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Computational Analysis of the Mature Unilateral Cleft Lip Nasal Deformity on Nasal Patency
BACKGROUND: Nasal airway obstruction (NAO) due to nasal anatomic deformities is known to be more common among cleft patients than the general population, yet information is lacking regarding severity and variability of cleft-associated nasal obstruction relative to other conditions causing NAO. This...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Wolters Kluwer Health
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6571342/ https://www.ncbi.nlm.nih.gov/pubmed/31333968 http://dx.doi.org/10.1097/GOX.0000000000002244 |
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author | Frank-Ito, Dennis O. Carpenter, David J. Cheng, Tracy Avashia, Yash J. Brown, David A. Glener, Adam Allori, Alexander Marcus, Jeffrey R. |
author_facet | Frank-Ito, Dennis O. Carpenter, David J. Cheng, Tracy Avashia, Yash J. Brown, David A. Glener, Adam Allori, Alexander Marcus, Jeffrey R. |
author_sort | Frank-Ito, Dennis O. |
collection | PubMed |
description | BACKGROUND: Nasal airway obstruction (NAO) due to nasal anatomic deformities is known to be more common among cleft patients than the general population, yet information is lacking regarding severity and variability of cleft-associated nasal obstruction relative to other conditions causing NAO. This preliminary study compares differences in NAO experienced by unilateral cleft lip nasal deformity (uCLND) subjects with noncleft subjects experiencing NAO. METHODS: Computational modeling techniques based on patient-specific computed tomography images were used to quantify the nasal airway anatomy and airflow dynamics in 21 subjects: 5 healthy normal subjects; 8 noncleft NAO subjects; and 8 uCLND subjects. Outcomes reported include Nasal Obstruction Symptom Evaluation (NOSE) scores, cross-sectional area, and nasal resistance. RESULTS: uCLND subjects had significantly larger cross-sectional area differences between the left and right nasal cavities at multiple cross sections compared with normal and NAO subjects. Median and interquartile range (IQR) NOSE scores between NAO and uCLND were 75 (IQR = 22.5) and 67.5 (IQR = 30), respectively. Airflow partition difference between both cavities were: median = 9.4%, IQR = 10.9% (normal); median = 31.9%, IQR = 25.0% (NAO); and median = 29.9%, IQR = 44.1% (uCLND). Median nasal resistance difference between left and right nasal cavities were 0.01 pa.s/ml (IQR = 0.03 pa.s/ml) for normal, 0.09 pa.s/ml (IQR = 0.16 pa.s/ml) for NAO and 0.08 pa.s/ml (IQR = 0.25 pa.s/ml) for uCLND subjects. CONCLUSIONS: uCLND subjects demonstrated significant asymmetry between both sides of the nasal cavity. Furthermore, there exists substantial disproportionality in flow partition difference and resistance difference between cleft and noncleft sides among uCLND subjects, suggesting that both sides may be dysfunctional. |
format | Online Article Text |
id | pubmed-6571342 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Wolters Kluwer Health |
record_format | MEDLINE/PubMed |
spelling | pubmed-65713422019-07-22 Computational Analysis of the Mature Unilateral Cleft Lip Nasal Deformity on Nasal Patency Frank-Ito, Dennis O. Carpenter, David J. Cheng, Tracy Avashia, Yash J. Brown, David A. Glener, Adam Allori, Alexander Marcus, Jeffrey R. Plast Reconstr Surg Glob Open Original Article BACKGROUND: Nasal airway obstruction (NAO) due to nasal anatomic deformities is known to be more common among cleft patients than the general population, yet information is lacking regarding severity and variability of cleft-associated nasal obstruction relative to other conditions causing NAO. This preliminary study compares differences in NAO experienced by unilateral cleft lip nasal deformity (uCLND) subjects with noncleft subjects experiencing NAO. METHODS: Computational modeling techniques based on patient-specific computed tomography images were used to quantify the nasal airway anatomy and airflow dynamics in 21 subjects: 5 healthy normal subjects; 8 noncleft NAO subjects; and 8 uCLND subjects. Outcomes reported include Nasal Obstruction Symptom Evaluation (NOSE) scores, cross-sectional area, and nasal resistance. RESULTS: uCLND subjects had significantly larger cross-sectional area differences between the left and right nasal cavities at multiple cross sections compared with normal and NAO subjects. Median and interquartile range (IQR) NOSE scores between NAO and uCLND were 75 (IQR = 22.5) and 67.5 (IQR = 30), respectively. Airflow partition difference between both cavities were: median = 9.4%, IQR = 10.9% (normal); median = 31.9%, IQR = 25.0% (NAO); and median = 29.9%, IQR = 44.1% (uCLND). Median nasal resistance difference between left and right nasal cavities were 0.01 pa.s/ml (IQR = 0.03 pa.s/ml) for normal, 0.09 pa.s/ml (IQR = 0.16 pa.s/ml) for NAO and 0.08 pa.s/ml (IQR = 0.25 pa.s/ml) for uCLND subjects. CONCLUSIONS: uCLND subjects demonstrated significant asymmetry between both sides of the nasal cavity. Furthermore, there exists substantial disproportionality in flow partition difference and resistance difference between cleft and noncleft sides among uCLND subjects, suggesting that both sides may be dysfunctional. Wolters Kluwer Health 2019-05-16 /pmc/articles/PMC6571342/ /pubmed/31333968 http://dx.doi.org/10.1097/GOX.0000000000002244 Text en Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of The American Society of Plastic Surgeons. This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND) (http://creativecommons.org/licenses/by-nc-nd/4.0/) , where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. |
spellingShingle | Original Article Frank-Ito, Dennis O. Carpenter, David J. Cheng, Tracy Avashia, Yash J. Brown, David A. Glener, Adam Allori, Alexander Marcus, Jeffrey R. Computational Analysis of the Mature Unilateral Cleft Lip Nasal Deformity on Nasal Patency |
title | Computational Analysis of the Mature Unilateral Cleft Lip Nasal Deformity on Nasal Patency |
title_full | Computational Analysis of the Mature Unilateral Cleft Lip Nasal Deformity on Nasal Patency |
title_fullStr | Computational Analysis of the Mature Unilateral Cleft Lip Nasal Deformity on Nasal Patency |
title_full_unstemmed | Computational Analysis of the Mature Unilateral Cleft Lip Nasal Deformity on Nasal Patency |
title_short | Computational Analysis of the Mature Unilateral Cleft Lip Nasal Deformity on Nasal Patency |
title_sort | computational analysis of the mature unilateral cleft lip nasal deformity on nasal patency |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6571342/ https://www.ncbi.nlm.nih.gov/pubmed/31333968 http://dx.doi.org/10.1097/GOX.0000000000002244 |
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