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Liquid volume and squeeze force effects on nasal irrigation using Volume of Fluid modelling

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Abstract

For various sinonasal conditions, including chronic rhinosinusitis, saline irrigation is an accepted standard-of-care treatment. This study was aimed at determining the effect of increased irrigation volumes and greater squeeze force on mucosal irrigation. A sinonasal cavity computational model was reconstructed from high-resolution CT scans of a healthy, unoperated 25-year old female. Seven combinations of irrigation volumes (70, 150, 200, and 400 mL) and squeeze forces (ramp time 0.1, 0.5, and 1.0 s) at a fixed head tilt of 0 degrees to the horizontal (Frankfort position) were performed. Velocity, pressure, and wall shear stress, together with mapping of surface coverage and residual volumes at specific locations and time were demonstrated. Higher volume irrigation (400 mL) and greater squeeze force (ramp time 0.1 s) improved irrigation coverage on the ipsilateral and contralateral sinonasal surfaces and increased shear force (approximately 140 Pa). An increase in irrigation volume from 70 to 150 mL approximately doubled sinus surface coverage and from 70 to 200 mL tripled sinus surface coverage. A faster squeeze also contributed to increased sinus surface coverage but its effect was less influential. We infer that the greater irrigation volume and squeeze force improve therapeutic benefit in terms of lavage and distribution of topical medications.

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Abbreviations

α l,g :

volume fraction of liquid and gas

κ :

surface curvature

μ :

dynamic viscosity

∇:

gradient

∇·:

divergence

⊗:

outer product of two tensors

ρ l,g :

density of liquid and gas

σ :

surface tension coefficient

\({\vec F}\) :

surface tension force

\({\vec g}\) :

gravity

HPC:

high performance computing

p :

static pressure

R 1,2 :

surface curvature as measured by two radii in orthogonal directions

t :

time

\({\vec v}\) :

velocity vector

WSS:

wall shear stress

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Acknowledgements

We gratefully acknowledge the financial support provided by Garnett Passe and Rodney Williams Memorial Foundation Conjoint Grant 2019. Kiao Inthavong is a consultant for ENT Technologies and received a research grant for part of this current work.

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Authors and Affiliations

  1. School of Engineering, RMIT University, Bundoora, Victoria, 3083, Australia

    Kendra Shrestha, Hana Salati & Kiao Inthavong

  2. Department of Otolaryngology, Head and Neck Surgery, Westmead Hospital, Westmead, NSW, 2145, Australia

    Eugene Wong & Narinder Singh

  3. School of Chemical and Biomolecular Engineering, the University of Sydney, Camperdown, NSW, 2006, Australia

    David F. Fletcher

  4. School of Medicine, the University of Sydney, Camperdown, NSW, 2006, Australia

    Narinder Singh

Authors
  1. Kendra Shrestha
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  2. Eugene Wong
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  3. Hana Salati
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  4. David F. Fletcher
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  5. Narinder Singh
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  6. Kiao Inthavong
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Correspondence to Kiao Inthavong.

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Shrestha, K., Wong, E., Salati, H. et al. Liquid volume and squeeze force effects on nasal irrigation using Volume of Fluid modelling. Exp. Comput. Multiph. Flow 4, 445–464 (2022). https://doi.org/10.1007/s42757-021-0123-5

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  • DOI: https://doi.org/10.1007/s42757-021-0123-5

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