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Quantification of airflow in the sinuses following functional endoscopic sinus surgery.
Rhinology. 2020 Jun 01; 58(3):257-265.R

Abstract

BACKGROUND

Despite functional endoscopic sinus surgery (FESS) being the standard of care in medically recalcitrant chronic rhinosinusitis (CRS), its effect on sinus ventilation has not been fully characterized. Airflow simulations can help improve our understanding of how surgical strategies affect post-surgical sinus ventilation.

METHODS

Eight postoperative sinonasal cavity models were reconstructed from a wide spectrum of CRS patients who had undergone FESS. Computational fluid dynamics modeling of steady-state, laminar, inspiratory airflow was performed. Ventilation was quantified and observed for all the sinuses in each model.

RESULTS

Sinus aeration was enhanced following FESS, particularly in the maxillary and ethmoid sinuses. The degree of improvement was related to the extent of surgery performed. This finding was accentuated at a higher inhalational flow rate of 15L/min. The relationship between ostium size and corresponding sinus inflow was stronger for the maxillary and sphenoid sinuses. Maxillary inflow reached 50% in a mega-antrostomy patient, while negligible flow occurred in the frontal sinuses for except one whom had undergone a modified Lothrop procedure.

CONCLUSIONS

This study has quantified sinus airflow in the largest set of post-FESS patients to date, to show that with increasing extensive surgery, the sinus and nasal cavity become more interconnected and functionally interdependent. Accordingly, sinus ventilation is improved. This may have important consequences for pre- and post-surgical assessment and planning, and on predicting how drug delivery treatments and devices can be designed to target the postoperative sinuses.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Siu J
Department of Surgery, The University of Auckland, Auckland, New Zealand.
Dong J
School of Engineering, RMIT University, Melbourne, Australia.
Inthavong K
School of Engineering, RMIT University, Melbourne, Australia.
Shang Y
School of Engineering, RMIT University, Melbourne, Australia.
Douglas RG
Department of Surgery, The University of Auckland, Auckland, New Zealand.

MeSH

Chronic DiseaseComputer SimulationEndoscopyHumansNasal CavityParanasal SinusesSinusitis

Pub Type(s)

Journal Article

Language

eng

PubMed ID

32238994

Citation

Siu, J, et al. "Quantification of Airflow in the Sinuses Following Functional Endoscopic Sinus Surgery." Rhinology, vol. 58, no. 3, 2020, pp. 257-265.
Siu J, Dong J, Inthavong K, et al. Quantification of airflow in the sinuses following functional endoscopic sinus surgery. Rhinology. 2020;58(3):257-265.
Siu, J., Dong, J., Inthavong, K., Shang, Y., & Douglas, R. G. (2020). Quantification of airflow in the sinuses following functional endoscopic sinus surgery. Rhinology, 58(3), 257-265. https://doi.org/10.4193/Rhin19.387
Siu J, et al. Quantification of Airflow in the Sinuses Following Functional Endoscopic Sinus Surgery. Rhinology. 2020 Jun 1;58(3):257-265. PubMed PMID: 32238994.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Quantification of airflow in the sinuses following functional endoscopic sinus surgery. AU - Siu,J, AU - Dong,J, AU - Inthavong,K, AU - Shang,Y, AU - Douglas,R G, PY - 2020/4/3/pubmed PY - 2020/10/28/medline PY - 2020/4/3/entrez SP - 257 EP - 265 JF - Rhinology JO - Rhinology VL - 58 IS - 3 N2 - BACKGROUND: Despite functional endoscopic sinus surgery (FESS) being the standard of care in medically recalcitrant chronic rhinosinusitis (CRS), its effect on sinus ventilation has not been fully characterized. Airflow simulations can help improve our understanding of how surgical strategies affect post-surgical sinus ventilation. METHODS: Eight postoperative sinonasal cavity models were reconstructed from a wide spectrum of CRS patients who had undergone FESS. Computational fluid dynamics modeling of steady-state, laminar, inspiratory airflow was performed. Ventilation was quantified and observed for all the sinuses in each model. RESULTS: Sinus aeration was enhanced following FESS, particularly in the maxillary and ethmoid sinuses. The degree of improvement was related to the extent of surgery performed. This finding was accentuated at a higher inhalational flow rate of 15L/min. The relationship between ostium size and corresponding sinus inflow was stronger for the maxillary and sphenoid sinuses. Maxillary inflow reached 50% in a mega-antrostomy patient, while negligible flow occurred in the frontal sinuses for except one whom had undergone a modified Lothrop procedure. CONCLUSIONS: This study has quantified sinus airflow in the largest set of post-FESS patients to date, to show that with increasing extensive surgery, the sinus and nasal cavity become more interconnected and functionally interdependent. Accordingly, sinus ventilation is improved. This may have important consequences for pre- and post-surgical assessment and planning, and on predicting how drug delivery treatments and devices can be designed to target the postoperative sinuses. SN - 0300-0729 UR - https://www.unboundmedicine.com/medline/citation/32238994/Quantification_of_airflow_in_the_sinuses_following_functional_endoscopic_sinus_surgery_ DB - PRIME DP - Unbound Medicine ER -