Northern Variant of nasal Aerodynamics (NVA)

When the main air flow comes through the nasal sinuses, even at 20 degrees below zero, the air is warming to + 25

     
 

Southern Variant of nasal Aerodynamics (SVA)

When the main air flow comes through the reserve nasal breathing way, the inferior nasal passage is so cool, with temperatures below zero, that the cold air enters in the nasopharynx, the season ACUTE RESPIRATORY DISEASE (ARD) programming and often leads to the SNORING during of the Night Sleeping

              

NASAL AERODYNAMICS and RHINOSINUSITISES

PRIMARY VALVE OF THE NOSE - IT'S HIS CAVERNOUS BODIES

Relationship between two parallel respiratory structures in the nose

The main cause of the night snoring is violations of the nasal aerodynamics

The functionality of the small ostiums of the nasal sinuses

Critical comparison of opposite opinions about the function of the nasal sinuses using Occam's Razor

The real significance of the limen nasi

NASAL AERODYNAMICS

VARIANTS OF NASAL AERODYNAMICS

NORMOGRAM OF NASAL AERODYNAMICS

PHYSIOLOGICAL BRIDGE REPRESENTED BY THE NASAL VALUE

SURGICAL RECONSTRUCTION OF NASAL AERODYNAMICS

SEPTOPLASRY UNDER CONTROL OF NASAL AERODYNAMICS

CONTRAINDICATION TO SEPTOPLASTY

PROTECTION OF THE INFERIOR NASAL PASSAGE FROM INSPIRATION

THE INSIDIOUSNESS OF THE UNILATERAL "SOUTHERN" NASAL AERODYNAMICS.

SNORING WHEN NASAL RESPIRATION IS SAVED.

Individual defence against infection by Severe Acute Respiratory Syndrome - SARS

     
 
 

ABSTRACT

 

This textbook «NASAL AERODYNAMICS and RHINOSINUSITISES» is recommended by Educational-methodical Association on Medical and Pharmaceutical derivation of universities in Russia as the Manual textbook for experts in ENT illnesses professional skillss improvement as a good application and in polyclinical conditions (outpatience practice).

In the given textbook, with the help of the author's technique was the first to research airflows in nasal passages, that has allowed to conduct the deep pathophysiological analysis of features nasal aerodynamics, which plays a leading role in the development of seasonal ACUTE RESPIRATORY DISEASE (ARD), with stagnant sinusitises, by the way RHINOSINUSITISES (RS).

The proposed rapid method of determining violations of a nasal aerodynamics considerably accelerates their diagnostics, facilitates the selection of pathogenetic therapy and helps develop pathogenesis-based preventive care (prophylaxis).

Designed as therapeutic ways of seasonal protection from violations of nasal aerodynamics and surgical ways of renovation of protective properties of aerodynamics of a nose, the application which one allows more successfully to treat and to notify seasonal ARD with RS.

The new techniques are protected by the Russian patents.

 
 

The Main Findings:

 

1. Relevance of nasal aerodinamics violations as a cause of seasonal ACUTE RESPIRATORY DISEASE (ARD) with RHINOSINUSITISES (RS) especially evident due to the rise in the World of a global epidemic of non-communicable respiratory diseases because even in the years expressed influenza epidemics reach at least 60%;

2. Basic protection from of the seasonal ARD with RS is the mucociliary protective mechanism of nasal mucous membrane, which consists of the mucociliary transport on helium film and the mucociliary clearance beneath the helium film, which successfully complement each other ;

3. The protective properties of nasal aerodynamics are playing a leading role among the nasal protective mechanisms that aim to preserve the activity of the mucociliary protective mechanism;

4. The nasal aerodynamics consists of two parallel respiratory structures, as form of the middle and superior nasal passages together with nasal sinuses, which perform the basic respiratory and protective functions of the nose, and inferior nasal passage together with common nasal passage, which perform the reserve respiratory function, that is activated when the bandwidth of the basic respiratory nasal airways is not enought for nasal respiration;

5. When the main air stream passes through the basic respiratory nasal airways (nasal sinuses), the air is warming to plus 25oC even at minus 20oC outside, that successfully protects against seasonal ARD with the RS and therefore, such type of the nasal aerodynamics is regarded as the Northern Variant of the nasal Aerodynamics (NVA), which corresponds normogramme of nasal aerodynamic;

6. A distinctive feature of the NVA is a distance between the anterior end of the inferior turbinate and the nasal septum within 2 mm and therefore an air column in the gleam of such width in fact blocking the inferior nasal passage and directs the main air flow in the middle and superior nasal passages with nasal sinuses, actually performing the role of “physiological jumper”;

7. When the main air stream passes through the reserve respiratory nasal airways, during cold temperature season the inferior nasal passage and nasopharynx on so much cool, that programming seasonal ADR, so such variant of the nasal aerodynamics is more suitable to a warm climate of Southern latitudes, due to the what he regarded as the Southern Version of nasal Aerodynamics (SVA);

8. The distinctive feature of SVA is not only the width of a lumen more than 2 mm between the anterior end of the inferior turbinate and the nasal septum, which leading to seasonal ARD, but also stagnant inflammatory process in the middle and superior nasal passages with the nasal sinuses, forming stagnant RS which is manifested in the form of seasonal ARD with the RS;

9. Overlapping of the reserve respiratory nasal airways programmed with the help of the physiological oedema his cavernous bodies, especially during sleep that is directing the main air stream of the nose passes through the nasal sinuses, in order to acieve maximum protective properties of a nose during sleep from ARD, but when a person is awake the bandwidth of the main nasal respiratory way becomes not enough, physiological oedema is receding and opening the reserve respiratory nasal airways that no longer threatens the ARD development due to sufficient activation the protective properties of the waking organism;

10. Additional overlap of the inferior nasal passage with the help of the limen nasi, anterior synechiae, spikes and curvatures of the nasal septum, promote the diversion of the main nasal air flow in the middle and superior nasal passages with nasal sinuses which activates the protective properties of the nasal aerodynamics;

11. Exceptionally only small ostiums of the nasal cellular system and nasal sinuses, working like a spray mechanism of the H.L.Bergson (1859–1941), provide their extremely active ventilation;

12. The protective properties of the nasal aerodynamics is also evident during expiration when warm and moist air stream helps to restore the nasal mucous membrane injured during inspiration, especially for the SVA ;

13. The unilateral SVA is the most aggressive, because it leads to a double overload of the inferior nasal passage, which working for both halves of the nose, that is typical for a deviated septum, so during septoplasty the NVA reconstruction from the SVA is needed;

14. Pathogenetic therapy of seasonal ARD with the RS in SVA, should be directed as at the treatment of acute post-traumatic inflammation of the reserve nasal respiratory airways, as well at the treatment of stagnant chronic inflammation in the middle and superior nasal passages with nasal sinuses;

15. Methods of therapeutic protection from violations of the SVA as well as surgical reconstruction of the NVA from of the SVA should be recognized as pathogenetic grounded prophylaxis of the seasonal ARD with the RS;

16. Since the main cause of the night snoring is blocking of the reserve respiratory nasal airway at SVA because of chronic congestive MS, physiological edema cavernous bodies and protective rhinedema of the inferior nasal passage, which leads to the mouth breathing, pathogenetic treatments snoring during sleep should be recognized as forced airing sinuses or surgical reconstruction the NVA from the SVA.

 
 
 
 

Relationship between two parallel respiratory structures in the nose


Ulyanov Y.P., Sadyev H.D., Sadyev T.H.

 
 

Department of Otorhinolaryngology for postgraduate professional education of the First Moscow State Medical University of Sechenov.  

 
 

Theses of the report - 2011 year

The presence in the nose parallel respiratory structures providing respiratory and protective function of the nose is discussed more than 100 years, while the relationships between them are regarded differently.

Actually discussed operational priority of one of the two respiratory structures of the nose, including as the common with inferior nasal passages and sinuses with their nasal passages.
At first glance, the respiratory function of the nose, seems really basic, but its protective function as a kind of secondary, although mouth respiration more productive because it pass under heavy physical exertion, when nasal respiration is not enough, and the protective function of the nose can not be replaced even mouth respiration, so the protective function for the nose should be regarded as basic.
Similarly and in matters of the nasal aerodynamics is still no consensus, because many believe that the main functions and the inferior and common nasal passages that are most functional, as provide direct access for the nasopharynx, and the way into the nasopharynx through the upper nasal passages communicating with the sinuses three times longer and therefore performs a secondary role as the accessory nasal sinuses.
However, it is the ethmoidal labyrinth provides basic respiratory function in newborns, when the inferior nasal passage has not yet been formed and is opened only to the two-year age. And our research of the nasal aerodynamics for more than 30 years, also confirmed that the majority of functional duties and perform the nasal sinuses with their nasal passages.
Such specificity of the nasal aerodynamics due to its structural-functional features, which to ventilate the sinuses the nature has provided a blocking parallel respiratory structures, both at the expense of inferior turbinate covering the inferior nasal passage and adjacent cavernous bodies ability to increase to 100 times when their blood filling, and due to the overlap of its common nasal passage by cavernous bodies during their blood filling, which we regarded as "physiological edema."

And the nasal sinuses, have also the protection against an overload with the help of the small size of their ostiums.

Thus, the small size of the ostiums, like the principle of a spray H.L.Bergson, not only extremely intensive ventilation sinuses, but at the same time advanced are warmed and humidified, as an inspiratory when the sinuses is sucked the warm and humid air, and on the expiration by sucking in the sinuses already warmed and humid air.
However, the throughput of the nasal sinuses, even with the middle and superior nasal passages limited by the rigidity of their design and therefore was sufficient only when a small body needs in inhaled air, which corresponds to a very quiet state of the man, especially during sleep, when just requires maximum protection of the respiratory tract, the most vulnerable in sleep state when the risk of injury to the cold and dry air max.
And in while awake or physical stress when the bandwidth of the main respiratory tract is not enough, as time advanced, and offers a shorter and more direct respiratory tract to the nasopharynx through the common and inferior nasal passages, which operate as a result of "reserve" respiratory function.
At the same time, the air flow passing through the "reserve" respiratory tract is warmed and humidified much less necessary, which creates a threat of injury to the respiratory tract, but they successfully withstand such an overload, since in that case and protective properties of the respiratory tract sufficiently activated.
And when, the total throughput of the nose is not enough that comes with considerable physical exertion, people are moving to mouth respiration, with the receipt of the respiratory tract completely untreated air stream, which will not injure the respiratory tract due to sufficient activation of the protective properties of the whole organism.
Therefore, on revealed the laws of nasal aerodynamics, the flow of air through the sinuses should be considered as basic, but the most suitable for the state of sleep, and Wake rhythms and physical stress, when the need for air flow increases, reflex offers a "reserve" respiratory path, which is already a safe at the expense of the respective activation and protective properties of the respiratory path.