Affiliation:
1. Department of Head and Neck Surgery & Communication Sciences Duke University Medical Center Durham North Carolina U.S.A.
2. Icahn School of Medicine at Mount Sinai New York New York U.S.A.
3. Department of Otolaryngology/Head & Neck Surgery University of North Carolina‐Chapel Hill Chapel Hill North Carolina U.S.A.
4. Computational Biology & Bioinformatics PhD Program Duke University Durham North Carolina U.S.A.
5. Department of Mechanical Engineering and Materials Science Duke University Durham North Carolina U.S.A.
Abstract
ObjectivesMany individuals with healthy normal nasal anatomy and function exhibit a prominent notch indentation at the junction of the ala and sidewall, specifically around the anterior–superior region of the unilateral nasal vestibule up to the internal nasal valve. This study evaluates the influence of various sizes of notched indentations at the anterior nasal airway on local airflow pattern.MethodsA retrospective study involving 25 healthy individuals, each exhibiting at least one unilateral notched indentation (40 total airways). Each individual's notched indentation was quantified after subject‐specific three‐dimensional nasal airway reconstruction from radiographic images. Computational fluid dynamics modeling was used to simulate nasal inspiratory airflow in each nasal airway at 15 L/min. Localized airflow distributions passing through the inferior, middle, and superior regions were calculated at 15 cross sections.ResultsNotched indentation size ranged 1.75–86.84 mm2 (average = 22.37 mm2). At the anterior airway, notched size significantly correlated with inferior airflow volume (R = 0.32, p = 0.04) but not in the middle (R = 0.21, p = 0.20) or superior (R = 0.06, p = 0.70) regions, whereas middle and superior regional resistance values were significantly correlated with notched size (middle: R = 0.54, p < 0.001; superior: R = 0.41, p = 0.009). Medially, resistance at the middle region significantly correlated with notched size (R = 0.56, p < 0.001). At the posterior airway, airflow distributions through the inferior, middle, and superior regions demonstrated weak correlation with notched size (inferior: R = 0.24, p = 0.14, middle: R = 0.24, p = 0.13; superior:R = 0.03, p = 0.83), whereas resistance was significantly correlated in the middle and inferior regions (middle: R = 0.56, p < 0.001;inferior: R = 0.43, p = 0.006).ConclusionsAnterior nasal airway notched indentation size had significantly stronger influence on localized airflow volume through the anterior–inferior airway than other regions of the nasal passage.Level of EvidenceN/A Laryngoscope, 2024
Funder
National Institute of Dental and Craniofacial Research