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. 2022 Jul 26:10:885130.
doi: 10.3389/fbioe.2022.885130. eCollection 2022.

Characterizing the respiratory-induced mechanical stimulation at the maxillary sinus floor following sinus augmentation by computational fluid dynamics

Qing Li  1 , Zhongyu Wang  1 , Chao Wang  2 , Hom-Lay Wang  3
Affiliations

Characterizing the respiratory-induced mechanical stimulation at the maxillary sinus floor following sinus augmentation by computational fluid dynamics

Qing Li et al. Front Bioeng Biotechnol. .

Abstract

Background: The relationship between maxillary sinus pneumatization and respiratory-induced fluid mechanics remains unclear. The purpose of this study was to simulate and measure the respiratory-induced mechanical stimulation at the sinus floor under different respiratory conditions and to investigate its potential effect on the elevated sinus following sinus-lifting procedures. Methods: The nasal airway together with the bilateral maxillary sinuses of the selected patient was segmented and digitally modeled from a computed tomographic image. The sinus floors of the models were elevated by simulated sinus augmentations using computer-aided design. The numerical simulations of sinus fluid motion under different respiratory conditions were performed using a computational fluid dynamics (CFD) algorithm. Sinus wall shear stress and static pressure on the pre-surgical and altered sinus floors were examined and quantitatively compared. Results: Streamlines with minimum airflow velocity were visualized in the sinus. The sinus floor pressure and the wall shear stress increased with the elevated inlet flow rate, but the magnitude of these mechanical stimulations remained at a negligible level. The surgical technique and elevated height had no significant influence on the wall pressure and the fluid mechanics. Conclusion: This study shows that respiratory-induced mechanical stimulation in the sinus floor is negligible before and after sinus augmentation.

Keywords: biomechanics; fluid dynamics; maxillary sinus floor augmentation; re-pneumatization; respiratory airflow.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Digital modeling. (A) Images including the whole nasal cavity and maxillary sinuses were taken by cone beam computed tomography. (B) Three-dimensional model of the airspace was rebuilt by medical imaging software. (C) Sinus augmentation was simulated by computer-aided design software: (i) model A: sinus floor of the presurgical model, (ii) model B: sinus augmentation through the transcrestal approach, (iii) model C: sinus augmentation through the lateral window approach.
FIGURE 2
FIGURE 2
(A) Meshed model with an airflow inlet and outlet, consists of approximately 2,000,000 grids. (B) Cross-section plane at the ostium revealed tetrahedral elements constituted the main body and gradually thickening prism layers at the air space boundary.
FIGURE 3
FIGURE 3
(A) Velocity distribution at the cross-section plane of the pre- and post-operative sinuses under different inlet flow rates. (B) Quantitative comparison of average airflow velocity within the pre- and post-operative sinuses under different flow rates.
FIGURE 4
FIGURE 4
Velocity streamline at the cross-section plane of the pre- and post-operative sinuses under different inlet flow rates.
FIGURE 5
FIGURE 5
Contours of Reynolds number at the middle coronal section under different inlet flow rates.
FIGURE 6
FIGURE 6
(A) Wall pressure contour of the pre- and post-operative sinus floor under different inlet flow rates. (B) Quantitative comparison of average wall pressure on the pre- and post-operative sinus floor under different flow rates.
FIGURE 7
FIGURE 7
(A) Shear stress distribution of the pre- and post-operative sinus floor under different inlet flow rates. (B) Quantitative comparison of average wall shear stress on the pre- and post-operative sinus floor under different flow rates.
See this image and copyright information in PMC

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