Effect of septoplasty or in combination with out fracture of the inferior turbinate on the airflow field and nasal airway / 中华耳鼻咽喉头颈外科杂志

ABSTRACT

<p><b>OBJECTIVE</b>To explore the effect of septoplasty or in combination with out fracture of the inferior turbinate in patients with nasal septum deviation on the airflow field and the nasal airway structure.</p><p><b>METHODS</b>Six patients with nasal septum deviation underwent spiral CT imaging scans before surgery and during the follow-up. The 3D finite element meshes of the nasal airway were developed from the above CT scans. Given three preconditions, the nasal airflow fields were described by the Navier-Stokes and continuity equations at the inspiratory flow rate of 12 L/min. The whole airflow patterns were obtained and then compared with the airflow filed and airway structure changes before and after surgery. SPSS 12.0 software was used to analyze the data.</p><p><b>RESULTS</b>Before surgery, area of the common airway and the middle and ventral medial regions in the concave side were (1.61 ± 0.18), (0.40 ± 0.10), (0.40 ± 0.14) cm(2) respectively, and those of convex side were (1.30 ± 0.18), (0.33 ± 0.05), (0.36 ± 0.10) cm(2) respectively. The differences between both sides were of no statistical significance (Z value was 1.782, 1.363, 0.526 respectively, all P > 0.05). Airflow of the above airways were (361 ± 68), (131 ± 25), (100 ± 28) ml respectively in concave side and (178 ± 33), (59 ± 26), (59 ± 18) ml respectively in convex side, which differences were significant statistically (Z value were 2.207, 2.201, 2.201 respectively, all P < 0.05). The inferior turbinate in concave side [(0.93 ± 0.10) cm] was statistically (Z = 2.214, P < 0.05) bigger than that in convex side [(0.58 ± 0.12) cm] before surgery. The airflow fields were in disorder in both ill-airways. After surgery, area of the common airway was (2.55 ± 0.44) cm(2) in concave side and (2.20 ± 0.72) cm(2) in convex side respectively, and area of the middle and ventral medial regions in the convex side were (0.58 ± 0.13), (0.81 ± 0.26) cm(2) respectively, which differences were of significance statistically when comparing to areas before surgery (Z value were 2.201, 2.201, 2.201, 2.201, P < 0.05). The airflow passed through nasal airway orderly in both sides. But the thickness of inferior turbinate was (0.73 ± 0.08) cm in concave side after surgery, which difference was significant statistically in comparison to that before surgery (Z = 2.264, P < 0.05). Consequently, nasal resistance decreased from (0.41 ± 0.03) kPa×L(-1)×s(-1) to (0.16 ± 0.01) kPa×L(-1)×s(-1) after surgery, the difference was significantly (Z = -2.207, P = 0.027).</p><p><b>CONCLUSION</b>Septoplasty or in combination with out fracture of the inferior turbinate, followed by the self-adaptation consecutively, could improve the airway and breathing capacity of the nose.</p>