- 學位論文
以CFD研究空鼻症患者黏膜下植入前後之鼻空調與鼻空氣動力學
CFD Prediction of the Nasal Air Condition and Aerodynamics of a Patient with Empty Nose Syndrome (ENS-IT) before and after Submucosal Implantation
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摘要
透過CFD數值模擬可以幫助我們了解真實手術或虛擬手術前後空鼻症(ENS)患者鼻腔的空氣動力學和空氣調節能力。鼻腔模型計算區域是由鼻黏膜下植入手術前後的CT掃描圖像和臉部特徵建立。真實手術後，患側和健康側的流量分配比率從1.13增加至1.57，鼻甲區流量分布的改善使得流經受器豐富的下鼻道氣流增加和上鼻道嗅覺區更大的壁剪切應力都可使空鼻症症狀獲得改善。真實手術後還增加了鼻黏膜表面的熱通量和水蒸氣通量，於患側鼻腔前部和鼻甲區熱通量大於50 W/m2閾值的鼻表面積也增加，因此可以提升對吸入空氣的感知。在三種不同氣候條件(環境條件、夏天條件、乾冷條件)下於後鼻孔的空氣品質也分別從33.62℃, 92.98%升至33.70℃, 93.98%；33.85℃, 94.60%升至33.92℃, 95.24%；33.14℃, 93.71%升至33.48℃, 94.29%。此外，無論是鼻側壁植入虛擬手術還是下鼻壁植入虛擬手術，患側鼻腔中的流態都會均勻分布且減少渦流的產生，熱通量感知的提升、嗅覺區更大的壁剪切應力和鼻中隔末端空氣品質的改善都可使空鼻症症狀紓緩，其中V1(側壁植入位置與較大植入物體積)手術方式又是這五種虛擬手術中表現最好的。在預測空鼻症患者鼻腔對微米等級顆粒的捕捉時發現，下鼻道的低速渦流會降低對顆粒的慣性效應，使寬大的鼻腔沉積效率低於正常鼻腔。無論是真實還是虛擬黏膜下植入手術後，氣流流態的改善使慣性效應增加和鼻腔空間的縮小都會促使顆粒撞擊牆壁的機會增加而沉積。
並列摘要
CFD simulation is conducted to realize the aerodynamics and air conditioning ability of the nasal cavity of empty nose syndrome (ENS) patients before surgery and after real or virtual surgery. The computational domains of nasal cavity models are realistically developed from the computed tomography images and face profiles before and after submucosal implant surgery. After real surgery, the ratio of volumetric flow on the disease side to that on the healthy side increases from 1.13 to 1.57 in a sine respiratory period. The real surgery redistributes the flow in the turbinate region and improves the symptoms by letting more air flow into the sensor-rich inferior meatus and higher wall shear stress on the superior turbinate olfactory region. The real surgery not only increases the heat and water fluxes from the mucous surface but also enhances the surface area on the disease side with heat flux greater than the threshold of 50 W/m2 at both the anterior and turbinate regions. Therefore, it can elevate the sensation of air on the disease side after real surgery. When breathing three different air conditions, the predicted air quality at choanae increases from 33.62℃, 92.98% to 33.70℃, 93.98% at ambient condition, from 33.85℃, 94.60% to 33.92℃, 95.24% at summer condition, and from 33.14℃, 93.71% to 33.48℃, 94.29% at cold & dry condition. In the second part of this study, we perform the submucosal implant virtual surgery at the different lateral or inferior positions in the turbinate region. In all cases, the vortex appearing in the inferior meatus reduces after the surgery. After the heat flux and wall shear stress analyses, it is expected that the ENS symptoms will be alleviated after the surgery through the increase of heat flux perception, higher wall shear stress at the olfactory region, and the improvement of the conditioned air quality at choanae. The V1 surgery with the lateral submucosal implant position shows the best ENS symptom improvement performance among the five submucosal implant virtual surgery positions. Finally, we predict the deposition of micro-size particles in the ENS nasal cavity. The existence of the low-velocity vortex in the ENS inferior nasal airway reduces the inertial deposition effect, causing the wide ENS nasal cavity with a lower deposition fraction than the healthy nasal cavity. After the real submucosal implant surgery, both the reduction of the nasal volume and the reduction of the low-velocity vortex increase the inertial deposition effect.
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