功能性鼻窦内镜术后对鼻腔鼻窦气流的影响  

Influence of Functional Endoscopic Sinus Surgery on Airflow of Postoperative Nasal Cavity and Sinuses

作　　者：熊观霞[1] 詹杰民[2] 江广理[1] 黎建峰[2] 容亮湾[2] 许庚[1] 

机构地区：[1]中山大学附属第一医院耳鼻咽喉科医院∥耳鼻咽喉科研究所,广东广州510080 [2]中山大学应用力学与工程系,广东广州510080

出　　处：《中山大学学报（医学科学版）》2009年第2期205-210,共6页Journal of Sun Yat-Sen University:Medical Sciences

基　　金：中山大学“临床医学研究5010计划”项目(No.180002)

摘　　要：【目的】用计算流体力学的方法研究功能性鼻窦内镜手术后鼻腔-鼻窦的气场参数特点。【方法】从30例健康青年人中,通过鼻内镜、鼻声反射测定仪及CT检查,严格筛选出一例研究对象,根据该入选对象的鼻腔CT影像资料,利用Fluent 6.1.22软件重建出正常鼻腔的数字模型,同时根据功能性鼻窦内镜手术的要求(切除钩突,开放筛窦、上颌窦和蝶窦)模拟出鼻内镜术后的鼻腔数字模型,再用Navier-Stokes方程对手术前后鼻腔气流的粘性运动进行数值计算,比较内镜手术前后鼻腔的气流速度、分布和压力的差异。【结果】功能性鼻内镜术后模型的总鼻道流量明显减少,中鼻道和开放的筛窦区域的气流量增加在13%以上;气流在上颌窦、筛窦、蝶窦前方部分区域的气流速度均大于0.01m/s;上颌窦中、上部的气流速度大于0.1m/s,并形成明显环状流场;术后模型鼻腔内部阻力减小,以术腔中后部阻力减少为主。【结论】鼻内镜术后的鼻腔气流力学参数发生了变化,功能性鼻内镜手术改变了鼻腔一些原有的生理力学特性。[ Objective ] To study the characteristics of the airflow-field parameter in nasal cavity and sinuses after functional endoscopic sinus surgery （FESS） by computational fluid dynamics （CFD）. [Methods] A subject was selected strictly from 30 healthy young people through nasal endoscopic examination, acoustic rhinometry measurement and CT scanning. Based on the CT image data of the subject, digital model of normal nasal cavity was reconstructed through Fluent 6.1.22 software. At the same time, according to the surgical requirements of FESS （remove the uncinate process and open the ethmoid sinus, maxillary sinus, and sphenoid sinus）, post-FESS digital nasal cavity model was simulated. The viscous motion of nasal airflow before and after FESS was calculated by Navier-Stokes equations to ＇compare the differences of airflow velocity, distribution, and pressure. [Results] In the post-FESS digital nasal cavity model, airflow through common nasal meatus decreased obviously but increased over 13% through middle nasal meatus and open ethmoid sinus. The airflow velocity in maxillary sinus, ethmoid sinus, and the anterior part of sphenoid sinus was all more than 0.01 m/s. In the middle-upper part of maxillary sinus, the airflow velocity was over 0.1 m/s and an obvious annular flow was observed. Resistance in the post-FESS digital nasal cavity model diminished mainly in the middle and posterior parts of the operational cavity. [ Conclusion ] The airflow dynamic parameters of pre- and post-FESS nasal cavity models are different which proves that FESS changes some natural physiological mechanic characteristics of nasal cavity.

关 键 词：三维重建 鼻腔 气流 计算流体力学 功能性内镜鼻窦手术 

分 类 号：R764.43[医药卫生—耳鼻咽喉科]