DOI: 10.5061/dryad.j32cb
title: Data from: Airflow in the human nasal passage and sinuses of chronic rhinosinusitis subjects

description: Chronic Rhinosinusitis (CRS) is a persistent inflammatory disease of the
 paranasal sinuses that is characterized by clinical symptoms that include
 a blocked nasal airway, mucus discharge, facial pain, headaches and
 anosmia [1, 2]. Functional endoscopic sinus surgery (FESS) is performed on
 patients who fail to improve following medical therapies such as
 antibiotics and corticosteroids (both systemic and topical nasal sprays).
 In sinus surgery, the goals are to open the obstructed sinus openings
 (ostia), to improve sinus ventilation and to restore mucociliary
 clearance. After initial surgery, a number of patients may continue to
 have ongoing symptoms and recalcitrant disease for which a more extensive
 operation such as the Modified Endoscopic Lothrop procedure (MELP) is
 performed [3–5]. The MELP procedure differs from standard frontal sinus
 dissection because both the frontal beak that narrows the frontal ostia,
 and the adjacent upper part of the nasal septum and frontal intersinus
 septum are removed, creating a single large common drainage pathway for
 both frontal sinuses. Current understanding of the relationship between
 nasal geometry (pre- and post-operative) and sinus ventilation is poor;
 and despite surgical intervention, efficient topical distribution of
 therapeutic drugs remains a significant challenge. Simulating nasal
 airflow in this complex patient group will improve our understanding of
 how surgical strategies affect post-surgical sinus ventilation, as well as
 providing new understanding for how drug delivery treatments and devices
 [6–10] can be designed to target delivery to the sinuses. Nasal passage is
 connected to sinus air pockets through an opening called ostia. Airflow in
 the human nasal cavity has been extensively studied using fluid dynamic
 simulations. We refer the reader to [11] and references there on. A number
 of studies have simulated airflow in both nasal passage and the sinuses
 [10, 12–24]. Xiong et al [12] simulated nasal airflow at 21 L/min in a
 normal healthy subject and found very little flow between the nasal
 passage and the sinuses. At the frontal sinus ostium they observed a
 limited flow rate of 0.014mL/s during inspiration and 0.018 mL/s during
 expiration. Zhu et al. [20] evaluated post-surgical airways after
 uncinectomy and bilateral inferior turbinate reduction and noticed that
 the surgery that aimed to affect flow partitioning also increased sinus
 ventilation in only one respiratory phase. The effects of surgery on
 altering nasal airflow is a complex realm and are not completely
 understood. Also, these studies do not sufficiently describe airflow in
 the sinus. This study describes airflow in the nasal passage and sinuses
 using fluid dynamic simulations. Specifically, airflow in pre-operative
 and post-operative CRS subject is investigated. FESS in CRS patients is
 known to increase nasal airway patency, however although this leads to
 reduced nasal resistance, the role of surgery in altering exchange of air
 between the sinus and nasal passages is not clear. Transient airflow is
 simulated in a healthy normal subject, a pre-operative subject with CRS,
 the same subject post-operatively after a standard FESS procedure, and a
 post-operative subject after a Lothrop procedure. Particular focus is
 given to describing airflow at the openings to the frontal and maxillary
 sinuses.
description: AllFourSubjects_NasoPressureFigure 6 of article. Steady-state nasopharyngeal pressure for all four subjects used in the study.WSS_2LPMWall shear stress data in Figure 5 compare with literature.WSS_Left12LPM.datNormalSubjec1_3PLpreop_3PLPostopSubj2b_3PLDrillOut_Subject3