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Rhinology/Allergy

(285) Investigating the Physiological Effects of Nasal Cycling Using Computational Models

Monday, October 2, 2023
2:45 PM – 3:45 PM East Coast USA Time
Has Audio

    Presenting Author(s)

  • Mark S. Nyaeme, Other

    Medical Student
    Carle Illinois College of Medicine At UIUC
    Urbana, Illinois, United States

    • Co-Author(s)

  • Sarah M. Russel, MD, MPH

    Resident Physician, Postdoctoral Research Fellow
    University of North Carolina - Chapel Hill, Department of Otolaryngology/Head and Neck Surgery
    Chapel Hill, North Carolina, United States

    • Senior Author(s)

  • DF

    Dennis O. Frank-Ito, PhD

    Associate Professor
    Duke University, Department of Head and Neck Surgery and Communication Sciences
    Durham, NC, USA

Disclosure(s):
Mark S. Nyaeme, Other: No relevant relationships to disclose.
Sarah M. Russel, MD, MPH: No relevant relationships to disclose.


Introduction: Nasal cycling is a natural phenomenon in which asymmetrical increases in blood flow in the inferior turbinate and septum cause alterations in airflow. Although the mechanism of nasal cycling is understood, its purpose remains unclear. One theory suggests that the more patent airway optimizes heating and humidification of inhaled air, and the more occluded airway enhances pathogen trapping. This study aims to investigate the physiology of nasal cycling through computational fluid dynamics (CFD) simulations of airflow and heat transfer.

Methods: Three-dimensional reconstructions of nasal passages were created from computed tomography scans of 26 subjects with normal anatomy. Each patient was categorized based on degree of nasal cycling as mid-cycle, mild or extreme cycling, and the more congested nasal passage was noted. CFD simulations of nasal airflow and heat transfer were performed to target 15L/min inspiratory flowrate. Summary statistics were reported, and Kruskal-Wallis was used to analyze differences in simulated airflow-related variables among nasal cycling groups.

Results: In the less congested unilateral nasal passage, subjects with extreme cycling had the greatest airflow (mean: mid-cycle 8.92L/min, mild 9.09L/min, extreme 10.6L/min, p=0.03). The opposite was true in the more congested passage with these subjects having the lowest airflow (mean: mid-cycle 6.09L/min, mild 5.91L/min, extreme 4.42L/min, p=0.03). Average mucosal heat flux in the more congested airway declined with increasing nasal cycling state (mean: mid-cycle 151.8W/m2, mild 139.4W/m2, extreme 111.8W/m2, p=0.01). Bilateral average mucosal heat flux was greatest in subjects experiencing mild cycling, albeit it was not statistically significant from the other cycling states (p=0.06). Nasal airway resistance and wall shear stress were unremarkable among cycling groups either unilaterally or bilaterally.

Conclusions: Findings from these simulations are consistent with the theory that the function of nasal cycling includes optimizing heating and humidification of inhaled air on the more patent side.