OBJECTIVETo explore the effect of septoplasty or in combination with out fracture of the inferior turbinate in patients with nasal septum deviation on the airflow field and the nasal airway structure.

METHODSSix patients with nasal septum deviation underwent spiral CT imaging scans before surgery and during the follow-up. The 3D finite element meshes of the nasal airway were developed from the above CT scans. Given three preconditions, the nasal airflow fields were described by the Navier-Stokes and continuity equations at the inspiratory flow rate of 12 L/min. The whole airflow patterns were obtained and then compared with the airflow filed and airway structure changes before and after surgery. SPSS 12.0 software was used to analyze the data.

RESULTSBefore surgery, area of the common airway and the middle and ventral medial regions in the concave side were (1.61 ± 0.18), (0.40 ± 0.10), (0.40 ± 0.14) cm(2) respectively, and those of convex side were (1.30 ± 0.18), (0.33 ± 0.05), (0.36 ± 0.10) cm(2) respectively. The differences between both sides were of no statistical significance (Z value was 1.782, 1.363, 0.526 respectively, all P > 0.05). Airflow of the above airways were (361 ± 68), (131 ± 25), (100 ± 28) ml respectively in concave side and (178 ± 33), (59 ± 26), (59 ± 18) ml respectively in convex side, which differences were significant statistically (Z value were 2.207, 2.201, 2.201 respectively, all P < 0.05). The inferior turbinate in concave side [(0.93 ± 0.10) cm] was statistically (Z = 2.214, P < 0.05) bigger than that in convex side [(0.58 ± 0.12) cm] before surgery. The airflow fields were in disorder in both ill-airways. After surgery, area of the common airway was (2.55 ± 0.44) cm(2) in concave side and (2.20 ± 0.72) cm(2) in convex side respectively, and area of the middle and ventral medial regions in the convex side were (0.58 ± 0.13), (0.81 ± 0.26) cm(2) respectively, which differences were of significance statistically when comparing to areas before surgery (Z value were 2.201, 2.201, 2.201, 2.201, P < 0.05). The airflow passed through nasal airway orderly in both sides. But the thickness of inferior turbinate was (0.73 ± 0.08) cm in concave side after surgery, which difference was significant statistically in comparison to that before surgery (Z = 2.264, P < 0.05). Consequently, nasal resistance decreased from (0.41 ± 0.03) kPa×L(-1)×s(-1) to (0.16 ± 0.01) kPa×L(-1)×s(-1) after surgery, the difference was significantly (Z = -2.207, P = 0.027).

CONCLUSIONSeptoplasty or in combination with out fracture of the inferior turbinate, followed by the self-adaptation consecutively, could improve the airway and breathing capacity of the nose.