Towards More Personalized Nasal Surgery

A preliminary study suggests that virtual nasal surgery may enable surgeons to perform personalized treatment of nasal obstruction using computer simulation techniques.

Researchers at the Medical College of Wisconsin (Milwaukee, USA) and the University of North Carolina (Chapel Hill, USA) prepared presurgery computed tomographic (CT) scans of a patient scheduled for septoplasty and right inferior turbinate reduction (ITR); the scans were used to generate three-dimensional (3D) models of the nasal airway. Prior to obtaining a postsurgery scan, the presurgery model was digitally altered to generate three virtual surgery models; right ITR only; septoplasty only; and septoplasty with right ITR. The results of the virtual surgery computational fluid dynamics (CFD) analyses were compared with actual postsurgical CFD outcome measures including nasal resistance, unilateral airflow allocation, and regional airflow distribution.

The results of the postsurgery CFD analysis and all virtual surgery models predicted similar reductions in overall nasal resistance, as well as more balanced airflow distribution between sides, primarily in the middle region, when compared with the presurgery state. In contrast, virtual ITR alone produced little change in either nasal resistance or regional airflow allocation. The study was published in the September 2011 issue of Archives of Facial Plastic Surgery.

"The CFD calculations of overall nasal resistance for the combined virtual septoplasty with ITR model correlated well with the actual postsurgery calculations,” concluded lead author John Rhee, MD, MPH, of the Medical College of Wisconsin. "As we look to the future, the hope is that this technology can be more routinely used day to day in the armamentarium of otolaryngologists and facial plastic surgeons.”

CFD is a branch of fluid mechanics that uses numerical methods and algorithms to solve and analyze problems that involve fluid flow, by solving governing partial differential equations or other mathematical equations of motion. Computers are used to perform the calculations required to simulate the interaction of liquids and gases with surfaces defined by boundary conditions; with high-speed supercomputers, better solutions can be achieved.

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Medical College of Wisconsin
University of North Carolina