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Int Forum Allergy Rhinol. 2018 Jun;8(6):695-706. doi: 10.1002/alr.22089. Epub 2018 Feb 2.

Influence of the location of nasal polyps on olfactory airflow and olfaction.

Author information

1
Department of Otolaryngology, The University of Tokyo, Tokyo, Japan.
2
Department of Mechanical Engineering, National Institute of Technology, Gifu College, Gifu, Japan.
3
Department of Otolaryngology, Saitama Medical Center, Saitama Medical University, Saitama, Japan.

Abstract

BACKGROUND:

Chronic rhinosinusitis with nasal polyps (CRSwNP) often results in decreased olfaction. In this study, we examined the relationship between nasal polyp location and olfactory airflow and odorant transport changes using virtual nasal polyp models at different locations and computational fluid dynamics (CFD) analysis. We also compared olfactory airflow and olfaction between patients with nasal polyps at different locations using CFD analysis and an olfactory test.

METHODS:

Nasal computed tomography images were used to generate a normal model and 4 virtual nasal polyp models based on polyp locations, including the olfactory region (all-olfactory model), the region anterior to the olfactory region (preolfactory model), the middle meatus (middle-meatus model), and the superior meatus (superior-meatus model). Various airflow parameters were compared between these models and a normal model without polyps. We then performed a similar comparison between the 3-dimensional (3D) reconstruction models of patients with nasal polyps, and retrospectively investigated the correlation between olfaction and nasal polyp location in those patients.

RESULTS:

Virtual nasal polyp analysis revealed dispersion of olfactory airflow in the all-olfactory model. Olfactory airflow and odorant transport showed maximum decrease in the preolfactory model and a slight decrease in the superior-meatus model. Olfactory airflow by polyps was further decreased by blockade of the olfactory airflow inlet than of the outlet. The findings obtained by patients corresponded well to those of the virtual polyp analysis.

CONCLUSION:

Olfactory airflow and olfaction are differentially affected by nasal polyp location. This finding is important for planning polyp-removal surgeries from the perspective of improving patient olfaction.

KEYWORDS:

Endoscopic sinus surgery; chronic rhinosinusitis with nasal polyps; odorant transport; olfaction; orthonasal airflow; retronasal airflow

PMID:
29394000
DOI:
10.1002/alr.22089
[Indexed for MEDLINE]

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