Nasal architecture: form and flow

The role of biofluid mechanics in the assessment of clinical and pathological observations: sixth International Bio-Fluid Mechanics Symposium and Workshop, March 28-30, 2008 Pasadena, California

Biofluid mechanics is increasingly applied in support of diagnosis and decision-making for treatment of clinical pathologies. Exploring the relationship between blood flow phenomena and pathophysiological observations is enhanced by continuing advances in the imaging modalities, measurement techniques, and capabilities of computational models. When combined with underlying physiological models, a powerful set of tools becomes available to address unmet clinical needs, predominantly in the direction of enhanced diagnosis, as well as assessment and prediction of treatment outcomes. This position paper presents an overview of current approaches and future developments along this theme that were discussed at the 5th International Biofluid Symposium and Workshop held at the California Institute of Technology in 2008. The introduction of novel mechanical biomarkers in device design and optimization, and applications in the characterization of more specific and focal conditions such as aneurysms, are at the center of attention. Further advances in integrative modeling, incorporating multiscale and multiphysics techniques are also discussed.

Visual exploration of nasal airflow

Rhinologists are often faced with the challenge of assessing nasal breathing from a functional point of view to derive effective therapeutic interventions. While the complex nasal anatomy can be revealed by visual inspection and medical imaging, only vague information is available regarding the nasal airflow itself: Rhinomanometry delivers rather unspecific integral information on the pressure gradient as well as on total flow and nasal flow resistance. In this article we demonstrate how the understanding of physiological nasal breathing can be improved by simulating and visually analyzing nasal airflow, based on an anatomically correct model of the upper human respiratory tract. In particular we demonstrate how various Information Visualization (InfoVis) techniques, such as a highly scalable implementation of parallel coordinates, time series visualizations, as well as unstructured grid multi-volume rendering, all integrated within a multiple linked views framework, can be utilized to gain a deeper understanding of nasal breathing. Evaluation is accomplished by visual exploration of spatio-temporal airflow characteristics that include not only information on flow features but also on accompanying quantities such as temperature and humidity. To our knowledge, this is the first in-depth visual exploration of the physiological function of the nose over several simulated breathing cycles under consideration of a complete model of the nasal airways, realistic boundary conditions, and all physically relevant time-varying quantities.

Inflow boundary profile prescription for numerical simulation of nasal airflow

Knowledge of how air flows through the nasal passages relies heavily on model studies, as the complexity and relative inaccessibility of the anatomy prevents detailed in vivo measurement. Almost all models to date fail to incorporate the geometry of the external nose, instead employing a truncated inflow. Typically, flow is specified to enter the model domain either directly at the nares (nostrils), or via an artificial pipe inflow tract attached to the nares. This study investigates the effect of the inflow geometry on flow predictions during steady nasal inspiration. Models that fully replicate the internal and external nasal airways of two anatomically distinct subjects are used as a reference to compare the effects of common inflow treatments on physiologically relevant quantities including regional wall shear stress and particle residence time distributions. Inflow geometry truncation is found to affect flow predictions significantly, though slightly less so for the subject displaying more pronounced passage area contraction up to the internal nasal valve. For both subject geometries, a tapered pipe inflow provides a better approximation to the natural inflow than a blunt velocity profile applied to the nares. Computational modelling issues are also briefly outlined, by comparing quantities predicted using different surface tessellations, and by evaluation of domain-splitting techniques.

Computational modeling of flow and gas exchange in models of the human maxillary sinus

The present study uses numerical modeling to increase the understanding of sinus gas exchange, which is thought to be a factor in sinus disease. Order-of-magnitude estimates and computational fluid dynamics simulations were used to investigate convective and diffusive transport between the nose and the sinus in a range of simplified geometries. The interaction between mucociliary transport and gas exchange was modeled and found to be negligible. Diffusion was the dominant transport mechanism for small ostia and large concentration differences between the sinus and the nose, whereas convection was important for larger ostia or smaller concentration differences. The presence of one or more accessory ostia can increase the sinus ventilation rate by several orders of magnitude, because it allows a net flow through the sinus. Estimates of nitric oxide (NO) transport through the ostium based on measured sinus and nasal NO concentrations suggest that the sinuses cannot supply all the NO in nasally exhaled air.

Morphological adaptation of the nasal valve area to climate

Ecogeographic variation in nasal valve angles stands as one of the best examples of human morphological adaptation to climate. A major physiological function of the nasal cavity is to condition the inhaled air to body core temperature and saturated with vapour to prevent damage to the alveolar epithelium in the lungs. The air conditioning capability of the nose is dependent on the nasal mucosal temperature and the airflow dynamics caused by the airway geometry. Morphological variation of the human nose has been attributed to the ecogeographic adaptation to climate where nasal cavities have been broadly categorised as tall and narrow (leptorrhines) or short and broad (platyrrhines) according to their morphology. We believe that there is a relationship between nasal valve angles and climate adaptation.

Mechanics of airflow in the human nasal airways

The mechanics of airflow in the human nasal airways is reviewed, drawing on the findings of experimental and computational model studies. Modelling inevitably requires simplifications and assumptions, particularly given the complexity of the nasal airways. The processes entailed in modelling the nasal airways (from defining the model, to its production and, finally, validating the results) is critically examined, both for physical models and for computational simulations. Uncertainty still surrounds the appropriateness of the various assumptions made in modelling, particularly with regard to the nature of flow. New results are presented in which high-speed particle image velocimetry (PIV) and direct numerical simulation are applied to investigate the development of flow instability in the nasal cavity. These illustrate some of the improved capabilities afforded by technological developments for future model studies. The need for further improvements in characterising airway geometry and flow together with promising new methods are briefly discussed.