a surgeryto treat atrophic rhinitis should be1) to restore the original surfacearea of the nose,2) to restore the physiological airflow distribution,and3) to create symmetric cavities.
nasal physiology; empty nose syndrome; ozena; computational fluiddynamics simulations; human nose; nasal epithelium
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