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Inhaled particulate matter is associated with nasal diseases such as allergic rhinitis, rhinosinusitis and neural disorders. Its health risks on humans are usually evaluated by measurements on monkeys as they share close phylogenetic relationship. However, the reliability of cross-species toxicological extrapolation is in doubt due to physiological and anatomical variations, which greatly undermine the reliability of these expensive human surrogate models. This study numerically investigated in-depth microparticle transport and deposition characteristics on human and monkey (Macaca fuscata) nasal cavities that were reconstructed from CT-images. Deposition characteristics of 1-30μm particles were investigated under resting and active breathing conditions. Similar trends were observed for total deposition efficiencies and a single correlation using Stokes Number was fitted for both species and both breathing conditions, which is convenient for monkey-human extrapolation. Regional deposition patterns were carefully compared using the surface mapping technique. Deposition patterns of low, medium and high inertial particles, classified based on their total deposition efficiencies, were further analyzed in the 3D view and the mapped 2D view, which allows locating particle depositions on specific nasal regions. According to the particle intensity contours and regional deposition profiles, the major differences were observed at the vestibule and the floor of the nasal cavity, where higher deposition intensities of medium and high inertial particles were shown in the monkey case than the human case. Comparisons of airflow streamlines indicated that the cross-species variations of microparticle deposition patterns are mainly contributed by two factors. First, the more oblique directions of monkey nostrils result in a sharper airflow turn in the vestibule region. Second, the monkey's relatively narrower nasal valves lead to higher impaction of medium and high inertial particles on the nasal cavity floor. The methods and findings in this study would contribute to an improved cross-species toxicological extrapolation between human and monkey nasal cavities., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2022 Elsevier B.V. All rights reserved.)

As a primary determinant of nasal physiological functions, the nasal morphology and its effects on the airflow dynamics have been extensively studied in literature. However, gross flow features reported in literature are mostly obtained from subjects at similar ages, while studies focusing on nasal subjects with distinct age differences are significantly less. To advance current understandings of nasal airflow dynamics in the context of age diversity, this study employed three anatomically accurate nasal cavity models with distinct age features (5-, 24- and 77-year-old models) and numerically compared the physiological nasal airflow fields within these nasal cavity models. To demonstrate the validity of the present numerical models, in vivo rhinomanometry measurement was conducted on the 24-year-old female nasal model, and key anatomical features and pressure-flow curves of all three models were compared with models with similar age features in literature work. Apart from results comparison based on conventional velocity flow fields and wall shear stress distributions, a method for quantifying flow partitions in confined airway spaces was developed to reveal the proportions of fractional flow that enters the olfactory region. Our results revealed dramatic intersubject discrepancies between considered nasal cavity models, especially for the fractional flow that enters the olfactory region. Specifically, the 5-year-old girl nasal model received the highest proportion of fractional flow, which accounts for 13.3% ~ 15% of overall inhalation flow rates under different activity levels. For the 24-year-old female model, on the contrary, the olfactory fractional flow was dramatically reduced (with a local to overall percentage around 4.3%-7.7%). Finally, for the elderly subject-77-year-old male model, minimum level of olfactory flux was observed with a local to overall percentage ranging between 3.1% and 4.9% for considered wide range of inhalation flow rates. Therefore, the local flow intersubject variation can reach nearly fourfold. The vast local flow difference is mainly due to the inherent anatomical features (e.g., immature nasal turbinate structure in the child model, the partial narrowing superior nasal valve in the elder model). The results may further lead to discrepant health effects associated with inhalation exposure to airborne particles., (© 2021 John Wiley & Sons Ltd.)

Nonhuman primates are occasionally used as laboratory models for sophisticated medical research as they bear the closest resemblance to humans in morphometry and physiological functions. A range of nonhuman primate species have been employed in the inhalation toxicity, nasal drug delivery and respiratory viral infection studies, and they provided valuable insight to disease pathogenesis while other laboratory animals such as rodents cannot recapitulate due to the lesser degree of similarity in metabolism, anatomy and cellular response to that of humans. It is anticipated that nonhuman primate models of respiratory diseases will continue to be instrumental for translating biomedical research for improvement of human health, and the confidence in laboratory data extrapolation between species will play a pivotal role. From the morphometry and flow dynamics point of view, this study performed a detailed comparative analysis between human and a cynomolgus monkey nasal airway, with intention to provide high-fidelity qualitative and quantitative linkage between the two species for more effective laboratory data extrapolation. The study revealed that cynomolgus monkey could be a good human surrogate in nasal inhalation studies; however, care should be given for interspecies data extrapolation as subtle differences in anatomy and airflow dynamics were present between the two species., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

In this study, we present a detailed flow analysis using an anatomically accurate rat nasal cavity model, in which the anatomy and physiology of the nasal airway was thoroughly examined. Special efforts were given to the swirling flow structures in the nasal vestibule (anterior section of the nose, lined by squamous epithelium), fractional flow patterns in the olfactory (posterior superior section of the rat nose, lined by olfactory epithelium), and a designated method to precisely quantify flow apportionment in the olfactory region was developed. Results revealed distinct inspiratory flow patterns in the anterior vestibule region, where the accelerated airflow undergoes two sharp turns as traveling through the tortuous airway, making a route in a shape of 8. Besides this, exceptionally large flow apportionment was observed at the interface of the olfactory recess, which can be as much as 15 times greater than that in the human nose. The thorough understanding of the airflow dynamics in the rat nasal cavity is necessary to avoid potential misinterpretation of rat-derived inhalation toxicity results. Research findings are expected to play a fundamental role in developing unbiased rat to human interspecies data extrapolation schemes., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Middle turbinate resection significantly alters the anatomy and redistributes the inhaled air. The superior half of the main nasal cavity is opened up, increasing accessibility to the region. This is expected to increase inhalation dosimetry to the region during exposure to airborne particles. This study investigated the influence of middle turbinate resection on the deposition of inhaled pollutants that cover spherical and non-spherical particles (e.g. pollen). A computational model of the nasal cavity from CT scans, and its corresponding post-operative model with virtual surgery performed was created. Two constant flow rates of 5 L/min, and 15 L/min were simulated under a laminar flow field. Inhaled particles including pollen (non-spherical), and a spherical particle with reference density of 1000 kg/m 3 were introduced in the surrounding atmosphere. The effect of surgery was most prominent in the less patent cavity side, since the change in anatomy was proportionally greater relative to the original airway space. The left cavity produced an increase in particle deposition at a flow rate of 15 L/min. The main particle deposition mechanisms were inertial impaction, and to a lesser degree gravitational sedimentation. The results are expected to provide insight into inhalation efficiency of different aerosol types, and the likelihood of deposition in different nasal cavity surfaces., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: The aim of this study was to use computational fluid dynamics (CFD) to investigate the effects on nasal heat exchange and humidification of two different surgical techniques for reducing the inferior turbinate under different environmental conditions., Methods: Virtual surgery using two techniques of turbinate reduction was performed in eight nasal airway obstruction patients. Bilateral nasal airway models for each patient were compared: 1) Pre-operative 2) Post inferior turbinoplasty 3) Post total inferior turbinate resection (ITR). Two representative healthy models were included. Three different environmental conditions were investigated 1) ambient air 2) cold, dry air 3) hot, humid air. CFD modelling of airflow and conditioning was performed under steady-state, laminar, inspiratory conditions., Findings: Nasal conditioning is significantly altered following inferior turbinate reduction surgery, particularly with ITR under cold, dry inspired air (CDA). The degree of impairment is minor under the simulated range of environmental conditions (temperature = 12-40 °C; relative humidity = 13-80%). Streams of significantly colder air are found in the nasopharynx and more prevalent under CDA in ITR. These are related to high velocity flow streams, which remain cool in their centre throughout the widened inferior nasal cavity., Interpretation: Reduced air-mucosal heat exchange and moisture carrying capacity occurs under cooler temperatures in patients following inferior turbinate surgery. The clinical impact in extremely cold and dry conditions in groups with poor baseline respiratory function, respiratory illness, or endurance athletes is of special interest., (Copyright © 2020 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Background: A major issue among computational respiratory studies is the wide variety of nasal morphologies being studied, caused by both inter-population and inter-subject variations., Method: Six nasal cavity geometries exhibiting diverse geometry variations were subjected to steady inhalation flow rate of 15L/min. to determine if any consistent flow behaviour could be found., Findings: Despite vastly different geometries we were able to identify consistent flow patterns including relatively high velocity in the nasal valve region, followed by flow continuing predominantly in the inferior half of the airway. We also found conformity among models where the inhaled air reached a near-conditioned state by the middle of the nasal cavity. Air from the front of the face reached the olfactory regions while air from the lateral sides of the face moved through the inferior half of the nasal cavity., Interpretation: The ability to predict gross flow features provides a baseline flow field to compare against. This contributes towards establishing well defined flow predictions and be used as a comparison for future larger studies., (Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.)

Aim: Inhaled allergens from house dust mite (HDM) are a major source of allergic disease such as allergic rhinitis and asthma. It has been a challenge to properly evaluate health risks caused by HDM related allergens including mite bodies, eggs and fecal pellets. This paper presents a numerical study on particle deposition of dust mite allergens in a human nasal cavity. Materials and methods: A realistic nasal cavity model was reconstructed from CT scans and a Computational Fluid Dynamics analysis of steady airflow was simulated. The discrete phase model was used to trace particle trajectories of three dust mite related particles. Results: The flow and particle model were validated by comparing with nasal resistance measurement and previous literature respectively. Aerodynamic characteristics and deposition of dust mite allergens in the nasal cavity were analyzed under different breathing conditions including rest and exercising conditions. Conclusions: The numerical results revealed the roles of different nasal cavity regions in filtering various types of dust mite allergens with consideration of breathing conditions.

Intranasal drug delivery has attracted significant attention because of the opportunity to deliver systemic drugs directly to the blood stream. However, the mucociliary clearance poses a challenge in gaining high efficacy of intranasal drug delivery because cilia continuously carry the mucus blanket towards the laryngeal region. To better understand mucus flow behaviour on the human nasal cavity wall, we present computational model development, and evaluation of mucus motion on a realistic nasal cavity model reconstructed from CT-scans. The model development involved two approaches based on the actual nasal cavity geometry namely: (i) unwrapped-surface model in 2D domain and (ii) 3D-shell model. Conservation equations of fluid motion were applied to the domains, where a mucus production source term was used to initiate the mucus motion. The analysis included mucus flow patterns, virtual saccharin tests and quantitative velocity magnitude analysis, which demonstrated that the 3D-shell model results provided better agreement with experimental data. The unwrapped-surface model also suffered from mesh-deformations during the unwrapping stage and this led to higher mucus velocity compared to experimental data. Therefore, the 3D-shell model was recommended for future mucus flow simulations. As a first step towards mucus motion modelling this study provides important information that accurately simulates a mucus velocity field on a human nasal cavity wall, for assessment of toxicology and efficacy of intranasal drug delivery., (Crown Copyright © 2019. Published by Elsevier Ltd. All rights reserved.)

Increased computational resources provide new opportunities to explore sophisticated respiratory modelling. A survey of recent publications showed a steady increase in the number of mesh elements used in computational models over time. Complex geometries such as the nasal cavity exhibit sharp gradients and irregular curvatures, leading to abnormal flow development across their surfaces. As such, a robust method for examining the near-wall mesh resolution is required. The non-dimensional wall unit y + (often used in turbulent flows) was used as a parameter to evaluate the near-wall mesh in laminar flows. Mesh independence analysis from line profiles showed that the line location had a significant influence on the result. Furthermore, using a single line profile as a measure for mesh convergence was unsuitable for representing the entire flow field. To improve this, a two-dimensional (2D) cross-sectional plane subtraction method where scalar values (such as the velocity magnitude) on a cross-sectional plane were interpolated onto a regularly spaced grid was proposed. The new interpolated grid values from any two meshed models could then be compared for changes caused by the different meshed models. The application of this method to three-dimensional (3D) volume subtraction was also demonstrated. The results showed that if the near-wall mesh was sufficiently refined, then narrow passages were less reliant on the overall mesh size. However, in wider passages, velocity magnitudes were sensitive to mesh size, requiring a more refined mesh., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

A major functional role of the nasal cavity is air conditioning of the inspired environmental air to near alveolar conditions. It is well known that the anatomical disparities among nasal passages can change airflow patterns to a great extent. However, its effect on nasal air conditioning performance remains largely unexplored. This research investigated the nasal air conditioning performance among nasal models with distinct vestibule phenotypes, including subjects with and without vestibule notches. For the mass transfer, we used a two-film theory model to determine the species transport. Airflow patterns, heat and mass transfer between the inhaled airflow and the nasal mucosa were analysed and compared. Results showed that the nasal air conditioning performance is closely related to nasal passage structures. The anatomical variations, especially the geometry changes in the anterior vestibule region, can increase both heat and mass transfer rate between nasal mucous and respiratory air at the vicinity of the notched regions, while for other regions such as the anterior superior nasal cavity, the heat transfer is greatly reduced to even zero heat flux due to lack of active airflow passing., (Copyright © 2018 IPEM. Published by Elsevier Ltd. All rights reserved.)

The complex nasal structure poses obstacles for efficient nasal drug administration beyond the nasal valve, especially when targeting the olfactory region. This study numerically detailed the naturally inhaled nanoparticle transport process from the initial releasing locations to the final deposited sites using a realistic human nasal passage. Dispersed nanoparticles at different coronal cross-sections were partitioned into multiple groups according to their final deposited locations. Results showed inhaled nanoparticles are more likely to move along the septum. Olfactory deposited particles entered the nose through the inner superior corner of the nostril; the middle meatus deposited particles entered the nose through the top third of the nostril; the inferior deposited particles entered via the bottom floor regions of the nostril. Therefore, targeted nasal inhalation therapies that intentionally release therapeutic particles from these recognized regions at the nostril plane can considerably improve the resultant topical disposition doses. However, it remains challenging to completely prevent undesired particle depositions as particles coming from the same location may produce multiple-sites depositions due to partition overlapping. Nevertheless, the fraction of undesired particle deposition is anticipated to be reduced at a great extent compared to unplanned releasing approaches., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Rats have been widely used as surrogates for evaluating the health effects of inhaled airborne particulate matter. To provide a thorough understanding of particle transport and deposition mechanisms in the rat nasal airway, this article presents a computational fluid dynamics (CFD) study of particle exposure in a realistic rat nasal passage under a resting flow condition. Particles covering a diameter range from 1 nm to 4 µm were passively released in front of the rat's breathing zone, and the Lagrangian particle tracking approach was used to calculate individual particle trajectories. Detailed particle deposition analysis shows the deposition of inertial particles >2 µm is high in the rat nasal vestibule and more than 70% of all inhaled inertial particles were trapped in this region. While for diffusive nanoparticles, the vestibule filtration effect is reduced, only less than 60% of inhaled nanoparticles were blocked by the anterior nasal structures. The particle exposure in the olfactory region only shows notable deposition for diffusive nanoparticles, which peaks at 9.4% for 5 nm particles. Despite the olfactory deposition remains at a low level, the ratio between the olfactory and the main passage is kept around 30-40% for 10-800 nm particles, which indicates a particle-size-independent distribution pattern in the main nasal passage and olfactory. This study provides a deep understanding of particles deposition features in a rat nasal passage, and the research findings can aid toxicologist in inter-species exposure-response extrapolation study.

In this study, the effects of nasal drug delivery device and the spray nozzle orientation on sprayed droplets deposition in a realistic human nasal cavity were numerically studied. Prior to performing the numerical investigation, an in-house designed automated actuation system representing mean adults actuation force was developed to produce realistic spray plume. Then, the spray plume development was filmed by high speed photography system, and spray characteristics such as spray cone angle, break-up length, and average droplet velocity were obtained through off-line image analysis. Continuing studies utilizing those experimental data as boundary conditions were applied in the following numerical spray simulations using a commercially available nasal spray device, which was inserted into a realistic adult nasal passage with external facial features. Through varying the particle releasing direction, the deposition fractions of selected particle sizes on the main nasal passage for targeted drug delivery were compared. The results demonstrated that the middle spray direction showed superior spray efficiency compared with upper or lower directions, and the 10µm agents were the most suitable particle size as the majority of sprayed agents can be delivered to the targeted area, the main passage. This study elaborates a comprehensive approach to better understand nasal spray mechanism and evaluate its performance for existing nasal delivery practices. Results of this study can assist the pharmaceutical industry to improve the current design of nasal drug delivery device and ultimately benefit more patients through optimized medications delivery., (Copyright © 2016 Elsevier Ltd. All rights reserved.)

To gain a better understanding of nanoparticle exposure in human nasal cavities, laboratory animals (e.g. rat) are used for in vivo studies. However, due to anatomical differences between human and rodent nasal cavities, direct particle deposition comparisons between species are difficult. This paper presents a comparative nanoparticle (1 nm, 10 nm, and 100 nm) deposition study using anatomically realistic models of a human and rat nasal cavity. The particle deposition fraction was highest consistently in the main nasal passage, for all nanoparticles tested, in the human model; whereas this was only the case for 10 nm, and 100 nm particles for the rodent model, where greater deposition was found in the anterior nose for 1 nm particles. A deposition intensity (DI) term was introduced to represent the accumulated deposition fraction on cross-sectional slices. A common and preferential deposition site in the human model was found for all nanoparticles occurring at a distance of 3.5 cm inside the nasal passage. For the rodent model maximum DI occurred in the vestibule region at a distance of 0.3 cm, indicating that the rodent vestibule produces exceptionally high particle filtration capability. We also introduced a deposition flux which was a ratio of the regional deposition fraction relative to the region's surface area fraction. This value allowed direct comparison of deposition flux between species, and a regional extrapolation scaling factor was found (e.g. 1/10 scale for vestibule region for rat to human comparison). This study bridges the in vitro exposure experiments and in vivo nanomaterials toxicity studies, and can contribute towards improving inter-species exposure extrapolation studies in the future., (© The Author 2016. Published by Oxford University Press on behalf of the Society of Toxicology. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.)

Micron-sized particle deposition in anatomically realistic models of a rat and human nasal cavity was numerically investigated. A steady laminar inhalation flow rate was applied and particles were released from the outside air. Particles showing equivalent total particle deposition fractions were classified into low, medium and high inertial particle. Typical particle sizes are 2.5, 9 and 20 μm for the human model and 1, 2 and 3 μm for the rat model, respectively. Using a surface-mapping technique the 3D nasal cavity surface was "unwrapped" into a 2D domain and the particle deposition locations were plotted for complete visual coverage of the domain surface. The total surface area comparison showed that the surface area of the human nasal model was about ten times the size of the rat model. In contrast, the regional surface area percentage analysis revealed the olfactory region of the rat model was significantly larger than all other regions making up ∼55.6% of the total surface area, while that of the human nasal model only occupying 10.5%. Flow pattern comparisons showed rapid airflow acceleration was found at the nasopharynx region and the nostril region for the human and rat model, respectively. For the human model, the main passage is the major deposition region for micro-particles. While for the rat model, it is the vestibule. Through comparing the regional deposition flux between human and rat models, this study can contribute towards better extrapolation approach of inhalation exposure data between inter-subject species.

Airflow analysis can assist in better understanding the physiology however the human nasal cavity is an extremely complicated geometry that is difficult to visualize in 3D space, let alone in 2D space. In this paper, an anatomically accurate 3D surface of the nasal passages derived from CT data was unwrapped and transformed into a 2D space, into a UV-domain (where u and v are the coordinates) to allow a complete view of the entire wrapped surface. This visualization technique allows surface flow parameters to be analyzed with greater precision. A UV-unwrapping tool is developed and a strategy is presented to allow deeper analysis to be performed. This includes (i) the ability to present instant comparisons of geometry and flow variables between any number of different nasal cavity models through normalization of the 2D unwrapped surface; (ii) visualization of an entire surface in one view and; (iii) a planar surface that allows direct 1D and 2D analytical solutions of diffusion of inhaled vapors and particles through the nasal walls. This work lays a foundation for future investigations that correlates adverse and therapeutic health responses to local inhalation of gases and particles., (Copyright © 2013 Elsevier B.V. All rights reserved.)

To analyze the effect of different endoscopic endonasal approaches (EEAs) on nasal airflow and heating and humidification in patients with pituitary adenoma (PA) by computational fluid dynamics (CFD). A three-dimensional pre-surgical model (Pre) of the nasal cavity and 6 that were post-EEA surgery were created from computed tomography scans as follows: small posterior septectomy (0.5 cm, sPS), middle posterior septectomy (1.5 cm, mPS), large posterior septectomy (2.5 cm, lPS), and sPS with middle turbinate resection (sPS-MTR), mPS-MTR, and lPS-MTR. Simulations were performed by CFD to compare the changes in different models. The temperature in the nasal vestibule rose more rapidly than in other parts of the nasal cavities in all models. There were no apparent differences in temperature and humidity among the models in sections anterior to the middle turbinate head (C6 section). MTR significantly influenced airflow distribution between the bilateral nasal cavities and the different parts of the nasal cavity, while changes in temperature and humidity in each section were mainly affected by MTR. The temperature and humidity of the choana and nasopharynx of each postoperative model were significantly different from those of the preoperative model and the change in values significantly correlated with the surface-to-volume ratio (SVR) of the airway. Changes due to the different nasal structures caused different effects on nasal function following the use of EEA surgery for the treatment of PA. CFD provided a new approach to assess nasal function, promising to provide patients with individualized preoperative functional assessment and surgical planning. [ABSTRACT FROM AUTHOR]

Background: Nasal saline irrigation has become standard of care in various sinonasal conditions, including allergic and nonallergic rhinitis, chronic rhinosinusitis, and in the postoperative patient. Evidence regarding the mechanisms and dynamics of liquid flow through the sinonasal cavity remains limited due to inadequate experimental models (cadaveric, 3‐dimensional [3D] printed, imaging of labeled dyes and radioisotopes). We aimed to develop a computational fluid dynamics (CFD) model of nasal irrigation to demonstrate sinonasal surface coverage, residence times across the mucosal surfaces, and shearing force of irrigation. Methods: A nasal cavity geometry derived from high‐resolution paranasal sinus computed tomography (CT) scans of a healthy, unoperated, 25‐year‐old patient was created. CFD analysis was performed to assess the distribution of nasal irrigation from a tapered nozzle bottle at a forward head‐tilt position of 45 degrees with a 2‐second burst at 35 mL/second. Results: The model demonstrates nasal irrigation from ipsilateral to contralateral with precise measures of velocity, pressure, wall shear stress, and mapping of surface coverage and residence times at specific locations and times. The nasal cavity experiences almost complete coverage of irrigation, while overflow from the nasal cavity facilitates moderate coverage of the ipsilateral maxillary (40%) and anterior ethmoid sinuses (30%). Negligible coverage of the sphenoid and frontal sinuses was noted. Conclusion: Detailed physical mechanisms of liquid irrigation injected from a commonly used squeeze bottle were shown. Ipsilateral maxillary and ethmoid sinus penetration are primarily due to overflow rather than direct jet entry, confirming the recommendation of larger volumes of irrigation to "flood" the sinus ostia. [ABSTRACT FROM AUTHOR]

Understanding the inhalation, transport and deposition of smoke particles during fire missions are important to evaluating the health risks for firefighters. In this study, measurements from Underwriters Laboratories' large-scale fire experiments on smoke particle size distribution and concentration in three residential fire scenes were incorporated into models to investigate the fate of inhaled toxic ultrafine particulates in a realistic firefighter nasal cavity model. Deposition equations were developed, and the actual particle dosimetry (in mass, number and surface area) was evaluated. A strong monotonic growth of nasal airway dosages of simulated smoke particles was identified for airflow rates and fire duration across all simulated residential fire scene conditions. Even though the "number" dosage of arsenic in the limited ventilation living room fire was similar to the "number" dosage of chromium in the living room, particle mass and surface area dosages simulated in the limited living room were 90–200 fold higher than that in the ventilated living room. These were also confirmed when comparing the dosimetry in the living room and the kitchen. This phenomenon implied that particles with larger size were the dominant factors in mass and surface area dosages. Firefighters should not remove the self-contained breathing apparatus (SCBA) during fire suppression and overhaul operations, especially in smoldering fires with limited ventilation. [ABSTRACT FROM AUTHOR]

Chronic rhinosinusitis (CRS) is a common sinonasal condition that debilitates quality of life. Nasal sprays are inefficient for targeting the sinuses because of the highly inertial atomised droplets. This study evaluated sinus drug delivery via a nebuliser in a human nasal cavity using Computational Fluid Dynamics (CFD) simulations of different breathing conditions. The nebuliser was quantified through high-speed imaging of the spray plume and average velocity, while laser diffraction was used for droplet size distributions. A CT scan was acquired of a 75-year-old male with a confirmed diagnosis of CRS, and airway segmentation was performed to extract the nasal cavity and sinuses. Virtual surgery was then performed on the computational model. Two nozzle designs for the nebuliser under normal breathing, slow exhalation, and breath hold were investigated. The results demonstrated that drug delivery with a fully blocked nostril with a breath hold notably improved deposition targeting the maxillary sinuses and ethmoid sinuses, while using a nozzle that allowed co-flow of air was recommended for targeting the frontal and sphenoid sinuses. • A breath-hold following inhalation with nebulised droplets <15 μm improved ethmoid sinus deposition. • An occluded nostril with 15 μm droplets improved maxillary sinus deposition. • A fully blocked nostril with a breath hold improved deposition in the maxillary sinuses and ethmoid sinuses. • A partially blocked nostril improved deposition in the frontal and sphenoid sinuses. [ABSTRACT FROM AUTHOR]

• This study examined the impact of nasal adhesions on airflow and mucosal cooling. • A 'no-adhesion' model was compared against five replica models with adhesions. • Adhesions caused changes in airflow and mucosal cooling downstream. • Anterior adhesions created greater disruption to local airflow and mucosal cooling • Posterior adhesions had a small effect on overall airflow and mucosal cooling. Nasal adhesions are a known postoperative complication following surgical procedures for nasal airway obstruction (NAO); and are a common cause of surgical failure, with patients often reporting significant NAO, despite relatively minor adhesion size. Division of such nasal adhesions often provides much greater relief than anticipated, based on the minimal reduction in cross-sectional area associated with the adhesion. The available literature regarding nasal adhesions provides little evidence examining their quantitative and qualitative effects on nasal airflow using objective measures. This study examined the impact of nasal adhesions at various anatomical sites on nasal airflow and mucosal cooling using computational fluid dynamics (CFD). A high-resolution CT scan of the paranasal sinuses of a 25-year-old, healthy female patient was segmented to create a three-dimensional nasal airway model. Virtual nasal adhesions of 2.5 mm diameter were added to various locations within the nasal cavity, representing common sites seen following NAO surgery. A series of models with single adhesions were created. CFD analysis was performed on each model and compared with a baseline no-adhesion model, comparing airflow and heat and mass transfer. The nasal adhesions resulted in no significant change in bulk airflow patterns through the nasal cavity. However, significant changes were observed in local airflow and mucosal cooling around and immediately downstream to the nasal adhesions. These were most evident with anterior nasal adhesions at the internal valve and anterior inferior turbinate. Postoperative nasal adhesions create local airflow disruption, resulting in reduced local mucosal cooling on critical surfaces, explaining the exaggerated perception of nasal obstruction. In particular, anteriorly located adhesions created greater disruption to local airflow and mucosal cooling, explaining their associated greater subjective sensation of obstruction. [ABSTRACT FROM AUTHOR]