Diseases, disorders and alterations of the nasal airways are among the pathologies with the highest incidence in the world population. In Europe alone, 11% of the population suffers from some type of nasal obstruction. More than 7 million nose surgeries are performed annually around the world, with failure rates of between 9% and 57%.
Much of the blame for the high rate of surgical failure lies in the diagnostic methodology, which has been applied for 40 years without any improvements. Active anterior rhinomanometry (AAR), peak inspiratory nasal flow (PIF) or acoustic rhinometry (AR), are invasive and cumbersome methodologies that do not provide enough detailed information to diagnose accurately and reliably the pathologies derived from nasal obstruction. We could say that the quality of the diagnosis is mainly based on the quality of the ENT specialist's training and experience in the treatment of specific clinical cases.
Nowadays we know very well the nasal physiology, its anatomical structures, bones and soft tissues, but we do not know - mainly due to the lack of tools available in the ENT field - the functional and quantitative capacity of the nasal cavity.
Imagine if you could accurately reproduce how air flows into your nose and how it behaves once inside. Imagine if you could simulate and visualize it with a computer so that you could analyze it in detail, from the velocity at which the air moves in the nose, to the temperature, the pressure, the vortices that are generated, the friction that is produced, etc... Imagine being able to do all this non-invasively and in a matter of minutes. Although it sounds like science fiction, we are talking about science, more specifically computational fluid dynamics (CFD).
What is computational fluid dynamics?
Computational fluid dynamics is the science that solves and analyzes the behavior of fluid flows (liquids and gases) by means of numerical methods and algorithms. In other words, the simulation, using computers, of all possible iterations of a fluid on a complex surface.
CFD technology has been used in a standardized way for 50 years in leading technological industries such as aerospace, naval, automotive, architecture... Since the late 1990s, computational fluid dynamics techniques have also been used to analyze airflow in the nasal passages, with the aim of improving our understanding of the mechanical behavior of the nasal cavity, and to use the information obtained from CFD analysis to assist the otolaryngologist in nasal diagnosis and surgery.
The importance of CFD studies in daily ENT clinical practice.
The scientific and quantitative information derived from the analysis of the actual behavior of the air in the nasal cavity is a revolutionary method to detect diseases and respiratory problems related to nasal obstruction and malformations. A non-invasive way to support and improve both diagnosis and treatment of nasal pathologies, such as: chronic rhinosinusitis, deviated septum, rhinoplasty, empty nose syndrome or sleep apnea syndrome, among many others.
Although CFD tools have always been very expensive and specialized and therefore beyond the reach of ENT specialists and patients, a technological democratization is currently being experienced that allows anyone to access this type of analysis.
CFD technology and its application in rhinology is a reality and fortunately it is here to stay.
