A Numerical Model of the Influence of Maxillary Sinus Ostium Size on the Distribution of Nitric Oxide Concentration in the Nasal Cavity and Sinuses.

Abstract ObjectiveUsing a numerical model, we aimed to study the influence of maxillary sinus ostium size variation on nitric oxide (NO) concentration distribution in the nasal cavity and sinuses and to determine the impact of differing sinus ostium size on sinusitis development and recurrence following sinus ostium opening surgery.MethodsWe obtained high-resolution computed tomography images of the nasal sinuses of a volunteer, following which we established a numerical model, determined NO concentration and air volume in the maxillary sinus on one side, then changed the maxillary sinus ostium size on that side, and finally established five models of sinus ostium of different sizes. Two sizes of sinus numerical models were established to determine effect of differing ostium size on the maxillary sinus cavity NO concentration distributions.ResultsA smaller sinus ostia size corresponded to lower NO concentration in nasal cavity and exhaled air; moreover, a concentration gradient was formed from sinus ostium to nasal cavity. A larger sinus ostia size demonstrated a lower NO concentration surrounding sinus ostium in the sinus cavity and formed a concentration gradient from ostium to cavity.ConclusionConstriction of the sinus cavity can lead to changes in NO concentration. Detection of NO concentration in nasally exhaled air can be used as an index to detect the patency of the maxillary sinus ostium. An excessive opening of sinus ostium leads to a decrease in NO concentration around sinus ostium, which is one of the main causes of persistent or recurrent inflammation in the maxillary sinus