Computational Fluid Dynamics Analysis of Nasal Airway Changes after Treatment with C-Expander

The use of the C-expander is an effective treatment modality for maxillary skeletal deficiencies which can cause ailments and significantly reduce life expectancy in late adolescents and young adults. However, the morphological and dynamic effects on the nasal airway have not been reported. The main goal of this study was to evaluate the nasal airway changes after the implementation of a C-expander. A sample of nine patients (8 females, 1 male, age range from 15 to 29 years) was included. The morphology parameters and nasal airway ventilation parameters of pretreatment and posttreatment were measured. All study data were normally distributed. A paired t -test was used to evaluate the changes before and after treatment. After expansion, the mean and standard deviation values of intercanine maxillary width (CMW) and intermolar maxillary width (MMW) increased from 35.75 ± 2.48 mm and 54.20 ± 3.17 mm to 37.87 ± 2.26 mm ( P < 0.05 ) and 56.65 ± 3.10 mm ( P < 0.05 ), respectively. The nasal cavity volume increased from 20320.00 ± 3468.25 mm3 to 23134.70 ± 3918.84 mm3 ( P < 0.05 ). The nasal pressure drop decreased from 36.34 ± 3.99 Pa to 30.70 ± 3.17 Pa ( P < 0.05 ), while the value of the maximum velocity decreased from 6.50 ± 0.31 m/s to 5.85 ± 0.37 m/s ( P < 0.05 ). Nasal resistance dropped remarkably from 0.16 ± 0.14 Pa/ml/s to 0.08 ± 0.06 Pa/ml/s ( P < 0.05 ). The use of C-expander can effectively broaden the area and volume of the nasal airway, having a positive effect in the reduction of nasal resistance and improvement of nasal airway ventilation. For patients suffering from maxillary width deficiency and respiratory disorders, a C-expander may be an alternative method to treat the disease.

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Performance and work of nasal breathing

Romanian Journal of Rhinology ◽

10.2478/rjr-2021-0003 ◽

2021 ◽

Vol 11 (41) ◽

pp. 11-17

Author(s):

Anita Bergmane ◽

Klaus Vogt ◽

Biruta Sloka

Keyword(s):

Airway Resistance ◽

Interquartile Range ◽

Nasal Airway ◽

Nasal Resistance ◽

Nasal Breathing ◽

First Line ◽

Significant Difference ◽

Before And After ◽

Potential Parameters ◽

Inspiratory Work

Abstract OBJECTIVE. To evaluate performance (Q) and work (W) of nasal breathing as potential parameters in functional diagnostic of nasal obstruction. MATERIAL AND METHODS. We included in our study 250 patients and we measured by 4-phase-rhinomanometry with decongestion test. We calculated performance Q of the “representative breath” in inspiration and expiration and in total breath, maximal performance Q (Qmax), Work W of nasal breathing in mJ and in mJ/litre and Q in J/min. RESULTS. The interquartile range of Win for representative breath before decongestion is 356 mJ/l, Wex 308 mJ/l, while after decongestion Win is 264 mJ/l and Wex 220 mJ/l. There is no significant difference between work before and after decongestion (p<0.001). Interquartile range for nasal breathing Q before decongestion is 19.2 J/min and after – 14.3 J/min. A significant correlation exists between logarithmic vertex resistance for inspiration and expiration and Qmax for inspiration and expiration (p<0.001). That means that the performance required by breathing depends in the first line on nasal resistance. CONCLUSION. Inspiratory work is 1.2 times higher than expiration work. Increase in nasal airway resistance is followed by increase in maximal nasal performance.

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Nasal resistance asymmetry as a predictor of satisfaction following nasal airway obstruction surgeries

Polski Przegląd Otorynolaryngologiczny ◽

10.5604/01.3001.0010.7498 ◽

2017 ◽

Vol 6 (4) ◽

pp. 1-9

Author(s):

Monika Prus ◽

Jarosław Wysocki ◽

Marta Krasny ◽

Kazimierz Niemczyk

Keyword(s):

Airway Obstruction ◽

Subjective Assessment ◽

Subjective Perception ◽

Nasal Airway ◽

Nasal Resistance ◽

Nasal Patency ◽

Self Evaluation ◽

Before And After ◽

The Right ◽

Medical University

Patients’ subjective assessment of nasal patency often does not correspond to the objective results of functional and imaging examinations. The objective of this study was to identify the rhinometry (AR) and rhinomanometry (RMM) parameters that were best correlated to patients’ self-evaluation of nasal patency before and after nasal airway obstruction surgery. The study material consisted of RMM and AR results as well as SNOT-20 self-evaluation questionnaires completed by 233 patients presenting with rhinological problems and routinely diagnosed at the RMM Lab of the Department and Clinic of Otolaryngology of the Medical University of Warsaw. Data were collected from 70 females (31.4%) aged 18 through 81 years and 153 males (68.6%) aged 16 through 81 years. The results were subjected to statistical analysis by a licensed statistician using the Statistica 10 software package. A statistically significant relationship was demonstrated between the subjective perception of nasal patency and RMM results. The higher the asymmetry of air flow within the left and the right nasal cavity, the higher the perceived restriction of nasal patency. Significant differences were observed between patients reporting maximum discomfort regarding impaired nasal patency and the remaining patients: the former were characterized by nasal resistance values being several-fold higher than that observed in the latter while nearly always improving after nasal airway obstruction surgeries. No significant reflection of patients’ self-evaluation of nasal patency was found in the acoustic rhinometry measurements.

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The effect of decongestion on nasal airway patency and airflow

Scientific Reports ◽

10.1038/s41598-021-93769-6 ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Qiwei Xiao ◽

Alister J. Bates ◽

Raul Cetto ◽

Denis J. Doorly

Keyword(s):

Nasal Airway ◽

Nasal Resistance ◽

Nasal Airflow ◽

Cross Sectional ◽

Airway Patency ◽

Flow Rates ◽

High Resolution Mri ◽

Nasal Anatomy ◽

Before And After ◽

Flow Through

AbstractNasal decongestant reduces blood flow to the nasal turbinates, reducing tissue volume and increasing nasal airway patency. This study maps the changes in nasal anatomy and measures how these changes affect nasal resistance, flow partitioning between superior and inferior cavity, flow patterns and wall shear stress. High-resolution MRI was applied to capture nasal anatomy in 10 healthy subjects before and after application of a topical decongestant. Computational fluid dynamics simulated nasal airflow at steady inspiratory flow rates of 15 L.min$$^{-1}$$ - 1 and 30 L.min$$^{-1}$$ - 1 . The results show decongestion mainly increases the cross-sectional area in the turbinate region and SAVR is reduced (median approximately 40$$\%$$ % reduction) in middle and lower parts of the cavity. Decongestion reduces nasal resistance by 50$$\%$$ % on average, while in the posterior cavity, nasal resistance decreases by a median factor of approximately 3 after decongestion. We also find decongestant regularises nasal airflow and alters the partitioning of flow, significantly decreasing flow through the superior portions of the nasal cavity. By comparing nasal anatomies and airflow in their normal state with that when pharmacologically decongested, this study provides data for a broad range of anatomy and airflow conditions, which may help characterize the extent of nasal variability.

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The Effect of Rapid Maxillary Expansion on Nasal Airway Resistance

British Journal of Orthodontics ◽

10.1179/bjo.13.4.221 ◽

1986 ◽

Vol 13 (4) ◽

pp. 221-228 ◽

Cited By ~ 49

Author(s):

Donald J. Timms

Keyword(s):

Pressure Difference ◽

Airway Resistance ◽

Rapid Maxillary Expansion ◽

Nasal Airway ◽

Maxillary Expansion ◽

Nasal Airway Resistance ◽

Before And After ◽

Probable Significance ◽

Airway Physiology ◽

Age Range

There has been a long-standing controversy over the efficacy of rapid maxillary expansion to relieve nasal obstruction and improve respiration. Recently rhinomanometry has provided a discipline for the investigation into nasal airway physiology with quantifiable parameters for evaluation and comparable studies. In this trial, a sample of 26 patients (13 male and 13 female, age range 10·10 to 19·6 years), receiving rapid maxillary expansion as part of their orthodontic mechano-therapy, were appraised for nasal airway resistance before and after expansion. The posterior rhinomanometric technique was used, measuring the respiratory flow between pharynx and the nostrils at a preset pressure difference between these two points. The formula for calculating the resistance is derived from the electrical Ohm's Law and requires that the pressure difference be divided by the flow. Reductions were recorded in all cases with an average of 36·2 per cent (range 11·6–58·6). The correlation between the resistance reductions and the delivered expansions (increases in trans-palatal widths) was weak (r = 0·32). In view of the probable significance of the liminal valve in nasal resistance, expansions in this area were assessed by changes in the transalar widths. The correlation between transalar increases and the trans-palatal expansions was weak (r = 0·115), as it was between the transalar increases and the reductions in nasal airway resistance (r = 0·30).

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571 Evaluating Need for Follow up Polysomnograms after Adenotonsillectomy in children

SLEEP ◽

10.1093/sleep/zsab072.569 ◽

2021 ◽

Vol 44 (Supplement_2) ◽

pp. A225-A225

Author(s):

Harish Rao

Keyword(s):

Sleep Disordered Breathing ◽

Patient Characteristics ◽

Study Data ◽

Clinical Suspicion ◽

Z Score ◽

Obstructive Sleep ◽

Before And After ◽

Age Range ◽

Disordered Breathing

Abstract Introduction Most children with Obstructive sleep apnea (OSA) undergo repeat polysomnogram (PSG) following adenotonsillectomy (T & A). Repeat PSG is often performed regardless of presence of symptoms of sleep disordered breathing after T & A. PSG data performed before and after T & A performed at our institution over past 2 years were reviewed. Data was collected on patient characteristics such as age, sex, BMI, comorbidities and AHI on pre-T & A study. Data was then analyzed looking at patient characteristics that can help predict significant OSA (AHI >5) in post T & A study. Methods Retrospective review of 50 consecutive PSGs before and after T & A performed at our institution over past 2 years was performed. Data was collected on age, sex, Obstructive AHI, BMI, O2 nadir and comorbidities to identify patient characteristics to predict significant OSA (AHI>5) in the post T & A study. Results Age range of our cohort was 2–16 years. Average age and BMI of our cohort was 5.8 years (median 5 years) and 16.6 respectively. 8 patients had significant OSA (AHI>5) in the after T & A study. AHI (>20) and increased BMI z-score at baseline was highly predictive of significant OSA (AHI>5) in the after T & A study. Conclusion Based on our data, follow up PSG is warranted if AHI is >20/hour on baseline diagnostic PSG. Similarly, high BMI z-score at baseline study is also highly predictive of significant OSA (AHI>5) in the post T & A study. Most children with associated comorbidities with mild (AHI 2–5 hour), moderate (AHI 5–10/hour) and lower end of severe OSA (AHI 10–20/hour) do not need repeat PSG after T & A unless symptoms of sleep disordered breathing are present. We are analyzing larger PSG database to identify other patient characteristics that may signal need for follow up PSG. As PSGs are expensive and time consuming, follow up PSGs should be performed only if clinical suspicion for residual OSA is high to optimize resource utilization. Support (if any):

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Study the Relationship Between Estrogen Hormone and Calcium in Normal Females Before and After Menopause in Baghdad / Iraq

Al-Kitab Journal for Pure Sciences ◽

10.32441/kjps.v2i1.152 ◽

2018 ◽

Vol 2 (1) ◽

Author(s):

Sameerah Mustafa ◽

Asal Tawfeeq ◽

Hadeel Hasan

Keyword(s):

Oral Contraceptive ◽

Healthy Controls ◽

Serum Samples ◽

Oral Contraceptive Pills ◽

Contraceptive Pills ◽

Menopausal Women ◽

Before And After ◽

Group A ◽

Group B ◽

Age Range

This study involved the collection of (90) samples of women serum which included (30) serum samples collected from women before menopause (reproductive women) in the age range of (22-43) years and were considered as (group A- control). While, (group B) included (30) serum samples collected from women using oral contraceptive pills between the ages of (22-43) years old. Whereas, another (30) serum samples were collected from women after menopause between the ages of (43-54) years and were considered as (group C). All of the collected serum samples were subjected to a number of serological and chemical tests for the measurement of (E2, HDL, LDL and Ca). Then, the obtained data were statistical analyzed and results showed a significant decrease (p˂ 0.05) in (E2 ,Ca and HDL) levels in menopausal women compared to that of the normal healthy controls. While, there were non-significant decrease (p> 0.05) in (E2, Ca and HDL) levels in women taking oral contraceptive when compared to the normal healthy controls. On the other hand, a significant increase (p˂ 0.05) was recorded in LDL level in menopausal women compared to that of the normal healthy controls whereas, no-significant increase (p˃ 0.05) in the LDL level in women taking oral contraceptives when compared to the control women.

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Profil Pasien Katarak Senilis Pada Usia 40 Tahun Keatas di RSI Siti Rahmah Tahun 2017

Health & Medical Journal ◽

10.33854/heme.v1i1.214 ◽

2019 ◽

Vol 1 (1) ◽

pp. 15-21

Author(s):

Rada Puspita ◽

Haves Ashan ◽

Fidiariani Sjaaf

Keyword(s):

High School ◽

Secondary Data ◽

Study Data ◽

Vision Impairment ◽

High School Education ◽

Frequency Data ◽

Private Companies ◽

The World ◽

Age Range ◽

Cataract Patients

Vision impairment is estimated to affect 285 million people in the world, where 16-20% experience blindness, from the number of blindness suffered at the age of 40-50 years. Cataract seninis is all lens opacities that are found in old age that is above 40 years. The purpose of identifying and collecting frequency data Profile of Senilis cataract patients at the age of 40 years and above at RSI Siti Rahmah Padang in 2017. The research method is descriptive type of research, this study data taken is secondary data, In this study data was taken from the Medical Record at RSI Siti Rahmah Padang. When the study was conducted in February-August 2018, the population of this study were all cataract patients at the age of 40 years and above at RSI Siti Rahmah Padang in 2017 with 80 samples. Data analysis is univariate presented in the form of a frequency distribution table. Results From 80 respondents as many as 40 people (50%) were in the age range of 60-69 years, as many as 42 people (52.5%) patients were male, as many as 31 people (38.8%) patients with high school education and 35 people (43.8%) patients work as private companies. Conclusion In general, most patients are at the age of 60-69 years, the most sex is men, the highest education is high school and most patients are private.

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Objective assessment of nasal resistance among electronic cigarette users

The Journal of Laryngology & Otology ◽

10.1017/s0022215121001432 ◽

2021 ◽

pp. 1-4

Author(s):

S W Lim ◽

AB Zulkiflee

Keyword(s):

Tobacco Smoking ◽

Repeated Measures ◽

Airway Resistance ◽

Electronic Cigarettes ◽

Objective Assessment ◽

Control Group ◽

Nasal Airway ◽

Nasal Resistance ◽

Short Term ◽

Nasal Airway Resistance

Abstract Background Electronic cigarettes have been a popular alternative to tobacco smoking. The effect of tobacco smoking on nasal airway resistance has been investigated before; however, the effect of the aerosol generated by electronic cigarettes is still unknown. This study aimed to evaluate the short-term effects of e-cigarettes on nasal airway resistance. Methods Sixty-one participants were recruited into a vapers group and a control group. The vapers group was instructed to smoke for 5 minutes, and their nasal resistance was measured pre-procedure and at 1 and 5 minutes post-procedure. The results were compared between both groups. Results Repeated measures analysis of variance demonstrated that vaping has no statistically significant effect on total nasal airway resistance. Conclusion Although the differences between both groups were not statistically significant overall, the vapers group showed a reduction in nasal airway resistance in the short term.

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Computed Tomography and Bronchoscopy in Endobronchial Tuberculosis

Canadian Respiratory Journal ◽

10.1155/2003/496296 ◽

2003 ◽

Vol 10 (8) ◽

pp. 445-448 ◽

Cited By ~ 11

Author(s):

Halil Yanardag ◽

Cüneyt Tetikkurt ◽

Seza Tetikkurt ◽

Sabriye Demirci ◽

Tuncer Karayel

Keyword(s):

Computed Tomography ◽

Retrospective Study ◽

Therapeutic Response ◽

Histopathological Examination ◽

Computed Tomographic ◽

Before And After ◽

Endobronchial Tuberculosis ◽

Age Range

BACKGROUND: The therapeutic response to endobronchial tuberculosis is usually evaluated by bronchoscopy. Currently, there are no published studies investigating the use of computed tomography for the evaluation of therapeutic response in endobronchial tuberculosis.OBJECTIVE: A retrospective study was performed to evaluate the bronchoscopic and computed tomographic features of endobronchial tuberculosis before and after treatment. The aim of this study was to investigate the usefulness of computed tomography for the assessment of treatment.METHODS: The clinical, pathological and bronchoscopic features of endobronchial tuberculosis were evaluated in 55 patients. The age range of the patients was 21 to 52 years. Computed tomography and bronchoscopy were performed before and after treatment.RESULTS: Diagnosis of tuberculosis was confirmed by culture and histopathological examination. Bronchoscopic examination revealed 89 endobronchial lesions of various types in 55 patients. The exudative type was the most common. Follow-up bronchoscopy revealed that exudative-, ulcerative- and granular-type lesions healed completely. Computed tomography performed after treatment correlated well with the follow-up bronchoscopic findings.CONCLUSION: The results suggest that follow-up computed tomography is useful for the evaluation of therapeutic response and complications associated with endobronchial tuberculosis, and may replace bronchoscopy.

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Stereotactic radiosurgery for cerebral cavernous malformation: comparison of hemorrhage rates before and after stereotactic radiosurgery

Journal of Neurosurgery ◽

10.3171/2021.2.jns21138 ◽

2021 ◽

pp. 1-7

Author(s):

Burak Karaaslan ◽

Beste Gülsuna ◽

Gökberk Erol ◽

Özlem Dağli ◽

Hakan Emmez ◽

...

Keyword(s):

Stereotactic Radiosurgery ◽

Seizure Control ◽

Cavernous Malformation ◽

Cerebral Cavernous Malformation ◽

Vascular Pathology ◽

Lesion Volume ◽

Developmental Venous Anomaly ◽

Effective Treatment Modality ◽

Radiological Data ◽

Before And After

OBJECTIVE Cerebral cavernous malformation (CM) is an angiographically occult vascular pathology. Although microsurgery is the gold standard treatment to control the symptoms of CM, resection carries high risk in some situations, especially eloquent areas. The objective was to evaluate annual hemorrhage rates (AHRs) before and after stereotactic radiosurgery (SRS) treatment of cerebral CM in different locations. METHODS A total of 195 patients (119 women and 76 men) with CM treated at the Gazi University Gamma Knife Center between April 2005 and June 2017 were analyzed. The mean ± SD follow-up period was 67.4 ± 31.1 months (range 12 days to 170 months). AHR before SRS, AHR after SRS, morbidity associated with radiation, seizure control rate after SRS, lesion volume, coexistence with developmental venous anomaly, and SRS treatment parameters were analyzed, with evaluation of radiological data and clinical charts performed retrospectively. The seizure control rate was assessed using the Engel outcome scale. RESULTS The AHR before SRS was 15.3%. Application of SRS to these patients significantly reduced the AHR rates to 2.6% during the first 2 years after treatment and to 1.4% thereafter. Favorable seizure control (Engel class I and II) after radiosurgery was achieved in 23 patients (88.5%) with epilepsy. Radiation-related temporary complications occurred in 15.4% of patients, and permanent morbidity occurred in 4.6%. CONCLUSIONS SRS is a safe and effective treatment modality for reducing the hemorrhage risk of CM. The authors suggest that SRS should be considered for the treatment of patients with CM, high surgical risks, and hemorrhage history, instead of a using a wait-and-see policy.

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