Abstract：
OBJECTIVE: Mucosal decongestion with nasal sprays is a common treatment for nasal airway obstruction. However, the impact of mucosal decongestion on nasal aerodynamics and the physiological mechanism of nasal airflow sensation are incompletely understood. The objective of this study is to compare nasal airflow patterns in nasal airway obstruction (NAO) patients with and without mucosal decongestion and nondecongested healthy subjects.
METHODS: Cross-sectional study of a convenience sample.
METHODS: Academic tertiary medical center.
METHODS: Forty-five subjects were studied (15 nondecongested healthy subjects, 15 nondecongested NAO patients, and 15 decongested NAO patients). Three-dimensional models of the nasal anatomy were created from computed tomography scans. Steady-state simulations of airflow and heat transfer were conducted at 15 L/min inhalation rate using computational fluid dynamics.
RESULTS: In the narrow side of the nose, unilateral nasal resistance was similar in decongested NAO patients and nondecongested healthy subjects, but substantially higher in nondecongested NAO patients. The vertical airflow distribution within the nasal cavity (inferior vs middle vs superior) was also similar in decongested NAO patients and nondecongested healthy subjects, but nondecongested NAO patients had substantially less middle airflow. Mucosal cooling, quantified by the surface area where heat flux exceeds 50 W/m2, was significantly higher in decongested NAO patients than in nondecongested NAO patients.
CONCLUSIONS: This pilot study suggests that mucosal decongestion improves objective measures of nasal airflow, which is consistent with improved subjective sensation of nasal patency after decongestion.
METHODS: Cross-sectional study of a convenience sample.
METHODS: Academic tertiary medical center.
METHODS: Forty-five subjects were studied (15 nondecongested healthy subjects, 15 nondecongested NAO patients, and 15 decongested NAO patients). Three-dimensional models of the nasal anatomy were created from computed tomography scans. Steady-state simulations of airflow and heat transfer were conducted at 15 L/min inhalation rate using computational fluid dynamics.
RESULTS: In the narrow side of the nose, unilateral nasal resistance was similar in decongested NAO patients and nondecongested healthy subjects, but substantially higher in nondecongested NAO patients. The vertical airflow distribution within the nasal cavity (inferior vs middle vs superior) was also similar in decongested NAO patients and nondecongested healthy subjects, but nondecongested NAO patients had substantially less middle airflow. Mucosal cooling, quantified by the surface area where heat flux exceeds 50 W/m2, was significantly higher in decongested NAO patients than in nondecongested NAO patients.
CONCLUSIONS: This pilot study suggests that mucosal decongestion improves objective measures of nasal airflow, which is consistent with improved subjective sensation of nasal patency after decongestion.
摘要：
目的：鼻腔喷雾剂粘膜充血是鼻气道阻塞的常用治疗方法。然而,粘膜充血对鼻腔空气动力学的影响和鼻腔气流感觉的生理机制尚不完全清楚。这项研究的目的是比较有或没有粘膜充血和未充血的健康受试者的鼻气道阻塞（NAO）患者的鼻气流模式。
方法：方便样本的横断面研究。
方法：学术三级医疗中心。
方法：研究了45名受试者（15名非充血健康受试者，15名非充血的NAO患者，和15名去充血的NAO患者)。通过计算机断层扫描创建鼻解剖结构的三维模型。使用计算流体动力学以15L/min的吸入速率进行气流和传热的稳态模拟。
结果：在鼻子的狭窄一侧，单侧鼻阻力在无充血的NAO患者和无充血的健康受试者中相似，但在非充血的NAO患者中明显更高。在非充血的NAO患者和非充血的健康受试者中，鼻腔内的垂直气流分布(下、中、上)也相似。但非充血的NAO患者的中间气流明显减少.粘膜冷却，通过热通量超过50W/m2的表面积来量化，无充血的NAO患者明显高于无充血的NAO患者。
结论：这项初步研究表明，粘膜充血可以改善鼻腔气流的客观指标，这与减轻充血后鼻通畅的主观感觉得到改善是一致的。
方法：方便样本的横断面研究。
方法：学术三级医疗中心。
方法：研究了45名受试者（15名非充血健康受试者，15名非充血的NAO患者，和15名去充血的NAO患者)。通过计算机断层扫描创建鼻解剖结构的三维模型。使用计算流体动力学以15L/min的吸入速率进行气流和传热的稳态模拟。
结果：在鼻子的狭窄一侧，单侧鼻阻力在无充血的NAO患者和无充血的健康受试者中相似，但在非充血的NAO患者中明显更高。在非充血的NAO患者和非充血的健康受试者中，鼻腔内的垂直气流分布(下、中、上)也相似。但非充血的NAO患者的中间气流明显减少.粘膜冷却，通过热通量超过50W/m2的表面积来量化，无充血的NAO患者明显高于无充血的NAO患者。
结论：这项初步研究表明，粘膜充血可以改善鼻腔气流的客观指标，这与减轻充血后鼻通畅的主观感觉得到改善是一致的。
