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OBJECTIVES: The aim of this study was to evaluate the effect of maxillary movements in orthognathic surgery on nasal airway volume change and its correlation with airflow and resistance. MATERIALS AND METHODS: This study included 25 patients (8 male, 17 female) with Class II (6 patients) or Class III (19 patients) malocclusion. All patients underwent Le Fort I and bilateral sagittal split ramus osteotomy. Nasal airflow and resistance were measured by using rhinomanometry and acoustic rhinometry pre and six months post-operatively. Nasal volume was measured using computed tomography before surgery and six months after surgery. RESULTS: Nasal volume increased in 10 out of 11 patients with CCW (counterclockwise) rotation and decreased in 1 patient while, nasal volume increased in 5 patients with CW (clockwise) rotation and decreased in 9 patients. Superior nasal airway volume increased significantly, while the effects on nasal flow and resistance were not significant. Additionally, no significant correlation was found between airway volume changes and variations in airflow and resistance. CONCLUSION: CCW rotation in orthognathic surgery patients significantly increased superior nasal airway volume but did not improve nasal airway flow and resistance.

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OBJECTIVE: To evaluate the nasal patency using acoustic rhinometry (AR) in patients with unilateral cleft lip and palate (UCLP) and to ascertain the rhinological importance of the same. METHODS: Eccovision Acoustic Rhinometer system was used for assessment of nasal cross-sectional area (CSA) and volume in 15 patients with UCLP. The CSA1, CSA2, and CSA3, which represent the CSA at the nasal valve area and anterior end of the inferior turbinate, the anterior half of the inferior turbinate and the anterior end of the middle turbinate, and the region of middle portion of middle turbinate, respectively, were compared on the cleft and non-cleft side. RESULTS: The mean ± SD of CSA1, CSA2, and CSA3 as well as the overall nasal CSA were significantly higher on non-cleft side compared to cleft side (P value < .001). The mean ± SD of nasal volume was also significantly higher in non-cleft side compared to cleft side (P value < .001). CONCLUSIONS: The nasal patency among patients with UCLP demonstrates a range of impairments that can be objectively measured using acoustic rhinometry. The orthodontic, orthopedic, or orthosurgical management of maxillary deficiency in these patients can affect the nasal area and volume and can have an impact on breathing, speech, and sleep. The pretreatment assessment may be useful to identify patients who are at potential risk of deterioration of nasal patency and airway post-intervention. Taking into consideration the multiple diagnostic procedures in the course of long-term multidisciplinary treatment of patients with cleft lip and palate, a noninvasive investigation technique such as AR may be the preferred mode of investigation to ascertain nasal patency.

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Intranasal vaccinations are becoming more important in both human and animal medicine to generate a localized IgA immune response not seen with parenteral vaccinations. This localized IgA response is more effective at reducing pathogen load on the mucosal surface of a potential host. One prerequisite for a successful nasal vaccination is the need to understand the distribution pattern of the nebulized vaccine, which requires an understanding the volume of the nares as well as the mucosal surface area. The exact mucosal surface area of ruminant nares has not yet been investigated. The aim of this concept study is to provide a detailed breakdown of a new method of volumetric rendering that can be used to calculate the volume and mucosal surface area of ruminant nares from computed tomographic images. The program Seg 3D was used to perform semi-automatic segmentation of a CT scan of a 9-month-old lamb head. Threshold segmentation and manual segmentation were used in combination to select the lamb's nasal cavity. The segmentation process yielded a volumetric rendering that was used to calculate the surface area and volume of the lamb's nasal cavity, with the segmentation process was repeated for each individual side of the lamb's nares. The surface area of the mucosal surface of each nostril is approximately 448 cm2, and the volume is approximately 45 cm3. The methodology described in this study successfully calculated the volume and surface area of a lamb's nares using volumetric rendering.

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OBJECTIVES/HYPOTHESIS: Children with cleft lip and palate (CLP) often suffer from nasal obstruction that may be related to effects on nasal volume. The objective of this study was to compare side:side volume ratios and nasal volume in patients with unilateral (UCLP) and bilateral (BCLP) clefts with age-matched controls. STUDY DESIGN: Retrospective case-control study using three-dimensional (3D) nasal airway reconstructions. METHODS: We analyzed 20 subjects (age range = 7-12 years) with UCLP and BCLP from a regional craniofacial center who underwent cone beam computed tomography (CT) prior to alveolar grafting. Ten multislice CT images from age-matched controls were also analyzed. Mimics software (Materialise, Plymouth, MI) was used to create 3D reconstructions of the main nasal cavity and compute total and side-specific nasal volumes. Subjects imaged during active nasal cycling phases were excluded. RESULTS: There was no statistically significant difference in affected:unaffected side volume ratios in UCLP (P = .48) or left:right ratios in BCLP (P = .25) when compared to left:right ratios in controls. Mean overall nasal volumes were 9,932 ± 1,807, 7,097 ± 2,596, and 6,715 ± 2,115 mm(3) for control, UCLP, and BCLP patients, respectively, with statistically significant volume decreases for both UCLP and BCLP subjects from controls (P < .05). CONCLUSIONS: This is the first study to analyze total nasal volumes in BCLP patients. Overall nasal volume is compromised in UCLP and BCLP by approximately 30%. Additionally, our finding of no major difference in side:side ratios in UCLP and BCLP compared to controls conflicts with pre-existing literature, likely due to exclusion of actively cycling scans and our measurement of the functional nasal cavity. LEVEL OF EVIDENCE: 3b. Laryngoscope, 126:1475-1480, 2016.

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BACKGROUND AND OBJECTIVES: Acoustic rhinometry (AR) measures nasal cavity geometry by analyzing reflected acoustic impulses. The authors aimed to find out whether AR could reflect the volume change developed from conchotomy. MATERIALS AND METHODS: To establish the test-retest reliability of the AR, 20 normal nasal cavities were tested with AR before conducting main study. The volumes of the 31 conchotomy specimens were measured with water displacement method (WDM). The nasal volume changes in accordance with conchotomy operations were measured with AR, and the paired values were compared. RESULTS: AR revealed highly consistent results as there was statistically significant correlation between test and retest values (r=0.98, p<0.0001). The volume of the conchotomy specimens measured with WDM was 1.40+/-0.63 cm3 (mean+/-SD) and the volume change measured with AR was 1.49+/-1.48 cm3 (mean+/-SD). There was statistically significant correlation between the two values (r=0.55, p<0.01), though they were not so consistent with each other. CONCLUSION: The nasal volume change after conchotomy measured with AR correlates with the conchotomy specimen volume with statistical significance, though the correlation between them does not always show consistency.

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