Export file:


  • RIS(for EndNote,Reference Manager,ProCite)
  • BibTex
  • Text


  • Citation Only
  • Citation and Abstract

Comparison of airflow characteristics after Draf Ⅲ frontal sinus surgery and normal person by numerical simulation

1 Department of Otolaryngology-Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China
2 Department of Otolaryngology-Head and Neck Surgery, Second Affiliated Hospital of Dalian Medical University, Dalian, China
3 Department of Engineering Mechanics, Dalian University of Technology, Dalian, China

Special Issues: Machine Learning and Big Data in Medical Image Analysis

Draf III frontal sinus surgery is confirmed as an effective surgical treatment for refractory sinusitis and frontal sinus tumors, etc. Although it has been reported to improve symptoms and reduce the recurrence rate of polyps significantly, the study of airflow characteristics in frontal sinus after Draf III is still rare, especially compared with normal person. This study was designed to describe the airflow characteristics of frontal sinus after Draf III procedure and differences compared with normal subject. One patient with refractory sinusitis received Draf III procedure15 months ago, and one normal person were selected retrospectively. The two subjects reported no discomfort and no abnormalities in their paranasal sinus within computed tomography scans. Computational fluid dynamics and numerical simulation calculation was performed with the finite volume method. The quantitative indexes of airflow in the frontal sinus of Draf III and normal subjects were achieved. Areas of relatively high-pressure and high wall shear stress located in a posterior part of frontal sinus ostium in both models. Inside frontal sinus, pressure and velocity of flow between Draf III and normal models were statistically significant differences (p < 0.01) after analyzed by Mann-Whitney U test. But airflow pattern of each section in frontal sinus was basically the same. Draf III sinus surgery is able to achieve nasal airflow patterns similar to those of normal person. Although values of airflow pressure and velocity were different from normal person, patients could have no subjective discomfort after surgery. “Frontal T” structure is a key anatomical site interacted with airflow to be an important cause of postoperative edema after Draf III procedure.
  Article Metrics

Keywords Draf III; modified Lothrop procedure; numerical simulation; computational fluid dynamics; airflow

Citation: Cheng Li, Xiuzhen Sun, Ming Zhao, Shen Yu, Qian Huang, Xiaoqing Zhang, Zhenxiao Huang, Shunjiu Cui, Bing Zhou. Comparison of airflow characteristics after Draf Ⅲ frontal sinus surgery and normal person by numerical simulation. Mathematical Biosciences and Engineering, 2019, 16(4): 1750-1760. doi: 10.3934/mbe.2019084


  • 1. P. J. Wormald, Salvage frontal sinus surgery: The endoscopic modified Lothrop procedure, Laryngoscope, 2 (2003), 276–283.
  • 2. W. Draf, Endonasal micro-endoscopic frontal sinus surgery: The fulda concept, Operative Techniques in Otolaryngology-Head and Neck Surgery, 2 (1991), 234–240.
  • 3. L. C. Shih, V. S. Patel and G. W. Choby, et al., Evolution of the endoscopic modified Lothrop procedure: A systematic review and meta-analysis, Laryngoscope, 2 (2018), 317–326.
  • 4. N. Choudhury, A. Hariri and H. Saleh, Extended applications of the endoscopic modified Lothrop procedure, J. Laryngol. Otol., 9 (2016), 827–832.
  • 5. C. Georgalas, F. Hansen and W. J. Videler, et al., Long terms results of Draf type III (modified endoscopic Lothrop) frontal sinus drainage procedure in 122 patients: A single centre experience, Rhinology, 2 (2011), 195–201.
  • 6. J. M. Yip, K. A. Seiberlin and P. J. Wormald, Patient-reported olfactory function following endoscopic sinus surgery with modified endoscopic Lothrop procedure/Draf 3, Rhinology, 2 (2011), 217–220.
  • 7. T. Ye, P. H. Hwang and Z. Huang, et al., Frontal ostium neo-osteogenesis and patency after Draf III procedure: A computer-assisted study, Int. Forum. Allergy Rhinol., 9 (2014), 739–744.
  • 8. D. K. Morrissey, A. Bassiouni and A. J. Psaltis, et al., Outcomes of revision endoscopic modified Lothrop procedure, Int. Forum. Allergy Rhinol., 5 (2016), 518–522.
  • 9. C. Li, B. Zhou and Q. Huang, et al., [Prospective study of the impact on nasal function of the Draf Ⅲ frontal sinus surgery], Chin. J. Otorhinolaryngol. Head Neck Surgery, 9 (2014), 1–5.
  • 10. R. Jankowski, D. Pigret and F. Decroocq, et al., Comparison of radical (nasalisation) and functional ethmoidectomy in patients with severe sinonasal polyposis. A retrospective study, Rev. Laryngol. Otol. Rhinol., 3 (2006), 131–140.
  • 11. A. Bassiouni and P. J. Wormald, Role of frontal sinus surgery in nasal polyp recurrence, Laryngoscope, 1 (2013), 36–41.
  • 12. X. Liu, Z. Gao and H. Xiong, et al., Three-dimensional hemodynamics analysis of the circle of Willis in the patient-specific nonintegral arterial structures, Biomech Model Mechan, 6 (2016), 1439–1456.
  • 13. P. Xu, X. Liu and H. Zhang, et al., Assessment of boundary conditions for CFD simulation in human carotid artery, Biomech. Model Mechan., 6 (2018), 1581–1597.
  • 14. S. Zhao, Z. Gao and H. Zhang, et al., Robust Segmentation of Intima-Media Borders with Different Morphologies and Dynamics During the Cardiac Cycle, IEEE J. Biomed. Health, 5 (2018), 1571–1582.
  • 15. B. Zhou, Q. Huang and S. Cui, et al., Impact of airflow communication between nasal cavities on nasal ventilation, Orl. J. Otorhinolaryngol. Relat. Spec., 5 (2013), 301–308.
  • 16. W. Draf and A. Minovi, The "Frontal T" in the refinement of endonasal frontal sinus type III drainage, Operative Techniques in Otolaryngology-Head and Neck Surgery, 2 (2006), 121–125.
  • 17. K. Zhao and J. Jiang, What is normal nasal airflow? A computational study of 22 healthy adults, Int. Forum. Allergy. Rh., 6 (2014), 435–446.
  • 18. K. Keyhani, P. W. Scherer and M. M. Mozell, Numerical simulation of airflow in the human nasal cavity, J. Biomech. Eng., 4 (1995), 429.
  • 19. J. Wen, K. Inthavong and J. Tu, et al., Numerical simulations for detailed airflow dynamics in a human nasal cavity, Resp. Physiol. Neurobi., 2 (2008), 125–135.
  • 20. J. H. Zhu, H. P. Lee and K. M. Lim, et al., Effect of accessory ostia on maxillary sinus ventilation: A computational fluid dynamics (CFD) study, Resp. Physiol. Neurobi., 2 (2012), 91–99.
  • 21. J. H. Zhu, K. M. Lim and K. T. M. Thong, et al., Assessment of airflow ventilation in human nasal cavity and maxillary sinus before and after targeted sinonasal surgery: A numerical case study, Resp. Physiol. Neurobi., (2014), 29–36.
  • 22. A. A. Gungor, The aerodynamics of the sinonasal interface: The nose takes wing-a paradigm shift for our time, Int. Forum. Allergy. Rh., 4 (2013), 299–306.
  • 23. J. Lindemann, T. Keck and K. Wiesmiller, et al., A numerical simulation of intranasal air temperature during inspiration, Laryngoscope, 6 (2004), 1037–1041.
  • 24. J. Lindemann, H. Brambs and T. Keck, et al., Numerical simulation of intranasal airflow after radical sinus surgery, Am. J. Otolaryng., 3 (2005), 175–180.
  • 25. O. Abouali, E. Keshavarzian and P. Farhadi Ghalati, et al., Micro and nanoparticle deposition in human nasal passage pre and post virtual maxillary sinus endoscopic surgery, Resp. Physiol. Neurobi., 3 (2012), 335–345.
  • 26. S. Yu, J. Z. Wang and X. Z. Sun, et al., Numerical analysis on deposition of particulate matters in respiratory tract, J. Med. Biomech., 3 (2016), 193–198.


Reader Comments

your name: *   your email: *  

© 2019 the Author(s), licensee AIMS Press. This is an open access article distributed under the terms of the Creative Commons Attribution Licese (http://creativecommons.org/licenses/by/4.0)

Download full text in PDF

Export Citation

Copyright © AIMS Press All Rights Reserved