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Dennis Onyeka Frank-Ito
Associate Professor in Head and Neck Surgery & Communication Sciences
Journal ArticleAnn Otol Rhinol Laryngol · June 2026
INTRODUCTION: The role of conductive factors on olfactory acuity has received little attention. The relationships between nasal anatomy, inspiratory airflow and olfaction remain unclear, including if nasal anatomic and functional factors account for some v ...
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Journal ArticleAnn Otol Rhinol Laryngol · March 2026
PURPOSE: Chronic rhinosinusitis (CRS), marked by nasal mucosal inflammation, is a common condition often assessed via computed tomography (CT). However, the extent of airway opacification due to CRS-related inflammation remains incompletely quantified rela ...
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Journal ArticleLaryngoscope · February 2026
OBJECTIVES: People with Cystic Fibrosis (CF) experience significant sinonasal airway opacification, leading to chronic airway-related conditions. The triple combination therapy Elexacaftor/Tezacaftor/Ivacaftor (ETI) has emerged as a therapeutic option for ...
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Journal ArticleOtolaryngol Head Neck Surg · February 2026
OBJECTIVE: Subglottic stenosis (SGS) coexists with bronchopulmonary disease, complicating topical therapy given the distinct anatomical targets. Optimizing inhaled medication delivery to both regions remain a therapeutic challenge. This study evaluates the ...
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Journal ArticleRespir Physiol Neurobiol · January 2026
BACKGROUND: Optimizing olfactory cleft drug delivery remains a significant challenge due to the anatomical complexity of the nasal cavity and olfactory cleft location. While various strategies have been explored to improve targeting, the influence of nasal ...
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Journal ArticleComputer Methods in Applied Mechanics and Engineering · October 1, 2025
We present an embedded finite element method for solving the incompressible Navier–Stokes equations on complex or moving domains while using a fixed structured background mesh. The key component of our approach is a ghost node framework that modifies basis ...
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Journal ArticleJ Voice · July 2025
OBJECTIVES: Extensive research has demonstrated that straw/tube phonation exercises produce positive effects on the voice quality of the user. The purpose of this study was to explore pedagogical practices employed by a range of voice professionals when us ...
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Journal ArticleAnn Otol Rhinol Laryngol · May 2025
PURPOSE: Functional septorhinoplasty is an effective treatment for nasal airway obstruction. Little distinction exists between bilaterally and unilaterally obstructed patients in literature. Our study evaluates outcomes in patients with unilateral nasal ai ...
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Journal ArticleExpert Opin Drug Deliv · April 2025
INTRODUCTION: Olfactory function, despite its critical role in human survival and quality of life, is often underappreciated. This could be associated with the fact that symptoms of olfactory dysfunction rarely occur in isolation as they are frequently con ...
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Journal ArticleFace · March 1, 2025
Background: This study compared the impact of spreader grafts (SG) and spreader flaps (SF) on the transport of intranasal drug delivery to target the posterolateral nasal wall. Method: SG and SF were each performed in sequence on two cadaveric specimens af ...
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Journal ArticleFacial Plast Surg Aesthet Med · 2025
Background: Some patients report persistent nasal obstruction after surgical treatment despite objective improvement. Objective: To compare patients' perceptions of nasal obstruction after surgery with objective nasal airflow as determined by computational ...
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Journal ArticleLaryngoscope · January 2025
OBJECTIVES: Many individuals with healthy normal nasal anatomy and function exhibit a prominent notch indentation at the junction of the ala and sidewall, specifically around the anterior-superior region of the unilateral nasal vestibule up to the internal ...
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Journal ArticleJournal of plastic, reconstructive & aesthetic surgery : JPRAS · May 2024
BackgroundCleft lip nasal deformity (CLND)-associated nasal airway obstruction (CL-NAO) may be inadequately characterized, with its functional implications subsequently underappreciated and neglected. The purpose of this systematic review is to (1 ...
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Journal ArticleLaryngoscope · April 2024
OBJECTIVE: Despite the increasing racial diversity of the United States, representation in academic medicine faculty does not reach concordance with the general population and worsens with higher rank. Few studies have examined this within academic Otolary ...
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Journal ArticleClin Biomech (Bristol) · April 2024
BACKGROUND: The nose is a viable pathway for topical drug delivery to the olfactory cleft for treatment of obstructive smell loss and nose-to-brain drug delivery. This study investigates how variations in nasal vestibule morphology influence intranasal spr ...
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Journal ArticleOtolaryngol Head Neck Surg · February 2024
OBJECTIVE: To assess inequities in representation among ranks and odds of promotion by race in academic otolaryngology. STUDY DESIGN: Cross-sectional study. SETTING: USÂ academic medical centers. METHODS: Demographic data was collected for medical students, ...
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Journal ArticleRespir Physiol Neurobiol · January 2024
BACKGROUND: Exercise-induced rhinitis (EIR) is a poorly understood phenomenon that may be related to increased inspiratory airflow. Characterization of the development of EIR is important to understand contributing factors. OBJECTIVE: To characterize how d ...
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Journal ArticleInt J Pharm · September 25, 2023
Conductive olfaction and nose to brain drug delivery are important processes that remain limited by inadequate odorant or drug delivery to the olfactory airspace. Primary challenges include anatomic barriers and poor targeting to the olfactory region. This ...
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Journal ArticleFace · September 1, 2023
Background: Unilateral cleft lip nasal deformity (uCLND) creates multiple sites of nasal airway obstruction, impacting patients’ quality of life. Surgical restoration of function remains technically challenging and complex. Objectives: This is a single pat ...
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Journal ArticleLaryngoscope · May 2023
OBJECTIVES: To determine parameter combinations for effective drug delivery of intranasal spray steroids to the ostiomeatal complex (OMC) and maxillary sinus (MS) in patients with chronic rhinosinusitis (CRS). METHODS: Each patient's sinonasal cavity was r ...
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Journal ArticleFace · March 1, 2023
Background: Midvault reconstruction is an essential element of functional rhinoplasty. An improved understanding of airflow patterns after spreader graft (SG) or spreader flap (SF) techniques can inform surgical techniques based on individual anatomy. Obje ...
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Journal ArticleLaryngoscope · February 2023
OBJECTIVES/HYPOTHESIS: Laryngotracheal stenosis (LTS) is a functionally devastating condition with high respiratory morbidity and mortality. This preliminary study investigates airflow dynamics and stenotic drug delivery in patients with one- and two-level ...
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Journal ArticleFacial Plast Surg Aesthet Med · 2023
Background: Anatomical variations influence nasal physiology, yet sex differences in physiology remains unclear. Objective: To investigate sex differences among Caucasians using computational fluid dynamics. Methods: Adult subjects were selected with norma ...
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Journal ArticleExp Comput Multiph Flow · 2023
Laryngotracheal stenosis (LTS) is a type of airway narrowing that is frequently caused by intubation-related trauma. LTS can occur at one or multiple locations in the larynx and/or trachea. This study characterizes airflow dynamics and drug delivery in pat ...
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Journal ArticleFacial Plast Surg Aesthet Med · 2023
Background: Unilateral cleft lip nasal deformity (uCLND) is associated with olfactory dysfunction, but the underlying etiology remains poorly understood. Objective: To investigate the etiology of uCLND-associated olfactory dysfunction using clinical, compu ...
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Journal ArticleInt J Pediatr Otorhinolaryngol · December 2022
IMPORTANCE: The U.S. is in an opioid epidemic with greater than 40,000 deaths annually. Pediatric adenotonsillectomy is one of the most common and painful otolaryngology surgeries performed, often associated with opioid prescriptions. OBJECTIVE: To underst ...
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Journal ArticleAm J Rhinol Allergy · May 2022
BACKGROUND: Endoscopic sinus surgery is a well-established treatment for chronic rhinosinusitis in patients with cystic fibrosis, though its benefits seem to be limited to improving sinonasal symptoms rather than affecting lung function. OBJECTIVE: This st ...
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Journal ArticleRespir Physiol Neurobiol · March 2022
This study identifies anatomical and airflow-induced relationships based on nasal morphological variations due to inter- and intra-racial differences and gender. Subject-specific nasal airway reconstruction was created from computed tomography images in 16 ...
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Journal ArticleInt J Comput Assist Radiol Surg · January 2022
PURPOSE: Individuals with unilateral cleft lip nasal deformity (uCLND) often require rhinoplasty in adolescence to correct nasal obstruction. The intent of this study is to identify sites of greatest nasal obstruction and evaluate the effects of isolated a ...
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Journal ArticleInhal Toxicol · 2022
OBJECTIVE: Olfaction requires a combination of sensorineural components and conductive components, but conductive mechanisms have not typically received much attention. This study investigates the role of normal nasal vestibule morphological variations in ...
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Journal ArticleCleft Palate Craniofac J · October 2021
OBJECTIVES: To evaluate the magnitude of olfactory recess opacity in patients with unilateral cleft lip nasal deformity (uCLND). DESIGN: Subject-specific 3-dimensional reconstruction of the nasal airway anatomy was created from computed tomography images i ...
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Journal ArticleRespir Physiol Neurobiol · September 2021
This study evaluated the impact of unilateral cleft lip nasal deformity (uCLND) on the ability of the nasal passages to warm and humidify inspired environmental air using computational fluid dynamics (CFD) modeling. Nasal air conditioning was simulated at ...
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Journal ArticleOtolaryngol Head Neck Surg · April 2021
OBJECTIVE: Adjuvant management for laryngotracheal stenosis (LTS) may involve inhaled corticosteroids, but metered dose inhalers are designed for pulmonary drug delivery. Comprehensive analyses of drug particle deposition efficiency for orally inhaled cort ...
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Journal ArticleClin Biomech (Bristol) · February 2021
BACKGROUND: The conductive mechanisms of olfaction are typically given little priority in the evaluation of olfactory function. The objective of this study is to investigate the role of nasal vestibule morphological variations on airflow volume at the olfa ...
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Journal ArticleSci Rep · June 29, 2020
Topical intra-nasal sprays are amongst the most commonly prescribed therapeutic options for sinonasal diseases in humans. However, inconsistency and ambiguity in instructions show a lack of definitive knowledge on best spray use techniques. In this study, ...
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Journal ArticleInt J Comput Assist Radiol Surg · April 2020
PURPOSE: A deviated nasal septum is the most common etiology for nasal airway obstruction (NAO), and septoplasty is the most common surgical procedure performed by ear-nose-throat surgeons in adults. However, quantitative criteria are rarely adopted to sel ...
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Journal ArticleInt J Comput Assist Radiol Surg · January 2020
PURPOSE: Virtual surgery planning based on computational fluid dynamics (CFD) simulations of nasal airflow has the potential to improve surgical outcomes for patients with nasal airway obstruction (NAO). Virtual surgery planning requires normative ranges o ...
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Journal ArticleInt Forum Allergy Rhinol · August 2019
BACKGROUND: Endoscopic craniofacial resections (CFR) are performed for extensive anterior skull base lesions. This surgery involves removal of multiple intranasal structures, potentially leading to empty nose syndrome (ENS). However, many patients remain a ...
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Journal ArticleClin Biomech (Bristol) · June 2019
BACKGROUND: A major issue among computational respiratory studies is the wide variety of nasal morphologies being studied, caused by both inter-population and inter-subject variations. METHOD: Six nasal cavity geometries exhibiting diverse geometry variati ...
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Journal ArticlePlast Reconstr Surg Glob Open · May 2019
BACKGROUND: Nasal airway obstruction (NAO) due to nasal anatomic deformities is known to be more common among cleft patients than the general population, yet information is lacking regarding severity and variability of cleft-associated nasal obstruction re ...
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Journal ArticleRhinology · April 1, 2019
BACKGROUND: Nasal septal perforations (NSPs) often cause bleeding, crusting, obstruction, and/or whistling. The objective was to analyze the impact of anterior NSP size and shape on nasal physiology using computational fluid dynamics (CFD). METHODS: A 3-di ...
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Journal ArticlePlast Reconstr Surg · March 2019
BACKGROUND: The nasal deformity that accompanies cleft conditions is often acknowledged as the most difficult obstacle to restoring facial balance in affected children. Despite considerable progress in the treatment of cleft lip and palate, the outcomes of ...
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Journal ArticleLasers Surg Med · February 2019
OBJECTIVES: Adenotonsillectomy (AT) is commonly used to treat upper airway obstruction in children, but selection of patients who will benefit most from AT is challenging. The need for diagnostic evaluation tools without sedation, radiation, or high costs ...
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Journal ArticleClin Biomech (Bristol) · January 2019
BACKGROUND: Despite advances in medicine and expenditures associated in treatment of nasal airway obstruction, 25-50% of patients undergoing nasal surgeries complain of persistent obstructive symptoms. Our objective is to develop a "stepwise virtual surger ...
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Journal ArticleMed Eng Phys · July 2018
A major functional role of the nasal cavity is air conditioning of the inspired environmental air to near alveolar conditions. It is well known that the anatomical disparities among nasal passages can change airflow patterns to a great extent. However, its ...
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Journal ArticleJournal of Aerosol Science · July 1, 2018
Despite human exposure to inhaled nanoparticles has been intensively studied, the effect of nasal cavity morphology on the distribution patterns of inhaled particles remains less investigated. This paper compared the total and regional deposition patterns ...
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Journal ArticleLaryngoscope · April 2018
OBJECTIVE: Very little is known about the impact of laryngotracheal stenosis (LTS) on inspiratory airflow and resistance, especially in air hunger states. This study investigates the effect of LTS on airway resistance and volumetric flow across three diffe ...
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Journal ArticleInt J Numer Method Biomed Eng · April 2018
Generating anatomically realistic 3-dimensional (3D) models of the human sinonasal cavity for numerical investigations of sprayed drug transport presents a host of methodological ambiguities. For example, subject-specific radiographic images used for 3D re ...
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Journal ArticleAm J Audiol · March 8, 2018
PURPOSE: This study assesses interaural differences in temporal bone anatomy in subjects with normal caloric findings. METHOD: Eligible patients included those referred to the Duke University Medical Center otology clinic complaining of dizziness, with a h ...
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Journal ArticleAm J Audiol · March 8, 2018
PURPOSE: The purpose of this study was to determine whether a significant order effect exists in the binaural bithermal caloric test. METHOD: Fifteen volunteers (mean age = 24.3 years, range = 18-38 years) with no history of vestibular disorder, hearing lo ...
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Journal ArticleJAMA Facial Plast Surg · January 1, 2018
IMPORTANCE: Nasal airway obstruction (NAO) is a common problem that affects patient quality of life. Surgical success for NAO correction is variable. Virtual surgery planning via computational fluid dynamics (CFD) has the potential to improve the success r ...
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Journal ArticleMathematical Modelling of Natural Phenomena · January 1, 2018
The objective of this study was to develop a personalized inflammatory model and estimate subject-specific parameters that could be related to changes in heart rate variability (HRV), a measure that can be obtained non-invasively in real time. An inflammat ...
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Journal ArticleJ Otol · December 2017
INTRODUCTION: Superior semicircular canal dehiscence (SCD) remains difficult to diagnose despite advances in high-resolution computed tomography (HRCT) imaging. We hypothesize possible associations between gross temporal bone anatomy and sub-millimeter pat ...
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Journal ArticleJ Otol · September 2017
OBJECTIVES: Recent studies have introduced middle ear volume (MEV) as a novel determinant of perforation-induced conductive hearing loss (CHL) in a mechanism driven by trans-tympanic membrane pressure differences. The primary aims of this preliminary repor ...
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ConferenceProceedings International Symposium on Biomedical Imaging · June 15, 2017
A major functional role of the nasal cavity is air conditioning of the inspired environmental air to nearly alveolar conditions in order to protect the moist and warm alveolar lining where gas exchange takes place. It is well known that the morphological d ...
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Journal ArticleJ Otol · June 2017
INTRODUCTION: Middle ear volume (MEV) is a clinically relevant parameter across middle ear diseases. MEV values between these techniques have never before been tested for agreement in ears with perforated tympanic membranes (TMs). METHODS: Middle ears were ...
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Journal ArticleInt J Numer Method Biomed Eng · May 2017
Virtual surgery planning based on computational fluid dynamics (CFD) simulations has the potential to improve surgical outcomes for nasal airway obstruction patients, but the benefits of virtual surgery planning must outweigh the risks of radiation exposur ...
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Journal ArticleRespir Physiol Neurobiol · October 2016
Although variations in nasal index (NI) have been reported to represent adaptation to climatic conditions, assessments of NI with airflow variables have not been rigorously investigated. This study uses computational fluid dynamics modeling to investigate ...
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Journal ArticleOtol Neurotol · September 2016
HYPOTHESIS: Anatomic variables within the mastoid will correlate with intensity of caloric responses. BACKGROUND: During caloric irrigation, heat is transferred from the external auditory canal to the lateral semicircular canal (LSCC) through aerated masto ...
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Journal ArticleJ Aerosol Med Pulm Drug Deliv · April 2016
BACKGROUND: Very little is known about the role of nasal morphology due to ethnic variation on particle deposition pattern in the sinonasal cavity. This preliminary study utilizes computational fluid dynamics (CFD) modeling to investigate sinonasal airway ...
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Journal ArticleJ Biomech · February 8, 2016
Although advances in computational modeling have led to increased understanding of nasal airflow, not much is known about the effects of normal sinonasal anatomic variabilities on nasal function. In this study, three distinct variations in the human nasal ...
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Journal ArticleJ Aerosol Med Pulm Drug Deliv · February 2016
BACKGROUND: There are methodological ambiguities in the literature on mesh refinement analysis for computational fluid dynamics (CFD) modeling of physiologically realistic airflow dynamics and particle transport in the human sinonasal cavity. To investigat ...
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Journal ArticleAm J Rhinol Allergy · 2016
BACKGROUND: Maxillary antrostomy is commonly performed during endoscopic sinus surgery. Little is known about the association surrounding recalcitrant maxillary sinusitis, antrostomy size, and intranasal airflow changes. Furthermore, the interaction betwee ...
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Journal ArticleRhinology · March 2015
BACKGROUND: Topical medication is increasingly used following functional endoscopic sinus surgery (FESS). Information on particle sizes that maximise maxillary sinus (MS) delivery is conflicting, and the effect of antrostomy size on delivery is unclear. Th ...
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Journal ArticleOtolaryngol Head Neck Surg · February 2015
OBJECTIVES: (1) To develop a method to account for the confounding effect of the nasal cycle when comparing preoperative and postoperative objective measures of nasal patency. (2) To illustrate this method by reporting objective measures derived from compu ...
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Journal ArticleComput Biol Med · February 2015
BACKGROUND: Changes in laryngeal airflow dynamics during episodes of vocal cord dysfunction (VCD) have not been well described. Very little is known about how inspiratory airflow is impacted when the vocal cords transition from normal inhalation state to a ...
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Journal ArticleAm J Rhinol Allergy · 2015
BACKGROUND: Endonasal endoscopic skull base surgery (EESBS) often requires significant alterations in intranasal anatomy. For example, posterior septectomy (PS) with middle turbinate resection (MTR) is frequently performed to provide access to large sellar ...
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Journal ArticleOtolaryngol Head Neck Surg · November 2014
INTRODUCTION: High failure rates for surgical treatment of nasal airway obstruction (NAO) indicate that better diagnostic tools are needed to improve surgical planning. This study evaluates whether computer models based on a surgeon's edits of presurgery s ...
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Journal ArticleOtolaryngol Head Neck Surg · January 2014
OBJECTIVES: To (1) quantify mucosal cooling (ie, heat loss) spatially in the nasal passages of nasal airway obstruction (NAO) patients before and after surgery using computational fluid dynamics (CFD) and (2) correlate mucosal cooling with patient-reported ...
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Journal ArticleJAMA Facial Plast Surg · 2014
IMPORTANCE A gold standard objective measure of nasal airway obstruction (NAO) does not currently exist, so patient-reported measures are commonly used, particularly the Nasal Obstruction Symptom Evaluation (NOSE) scale and the visual analog scale (VAS). H ...
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Journal ArticleJAMA Facial Plast Surg · 2014
IMPORTANCE: Collapse or compromise of the internal nasal valve (INV) results in symptomatic nasal obstruction; thus, various surgical maneuvers are designed to support the INV. OBJECTIVE: To determine the effect on nasal airflow after various surgical tech ...
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Journal ArticleJ Biomech · October 18, 2013
Surgeries to correct nasal airway obstruction (NAO) often have less than desirable outcomes, partly due to the absence of an objective tool to select the most appropriate surgical approach for each patient. Computational fluid dynamics (CFD) models can be ...
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Journal ArticleInt Forum Allergy Rhinol · October 2013
BACKGROUND: The effects of increases in maxillary sinus (MS) airflow following functional endoscopic sinus surgery (FESS) are unknown. The goal of this study was to quantify the effects of FESS on airflow into the MS in a cohort of patients with chronic rh ...
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Journal ArticleOtolaryngol Head Neck Surg · March 2013
OBJECTIVE: To use computational fluid dynamics (CFD) technology to help providers understand (1) how septal perforations may alter nasal physiology and (2) how these alterations are influenced by perforation size and location. STUDY DESIGN: Computer simula ...
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Journal ArticleInt Forum Allergy Rhinol · January 2013
BACKGROUND: Quantitative methods for comparing intranasal drug delivery efficiencies pre- and postoperatively have not been fully utilized. The objective of this study is to use computational fluid dynamics techniques to evaluate aqueous nasal spray penetr ...
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Journal ArticleRhinology · September 2012
BACKGROUND: This study investigates how deviated nasal septum affects the quantity and distribution of spray particles, and examines the effects of inspiratory airflow and head position on particle transport. METHODS: Deposition of spray particles was anal ...
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Journal ArticleAm J Rhinol Allergy · May 1, 2012
BACKGROUND: Nasal airway obstruction (NAO) is a common health condition impacting mood, energy, recreation, sleep, and overall quality of life. Nasal surgery often addresses NAO but the results are sometimes unsatisfactory. Evaluating surgical treatment ef ...
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Journal ArticleOtolaryngol Head Neck Surg · February 2012
OBJECTIVE: To study the effects of nasal deformity on aerosol penetration past the nasal valve (NV) for varying particle sizes using sprays or nebulizers. STUDY DESIGN: Computed mathematical nasal airway model. SETTING: Department computer lab. SUBJECTS AN ...
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Journal ArticleAm J Rhinol Allergy · 2012
BACKGROUND: Nasal airway obstruction (NAO) is a common health condition impacting mood, energy, recreation, sleep, and overall quality of life. Nasal surgery often addresses NAO but the results are sometimes unsatisfactory. Evaluating surgical treatment ef ...
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Journal ArticleArch Facial Plast Surg · 2012
OBJECTIVES: To demonstrate the effect of individual components of functional nasal airway surgery in a patient with multifactorial obstruction and to discuss the potential benefit of computational fluid dynamics (CFD)–aided virtual surgery. METHODS: A 53-y ...
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