钱玉梅 吴亚东 焦婷

中文摘要:
      目的 通过计算机数值模拟方法，研究单侧上颌骨全切除术后患者的上呼吸道吸气相气流动力学特征。方法 基于3例单侧上颌骨肿瘤患者术后的CT图像，三维重建患者的上呼吸道结构，利用计算流体力学方法对气流流动进行数值模拟。结果 获取患者术后上呼吸道吸气相气流流动趋势，气流在缺损侧鼻腔发生流动分离，在整个缺损腔形成低速大尺度漩涡。结论 3例单侧上颌骨全切除术后患者的上呼吸道气流整体流动模式大体一致，说明这类患者呼吸模式具有共性。单侧上颌骨全切除术造成上呼吸道结构改变，扰乱了上呼吸道气流流动模式，影响了患者的上呼吸道生理功能。单侧上颌骨全切除术后患者的上呼吸道气流数值模拟有助于解释患者出现的鼻腔干燥、结痂、分泌物堆积等症状和体征。
英文摘要:
      Objective To study the characteristics of upper airway airflow dynamics during inspiration after unilateral total maxillectomy by means of computer numerical simulation. Methods Based on postoperative CT images of three patients with unilateral maxillary tumor, three-dimensional upper airway structures of the patients were reconstructed, and the upper airway airflow was simulated numerically by computational fluid dynamics method. Results The upper airway airflow trends of the patients during inspiration after unilateral maxillectomy were obtained. Airflow in the defect nasal cavity was separated, and made the spacious vortices of low velocity occurred throughout the entire maxillary defect cavity. Conclusions The upper airway trends of the three patients were generally in conformity with each other after their unilateral total maxillectomy, which illustrated that the respiratory patterns of such patients were of universality. Unilateral total maxillectomy resulted in structure changes of patients’ upper airway, which could disturb the upper airway airflow patterns，and affect the physiological functions of patients’ upper airway. Numerical simulation of patients' upper airway airflow after unilateral total maxillectomy could help to explain the phenomena of nasal drying and crusting, secretion accumulation as well as other symptoms of the kind of patients.