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Über dieses Buch

This book explores computational fluid dynamics in the context of the human nose, allowing readers to gain a better understanding of its anatomy and physiology and integrates recent advances in clinical rhinology, otolaryngology and respiratory physiology research. It focuses on advanced research topics, such as virtual surgery, AI-assisted clinical applications and therapy, as well as the latest computational modeling techniques, controversies, challenges and future directions in simulation using CFD software. Presenting perspectives and insights from computational experts and clinical specialists (ENT) combined with technical details of the computational modeling techniques from engineers, this unique reference book will give direction to and inspire future research in this emerging field.



Chapter 1. Clinical and Biomedical Engineering in the Human Nose

The convergence of Computational Fluid Dynamics (CFD) with otorhinolaryngology has provided an avenue for a multidisciplinary approach to observe nasal physiology. This chapter provides a history of its beginnings to its advances that parallel with increased computational power, and a discussion on how it could be applied to specific clinical applications. Furthermore, the challenges in bringing the techniques to be used as a diagnostic for clinical practice is discussed.
Kiao Inthavong, Eugene Wong, Jiyuan Tu, Narinder Singh

Chapter 2. Anatomy and Physiology of the Human Nose

A good understanding of the normal human nose anatomy and function is critical to perform human respiratory system computer modelling and computational fluid dynamic (CFD) analysis. This chapter provides a broad overview of the function and organisation of the human respiratory system, including essential anatomical definitions, anatomy and naming conventions, as well as particular areas of surgical interest. The topics include Functions and Organisation of the Respiratory System, and the nasal cavity anatomy, function, physiology, and histology.
Eugene Wong, Joey Siu, Richard Douglas, Narinder Singh

Chapter 3. Sinonasal Anatomic Variants, Diseases and their Management

There is an enormous range of anatomical variants of the nasal cavity and paranasal sinuses, and these can be influenced by gender, age and ethnic adaptations to local climate. A further factor is pneumatization of the paranasal sinuses which is highly variable between individuals. When significant deviations occur from typical airway geometries, this can lead to nasal airway obstruction having the potential to significantly reduce quality of life in patients. This chapter presents the main factors affecting anatomy geometry, and common disorders, diseases, and its management.
Joey Siu, Richard Douglas

Chapter 4. Surgery of the Nasal Cavity

Early use of computational fluid dynamics (CFD) for studies in the nose primarily focussed on understanding airflow and physiology. With advanced techniques evolving CFD models have become more advanced, and the technology for the study of surgery has been improved through the analysis of pre-and post-operative models. This development has led to the use of “virtual” surgery in computer models to predict the results of existing procedures and to potentially create new procedures. This chapter covers pre-operative assessment and current methods of planning for nasal surgery, types of nasal surgery and an introduction to virtual surgery using CFD.
Kimberley Bradshaw, Narinder Singh

Chapter 5. Computational Reconstruction of the Human Nasal Airway

Reconstructing the human airways begins with image acquisition which involves the procurement of medical images typically from computed tomography (CT) or magnetic resonance (MR) imaging. This produces a 3D matrix of a series of 2D cross-sections, that contains information about tissues and anatomic structures. Reconstructing the airway from the medical scans involves segmentation of the region of interest. The segmentation step extracts a contiguous airway region which is ready for 3D model processing. This chapter discusses CT and MR scan imaging, followed by some common segmentation algorithms based on thresholding, edge detection, and region characteristics.
Jose Luis Cercos-Pita

6. Computational Meshing for CFD Simulations

In CFD modelling, small cells or elements are created to fill this volume. They constitute a mesh where each cell represents a discrete space that represents the flow locally. Mathematical equations that represent the flow physics are then applied to each cell of the mesh. Generating a high quality mesh is extremely important to obtain reliable solutions and to guarantee numerical stability. This chapter begins with a basic introduction to a typical workflow and guidelines for generating high quality meshes, and concludes with some more advanced topics, i.e., how to generate meshes in parallel, a discussion on mesh quality, and examples on the application of lattice-Boltzmann methods to simulate flow without any turbulence modelling on highly-resolved meshes.
Andreas Lintermann

Chapter 7. Fundamentals of Fluid Dynamics

The purpose of CFD is to map and quantify fluid flows in space and time. CFD simulations achieve this by solving the equations that govern flow: conservation of mass; balance of momentum; and conservation of energy. This chapter describes what these equations conceptually mean and how they are derived by applying basic physics statements such as Newton’s second law and the first law of thermodynamics to fluids. Fluid flow phenomena including boundary layers, turbulence, and unsteadiness are introduced and techniques to model them via CFD simulations are discussed. Turbulence models, which allow CFD simulations to achieve accurate results without having to calculate the smallest velocity fluctuations in a flow, thereby accelerating simulations, are also discussed and the most common models used in respiratory airflow simulations are compared.
Alister J. Bates

8. Clinical Implications of Nasal Airflow Simulations

This chapter provides an up-to-date literature review on the relevance of CFD modeling results in clinical settings and the efforts made in the field to establish normative ranges for some CFD-derived variables. We discuss the significance of CFD-derived variables such as unilateral nasal airflow partitioning, nasal airway resistance, heat flux and wall shear stress on nasal function or symptomatology, and the strong associations established with these variables. Two important issues are discussed: (i) a need to establish meaningful representation involving combinations of different computed variables in order to accurately capture the full dynamical nature of patient-reported symptomatology; (ii) a need to develop a robust database of normative values for CFD-derived variables since typical healthy human sinonasal airway anatomies are characterized by substantial intersubject variability that confound concise description of normal airflow profile.
Dennis Onyeka Frank-Ito, Guilherme Garcia

Chapter 9. Clinical CFD Applications 1

This chapter is the first of two chapters demonstrating the wide variety of CFD studies in clinical applications presented from leading researchers in their respective fields. This chapter covers the latest research techniques and outcomes in airflow and conditioning in the nasal cavity; fluid and particle dynamics from sniffing; nasal obstruction and empty nose syndrome; nasal nitric oxide (nNO) dynamics and the ostiomeatal complex.
Chengyu Li, Kai Zhao, Dennis Shusterman, Hadrien Calmet, Alister J. Bates, Joey Siu, Richard Douglas

Chapter 10. Clinical CFD Applications 2

This chapter is the second of the two chapters demonstrating the wide variety of CFD studies in clinical applications presented from leading researchers in their respective fields. This chapter covers the latest research techniques and outcomes in whole lung modelling; Modeling the Effect of Airway Motion Using Dynamic Imaging; and Automatic reconstruction of the nasal geometry from CT scans.
Yu Feng, Hamideh Hayati, Alister J. Bates, Koch Walter, Lehner Matthias, Benda Odo, Ortiz Ramiro, Koch Gerda

11. CFD Applications for Drug Delivery

This chapter provides the latest research trends in applications of CFD for investigating nasal drug delivery. Contributions include research and outcomes from the regulatory body, US Food Drug Administration on recent projects. Additionally, the chapter showcases the application of multiphase flow for capturing nasal spray drug delivery for improving olfactory targeting for nose-to-brain drug delivery, and nasal irrigation targeting the sinuses.
Kendra Shrestha, Ross Walenga, Jinxiang Xi, Yidan Shang, Hana Salati, Jim Bartley, David White

Chapter 12. Future Topics, Challenges

Rapidly developing computational techniques and technologies have led to increased research activity in computational modelling of nasal airflow. The research has reached a critical crossroad where novel techniques and ideas will be needed to develop and shape the future trends in nasal airway modelling, including advanced multiphysics approaches with real breathing conditions. This chapter also discusses some recent developments including whole respiratory airway and lung models, and how big data and artificial intelligence can be integrated into current capability to advance the field.
Kiao Inthavong


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