The nose Our vision F LUID DYNAMICS OF THE NASAL CAVITY : The procedure HOW TO , WHAT FOR . Why Open? The future Maurizio Quadrio Politecnico di Milano Dept. of Aerospace Sciences and Technologies
The nose Our vision The procedure Why Open? The future
C REDITS The nose Our vision Giovanni Felisati (Polo Osp. s.Paolo Milano & UniMI) The procedure Carlotta Pipolo (Polo Osp. s.Paolo Milano & UniMI) Why Open? Francesco Messina (Polo Osp. s.Paolo Milano) The future Samuele Zampini (DAST PoliMI) Stefano Corti (DAST PoliMI, STR) Chiara Pesci (DAST PoliMI)
O UTLINE The nose T HE NOSE 1 Our vision The procedure O UR vision 2 Why Open? The future T HE PROCEDURE 3 W HY O PEN ? 4 T HE FUTURE 5
F UNCTIONS OF THE HUMAN NOSE The nose Our vision The First (upper) part of respiratory airways procedure Why Open? Air filtering The future Air humidification Air heating Olfactive perception (+ taste)
I NTERNAL STRUCTURE The nose Our vision The procedure Why Open? The future
S INUSES AND TURBINATES The nose Our vision The procedure Why Open? The future
A 3D VIEW The nose Our vision The procedure Why Open? The future
C ORONAL SECTION : TURBINATES AND MEATA The nose Our vision The procedure Why Open? The future
S IGNIFICANT LONGITUDINAL VARIATIONS The nose Our vision The procedure Why Open? The future
H OW TO STUDY THE NASAL CAVITY The nose Our vision The procedure In-vivo approach: difficult, not useful Why Open? In-vitro approach: rarely used The future First meaningful CFD study in 2004 (Zhao, Chem. Senses)
CFD: STATE OF THE ART C HARACTERISTICS AND LIMITATIONS The nose Our vision The Long times (weeks/months) for producing a mesh procedure Why Open? Questionable (but never questioned!) modellistic The future approaches RANS (or laminar) Results cannot be verified
M ODELLING LIMITATIONS The nose Our vision The procedure Why Open? The future
O UTLINE The nose T HE NOSE 1 Our vision The procedure O UR vision 2 Why Open? The future T HE PROCEDURE 3 W HY O PEN ? 4 T HE FUTURE 5
T HE PROBLEM The nose Our vision The procedure In 2009 Regione Lombardia has spent: Why Open? Septoplastic: 5600 procedures, 8.6M e The future Turbinates surgery: 3000 procedures, 4.3M e FESS: 5700 procedures, 11.6M e
FESS Nowadays functional endoscopic sinus surgery (FESS) is the gold standard for chronic NBD The nose treatment. The operation generally involves Our vision inferior/middle turbinoplasty and uncinate and The procedure ethmoid excision, sometimes followed by opening Why Open? of the maxillary, sphenoid and frontal sinuses. A The future correction of a nasal septal deviation can also be necessary. ... However, we are currently unable to assess the relevance of every single anatomic anomaly and its surgical modification on the overall nasal flow quality and nasal obstruction. Quadrio et al, 2013? 2014?
O UTLINE The nose T HE NOSE 1 Our vision The procedure O UR vision 2 Why Open? The future T HE PROCEDURE 3 W HY O PEN ? 4 T HE FUTURE 5
T HE PROCEDURE The nose Our vision Patient-specific procedure The procedure CFD results from a CT scan Why Open? Support to surgery planning (virtual surgery) The future Reliable results Robust and feasible procedure (time and cost) Goal: reduce / optimize surgery
T HE TOOLCHAIN The nose Our vision The procedure 1 Analysis of CT scan (3DSlicer) Why Open? 2 STL from CT scan (3DSlicer) The future 3 Volume mesh (OpenFOAM – snappyHexMesh) 4 CFD (OpenFOAM)
1/4 A NALYSIS OF THE CT SCAN I MPORTANT SEPTAL DEVIATION The nose Our vision The procedure Why Open? The future
1/4 A NALYSIS OF THE CT SCAN (2) N EARLY - COMPLETE OBSTRUCTION The nose Our vision The procedure Why Open? The future
2/4 STL FROM CT SCAN W RONG HU THRESHOLD The nose Our vision The procedure Why Open? The future
2/4 STL FROM CT SCAN (2) C ORRECT HU THRESHOLD The nose Our vision The procedure Why Open? The future
3/4 V OLUME MESH C ASTELLATED MESH The nose Our vision The procedure Why Open? The future
3/4 V OLUME MESH (2) C ASTELLATED MESH The nose Our vision The procedure Why Open? The future
3/4 V OLUME MESH (3) S NAP The nose Our vision The procedure Why Open? The future
3/4 V OLUME MESH (4) C ASTELLATED MESH The nose Our vision The procedure Why Open? The future
3/4 V OLUME MESH (5) A DDING LAYERS The nose Our vision The procedure Why Open? The future
4/4 CFD S TEADY INSPIRATION , LAMINAR The nose Our vision The procedure Why Open? The future
O UTLINE The nose T HE NOSE 1 Our vision The procedure O UR vision 2 Why Open? The future T HE PROCEDURE 3 W HY O PEN ? 4 T HE FUTURE 5
T HE ROLE OF O PEN SOURCE AND O PEN FOAM The nose Our vision The procedure Freedom Why Open? The future Reliability Flexibility
O UTLINE The nose T HE NOSE 1 Our vision The procedure O UR vision 2 Why Open? The future T HE PROCEDURE 3 W HY O PEN ? 4 T HE FUTURE 5
N EXT STEPS The nose Our vision The Virtual surgery procedure Why Open? 3D-PIV lab experiment for validation (grant from The future Ministry of Health) LES Trial before large scale deployment
V IRTUAL SURGERY R EMOVING SEPTAL DEVIATION / TURBINATE REDUCTION The nose Our vision The procedure Why Open? The future
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