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. Thi...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer
2019-05-01
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| Series: | Plastic and Reconstructive Surgery, Global Open |
| Online Access: | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000002244 |
| _version_ | 1818886433670168576 |
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| author | Dennis O. Frank-Ito, PhD David J. Carpenter, BS, MHS Tracy Cheng, AB Yash J. Avashia, MD David A. Brown, MD, PhD Adam Glener, MD Alexander Allori, MD, MPH Jeffrey R. Marcus, MD |
| author_facet | Dennis O. Frank-Ito, PhD David J. Carpenter, BS, MHS Tracy Cheng, AB Yash J. Avashia, MD David A. Brown, MD, PhD Adam Glener, MD Alexander Allori, MD, MPH Jeffrey R. Marcus, MD |
| author_sort | Dennis O. Frank-Ito, PhD |
| collection | DOAJ |
| 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. |
| first_indexed | 2024-12-19T16:21:16Z |
| format | Article |
| id | doaj.art-5aca78c88f8546bcab273a50f3585dc6 |
| institution | Directory Open Access Journal |
| issn | 2169-7574 |
| language | English |
| last_indexed | 2024-12-19T16:21:16Z |
| publishDate | 2019-05-01 |
| publisher | Wolters Kluwer |
| record_format | Article |
| series | Plastic and Reconstructive Surgery, Global Open |
| spelling | doaj.art-5aca78c88f8546bcab273a50f3585dc62022-12-21T20:14:29ZengWolters KluwerPlastic and Reconstructive Surgery, Global Open2169-75742019-05-0175e224410.1097/GOX.0000000000002244201905000-00018Computational Analysis of the Mature Unilateral Cleft Lip Nasal Deformity on Nasal PatencyDennis O. Frank-Ito, PhD0David J. Carpenter, BS, MHS1Tracy Cheng, AB2Yash J. Avashia, MD3David A. Brown, MD, PhD4Adam Glener, MD5Alexander Allori, MD, MPH6Jeffrey R. Marcus, MD7From the *Division of Head and Neck Surgery and Communication Sciences, Duke University Medical Center, Durham, N.C.From the *Division of Head and Neck Surgery and Communication Sciences, Duke University Medical Center, Durham, N.C.From the *Division of Head and Neck Surgery and Communication Sciences, Duke University Medical Center, Durham, N.C.¶Division of Plastic, Maxillofacial and Oral Surgery, Duke University Medical Center, Durham, N.C.¶Division of Plastic, Maxillofacial and Oral Surgery, Duke University Medical Center, Durham, N.C.¶Division of Plastic, Maxillofacial and Oral Surgery, Duke University Medical Center, Durham, N.C.¶Division of Plastic, Maxillofacial and Oral Surgery, Duke University Medical Center, Durham, N.C.¶Division of Plastic, Maxillofacial and Oral Surgery, Duke University Medical Center, Durham, N.C.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.http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000002244 |
| spellingShingle | Dennis O. Frank-Ito, PhD David J. Carpenter, BS, MHS Tracy Cheng, AB Yash J. Avashia, MD David A. Brown, MD, PhD Adam Glener, MD Alexander Allori, MD, MPH Jeffrey R. Marcus, MD Computational Analysis of the Mature Unilateral Cleft Lip Nasal Deformity on Nasal Patency Plastic and Reconstructive Surgery, Global Open |
| 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 |
| url | http://journals.lww.com/prsgo/fulltext/10.1097/GOX.0000000000002244 |
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