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 function of the nose, and inferior nasal passage together with common nasal passage, which perform the reserve respiratory functions, 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.

 
 
 
 

The functionality of the small ostiums of the nasal sinuses


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

Because today the most reliable criterion validity in medicine recognizes the pathophysiologic analysis, which we have already discussed in 2011, in have identified us two parallel respiratory structures in the nose. The mainest of which were the middle and superior nasal passages with nasal sinuses that provides the best moisturizing and heating of the air flow coming to the most unprotected mucous membranes respiratory tract a sleeping man.
And awake or during exercise when the bandwidth of the middle and superior nasal passages and nasal sinuses becomes deficient due to reflex reductions of cavernous bodies, are common and inferior nasal passages, causing the breathing path serves as a reserve, he was named as a backup.
However, today, the ability of the nasal sinuses, so actively involved in the processing of inhaled air flow, was in doubt because of the small size of ostiums of the nasal sinuses and their cellular system.
Although most contemporary authors recognize that the airing of the nasal sinuses, occurs under the influence of negative pressure in the nasal cavity, that develops when inhaling the air outflow of the nasal sinuses and this portion of the air is the most cleaned up and warmed with the hydrated
Ventilation of the nasal sinuses, according to E.N. Malyutin (1910): "when you inhale air enters through the middle and superior nasal passages, in nasal cavities going on air from the suction underpressure by the air stream which runs past their ostiums, and then fill the cavities with new fresh air."
This opinion of the authors fully confirms the well-known principle of spray H. Bergson (Henri Bergson is a prominent French philosopher and inventor of the 1859-1941), which consists of two mutually perpendicular tubes, holes that are touching.
However, the opening of the horizontal tube through which insufflated with air, there must be a wider tube than vertical tube placed into the liquid. When the insufflated with air through a horizontal tube at the top of the vertical tube creates a vacuum that picks up the fluid level to the upper hole, followed by its intense spray. However, further increasing the diameter of the vertical tube leads to stop the fluid suction and spraying.
With a similar mechanism of forced ventilation of the nasal sinuses is difficult not to agree, because it is similar to the spray bottle of H.Bergson, breathing in the air stream of the middle and superior nasal passages is perpendicular to the ostiums of the nasal sinuses, which is significantly narrower than the lumen of the nasal passages. As a result, over of the nasal sinus ostiums is developing of significant negative pressure, that it can empty the sinuses, as the warm air and the liquid.
After inhalation, when the negative pressure in the middle and superior nasal passages disappears and gives way to a positive expiratory pressure, when in the nasal sinuses is still a negative pressure, which together, with the same intensity the air outside is filled with these sinuses.
As a result, such small ostiums of the nasal sinuses quite provide the mechanism of their forced ventilation but increase diameter of the ostiums of the nasal sinuses can only destroy this mechanism.
Moreover, today at the edges of these small ostiums of the nasal sinuses are detected and cavernous bodies, which also regulates the intensity of reflexo airing sinuses.
Therefore, such small ostiums of the nasal sinuses quite rightly should recognize as passive additional protective mechanism of dual-nose, how to protect the mucous membranes of the nasal sinuses from congestion cold and dry air, and forced ventilation of the nasal sinuses, for to protecting warming and humidifying inhaled air.
As a result thanks to the principle of the mechanism of forced ventilation of the nasal sinuses H. Bergson, even small ostiums of the nasal sinuses may well provide a full airing of the nasal sinuses, therefore, surgical enlargement lumen ostiums of the nasal sinuses can only destroy this mechanism.
Therefore, identified by many authors expressed warming of the cold air in the nose to plus 25 degrees with a maximum humidity of inhaled air (up to 2 litres of fluid per day), it can be reasonably seen as programmed properties of the nasal sinuses.
Consequently, the flow of air through the paranasal sinuses should recognize the fundamental, calm man, and with the active status of the human and the common and inferior nasal passages are included in the breath as an additional reserv of the nasal breathing system.