Characterization of nasal aerodynamics and air conditioning ability using CFD and its application to improve the empty nose syndrome (ENS) submucosal floor implant surgery–Part II virtual surgery

Background: Informative virtual surgeries provide useful insights for surgical options to patients. In the case of evaluating surgical treatments for the empty nose syndrome (ENS), reliable CFD virtual surgery is a predictive tool for symptom improvement. Methods: Five submucosal implant surgeries with two different implant volumes and three different implant sites were performed on the diseased side of an ENS patient. In each case, a post-surgery nasal cavity was created based on ENS patient's computed tomography images. The airflow and air-conditioning abilities of these nasal surgery models were computed to examine the effects of implant size and site on the surgical outcomes. Significant findings: The largest improvements were achieved with the larger submucosal implant size at the lateral site. Airflow was redistributed into the inferior and superior meatuses, enhancing air interactions with the nasal mucus. The increased wall shear stress enhanced mucus secretion and sensation of airflow. The reduced vortex size alleviated the paradoxical nasal obstruction feeling. The results suggested that larger implant sizes and the lateral implant site would be advisable for submucosal implant surgeries on ENS patients. Inferior implant with a smaller size being a second advisable approach in terms of heating and humidification efficiencies.