| Objective To investigate the relationship between morphological related parameters of nasal septum and characteristics of nasal airflow field and the severity of subjective and objective conditions in patients with chronic rhinosinusitis without nasal polyps(CRSsNP).Methods 66 cases of CRSsNP group and 60 cases of normal control group were selected in this study.The subjective condition of CRSsNP group was evaluated by visual analogue scale(VAS)and sinus-nasal outcome test-20(SNOT-20).Objective evaluation of the two groups was performed by the Lund-Mackay sinus CT score;we created three-dimensional reconstruction of the nasal septum based on high-resolution CT data of nose.The morphological parameters of nasal septum in the two groups were compared.According to the angle of the nasal septum deflection,the CRSsNP group and control group were divided into three groups: mild,moderate and severe(mild 0 ° ~ 9 °,moderate 10 ° ~ 15 °,and severe> 15 °).According to the contact septal spur,the two groups were divided into a group with contact spur and group without a contact spur.Therefore,we analyzed the relationship between the nasal septum morphology and the subjective and objective disease severity of CRSsNP;we created computational fluid dynamics nasal cavity airway models and compared the two groups nasal airflow characteristics.Therefore,we analyzed the relationship between the nasal airflow characteristics and the subjective and objective disease severity of CRSsNP.Results 1.Nasal septum morphological parameters: septal deviation angle,septal volume,septal surface area,and the rate of contact super(+)in the CRSsNP group were found to be significantly larger than the control group(P<0.05).the degree of nasal septum deviation was statistically significant between the CRSsNP group and the control group(P<0.05).moderate and severe deflection were found to be correlated with the occurrence of CRSsNP.2.In the CRSsNP group,the angle of the nasal septum and the subjective disease score(VAS,SNOT-20)was positively correlated(r=0.283,P=0.021;r= 0.294,P=0.016).The VAS score of severe deviation group was significantly higher than that of mild deviation group,and LM score of severe deviation group was significantly higher than that of moderate deviation group.3.Compared with CRSsNP patients with contact nasal septal spur(-),the scores of nasal obstruction VAS,headache VAS,anosmia VAS,total VAS and total SNOT-20 in CRSsNP patients with contact septal spur(+)were significantly higher(P<0.05),but there was no statistical difference in the LM scores between the two groups(P> 0.05).4.The nasal airflow distribution in patients with CRSsNP was uneven compared to the normal people,and the pressure and velocity gradients were significantly different than that of the normal people.5.The CFD-nasal airway resistance and the mucosal area-volume ratio of nasal cavity in CRSsNP patients were significantly larger than those in control group(P<0.05).nasal cavity volume and mucosal area were significantly lower than that in control group(P<0.05).6.In the CRSsNP group,there were significant correlation between CFD-NAR and nasal obstruction VAS(r=0.631,P<0.001),CFD-NAR and total VAS(r=0.293,P=0.017),and the mucosal area-volume ratio of nasal cavity and nasal obstruction VAS(r= 0.308,P=0.012),however,the LM score did not correlate with the mucosal area-volume ratio and the CFD-NAR(P> 0.05).Conclusion The morphological parameters of the nasal septum and the presence or absence of contact nasal septal spur in patients with CRSsNP can be used as objective indicators of nasal septum,and have a certain degree of influence on the symptoms and disease severity of CRSsNP patients.There are significant differences in nasal airflow characteristics between CRSsNP patients and normal people,and the nasal airflow characteristics may be related to the subjective symptoms of CRSsNP patients. |
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