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All of us who perform nasal surgery are familiar with the disappointing presence of nasal adhesions (NA) or synechiae in our postop patients. These can often lead to patients deriving less perceived benefit from their surgery than that which they had hoped for (the surgeon too!). This study uses computational fluid dynamics (CFD) to assess nasal airflow, by measuring nasal cooling, and the introduction of virtual adhesions into the CT airways of four healthy volunteers. Although the technology is novel and the sample size very small, it does demonstrate that NAs have a significant impact on nasal airway and perception of nasal airflow. It also helps to explain why sometimes a small NA can cause a lot of symptoms for a patient, as the distortion of the airflow beyond that perforation can be much more significant than the small size of the perforation would suggest. This study is useful and interesting, and helps to justify dividing nasal adhesions in postoperative patients with symptoms.

The impact of adhesions on nasal airflow: A quantitative analysis using computational fluid dynamics.
Senanayake P, Warfield-McAlpine P, Salati H, et al.
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Joanna Stephens

United Lincolnshire Hospitals NHS Trust, UK.

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