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F LUID DYNAMICS OF THE NASAL CAVITY : The procedure HOW TO , WHAT - PowerPoint PPT Presentation

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


  1. 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

  2. The nose Our vision The procedure Why Open? The future

  3. 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)

  4. 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

  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)

  6. I NTERNAL STRUCTURE The nose Our vision The procedure Why Open? The future

  7. S INUSES AND TURBINATES The nose Our vision The procedure Why Open? The future

  8. A 3D VIEW The nose Our vision The procedure Why Open? The future

  9. C ORONAL SECTION : TURBINATES AND MEATA The nose Our vision The procedure Why Open? The future

  10. S IGNIFICANT LONGITUDINAL VARIATIONS The nose Our vision The procedure Why Open? The future

  11. 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)

  12. 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

  13. M ODELLING LIMITATIONS The nose Our vision The procedure Why Open? The future

  14. 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

  15. 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

  16. 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?

  17. 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

  18. 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

  19. 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)

  20. 1/4 A NALYSIS OF THE CT SCAN I MPORTANT SEPTAL DEVIATION The nose Our vision The procedure Why Open? The future

  21. 1/4 A NALYSIS OF THE CT SCAN (2) N EARLY - COMPLETE OBSTRUCTION The nose Our vision The procedure Why Open? The future

  22. 2/4 STL FROM CT SCAN W RONG HU THRESHOLD The nose Our vision The procedure Why Open? The future

  23. 2/4 STL FROM CT SCAN (2) C ORRECT HU THRESHOLD The nose Our vision The procedure Why Open? The future

  24. 3/4 V OLUME MESH C ASTELLATED MESH The nose Our vision The procedure Why Open? The future

  25. 3/4 V OLUME MESH (2) C ASTELLATED MESH The nose Our vision The procedure Why Open? The future

  26. 3/4 V OLUME MESH (3) S NAP The nose Our vision The procedure Why Open? The future

  27. 3/4 V OLUME MESH (4) C ASTELLATED MESH The nose Our vision The procedure Why Open? The future

  28. 3/4 V OLUME MESH (5) A DDING LAYERS The nose Our vision The procedure Why Open? The future

  29. 4/4 CFD S TEADY INSPIRATION , LAMINAR The nose Our vision The procedure Why Open? The future

  30. 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

  31. T HE ROLE OF O PEN SOURCE AND O PEN FOAM The nose Our vision The procedure Freedom Why Open? The future Reliability Flexibility

  32. 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

  33. 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

  34. V IRTUAL SURGERY R EMOVING SEPTAL DEVIATION / TURBINATE REDUCTION The nose Our vision The procedure Why Open? The future

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