Hostname: page-component-78c5997874-g7gxr Total loading time: 0 Render date: 2024-11-05T04:20:31.372Z Has data issue: false hasContentIssue false
  • English
  • Français

Computational fluid dynamic modelling of maxillary sinus irrigation after maxillary antrostomy and modified endoscopic medial maxillectomy

Published online by Cambridge University Press:  20 April 2021

Z Turfe ,
K Zhao ,
J N Palmer  and
J R Craig
Z Turfe*
Affiliation:
Department of Otolaryngology, Henry Ford Health System, Detroit, USA
K Zhao
Affiliation:
Department of Otolaryngology, The Ohio State University, Columbus, USA Department of Biomedical Engineering, The Ohio State University, Columbus, USA
J N Palmer
Affiliation:
Department of Otolaryngology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA
J R Craig
Affiliation:
Department of Otolaryngology, Henry Ford Health System, Detroit, USA
*
Author for correspondence: Dr Zaahir Turfe, Henry Ford Health System, 2799 W Grand Blvd, Detroit48202, USA E-mail: [email protected] Fax: +1313 916 7263
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective

For recalcitrant chronic maxillary sinusitis, modified endoscopic medial maxillectomy has been shown to be clinically beneficial after failed maxillary antrostomy as endoscopic medial maxillectomy may offer improved topical therapy delivery. This study compared irrigation patterns after maxillary antrostomy versus endoscopic medial maxillectomy, using computational fluid dynamic modelling.

Case report

A 54-year-old female with left chronic maxillary sinusitis underwent maxillary antrostomy, followed by endoscopic medial maxillectomy. Computational fluid dynamic models were created after each surgery and used to simulate irrigations.

Results

After maxillary antrostomy, irrigation penetrated the maxillary sinus at 0.5 seconds, initially contacting the posterior wall. The maxillary sinus was half-filled at 2 seconds, and completely filled at 4 seconds. After endoscopic medial maxillectomy, irrigation penetrated the maxillary sinus at 0.5 seconds and immediately contacted all maxillary sinus walls. The maxillary sinus was completely filled by 2 seconds.

Conclusion

Computational fluid dynamic modelling demonstrated that endoscopic medial maxillectomy allowed faster, more forceful irrigation to all maxillary sinus walls compared with maxillary antrostomy.

Keywords

Maxillary SinusEndoscopicSinusitis
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 135 , Issue 6 , June 2021 , pp. 555 - 559
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Dr Z Turfe takes responsibility for the integrity of the content of the paper

Presented as a poster at the Combined Otolaryngology Spring Meeting, 19 April 2018, National Harbor, Maryland, USA.

References

Kennedy, DW, Zinreich, SJ, Shaalan, H, Kuhn, F, Naclerio, R, Loch, E. Endoscopic middle meatal antrostomy: theory, technique and patency. Laryngoscope 1987;97:1–9CrossRefGoogle ScholarPubMed
Konstantinidis, I, Constantinidis, J. Medial maxillectomy in recalcitrant sinusitis: when, why and how? Curr Opin Otolaryngol Head Neck Surg 2014;22:68– 74CrossRefGoogle ScholarPubMed
Cho, DY, Hwang, PH. Results of endoscopic maxillary mega-antrostomy in recalcitrant maxillary sinusitis. Am J Rhinol 2008;22:658–62CrossRefGoogle ScholarPubMed
Costa, ML, Psaltis, AJ, Nayak, JV, Hwang, PH. Long-term outcomes of endoscopic maxillary mega-antrostomy for refractory chronic maxillary sinusitis. Int Forum Allergy Rhinol 2015;5:60–5CrossRefGoogle ScholarPubMed
Wang, EW, Gullung, JL, Schlosser, RJ. Modified endoscopic medial maxillectomy for recalcitrant chronic maxillary sinusitis. Int Forum Allergy Rhinol 2011;1:493–7CrossRefGoogle ScholarPubMed
Woodworth, BA, Parker, RO, Schlosser, RJ. Modified endoscopic medial maxillectomy for chronic maxillary sinusitis. Am J Rhinol 2006;3:317–19CrossRefGoogle Scholar
Harvey, RJ, Goddard, JC, Wise, SK, Schlosser, RJ. Effects of endoscopic sinus surgery and delivery device on cadaver sinus irrigation. Otolaryngol Head Neck Surg 2008;139:137–42CrossRefGoogle ScholarPubMed
Singhal, D, Weitzel, EK, Lin, E, Feldt, B, Kriete, B, McMains, KC et al. Effect of head position and surgical dissection on sinus irrigant penetration in cadavers. Laryngoscope 2010;120:2528–31CrossRefGoogle ScholarPubMed
Grobler, A, Weitzel, EK, Buele, A, Jardeleza, C, Cheong, YC, Field, J et al. Pre- and postoperative sinus penetration of nasal irrigation. Laryngoscope 2008;118:2078–81CrossRefGoogle ScholarPubMed
Snidvongs, K, Chaowanapanja, P, Aeumjaturapat, S, Chusakul, S, Praweswararat, P. Does nasal irrigation enter paranasal sinuses in chronic rhinosinusitis? Am J Rhinol 2008;22:483–6CrossRefGoogle ScholarPubMed
Wormald, PJ, Cain, T, Oates, L, Hawke, L, Wong, I. A comparative study of three methods of nasal irrigation. Laryngoscope 2004;114:2224–2227CrossRefGoogle ScholarPubMed
Bleier, BS, Preena, D, Schlosser, RJ, Harvey, RJ. Dose quantification of topical drug delivery to the paranasal sinuses by fluorescein luminosity calculation. Int Forum Allergy Rhinol 2012;2:316–20CrossRefGoogle Scholar
Craig, JR, Zhao, K, Doan, N, Khalili, S, Lee, JY, Adappa, ND et al. Cadaveric validation study of computational fluid dynamics model of sinus irrigations before and after sinus surgery. Int Forum Allergy Rhinol 2016;6:423–8CrossRefGoogle ScholarPubMed
Zhao, K, Scherer, PW, Hajiloo, SA, Dalton, P. Effect of anatomy on human nasal air flow and odorant transport patterns: implications for olfaction. Chem Senses 2004;29:365–79CrossRefGoogle ScholarPubMed
Zhao, K, Pribitkin, EA, Cowart, BJ, Rosen, D, Scherer, PW, Dalton, P. Numerical modeling of nasal obstruction and endoscopic surgical intervention: outcome to airflow and olfaction. Am J Rhinol 2006;20:308–16CrossRefGoogle ScholarPubMed
Zhao, K, Craig, JR, Cohen, NA, Adappa, ND, Khalili, S, Palmer, JN. Sinus irrigations before and after surgery– visualization through computation fluid dynamics simulations. Laryngoscope 2016;126:90–6CrossRefGoogle Scholar
Craig, JR, Palmer, JN, Zhao, K. Computational fluid dynamic modeling of nose-to-ceiling head positioning for sphenoid sinus irrigation. Int Forum Allergy Rhinol 2017;7:474–9CrossRefGoogle ScholarPubMed
Supplementary material: File

Turfe et al. supplementary material

Turfe et al. supplementary material

Download Turfe et al. supplementary material(File)
File 30.9 MB