NOSE Pilot Study Investigating the Practical Use of Computational Fluid Dynamics Simulation of Airflow in the NNOSEasal Cavity and Paranasal Sinuses NOSE Pilot Study Investigating the Practical Use of Computational Fluid Dynamics Simulation of Airflow in the Nasal Cavity and Paranasal Sinuses NOSE Version 1.0 2018-08-30 NOSE Pilot Study Investigating the Practical Use of Computational Fluid Dynamics Simulation Version 1.0 of Airflow in the Nasal Cavity and Paranasal Sinuses NOSE Pilot Study Investigating the Practical Use of Computational Fluid Dynamics Simulation of Airflow in the Nasal Cavity and Paranasal Sinuses Project Number 1000043433 Project Title NOSE Pilot Study Document Reference Investigating the Practical Use of Computational Date 2018-08-30 Title Fluid Dynamics Simulation of Airflow in the Nasal Cavity and Paranasal Sinuses Document Name NOSE_PS_FINAL_v1 Version Draft draft final Restrictions public internal restricted : Distribution Steirische Forschungsförderung Authors Koch Walter, Koch Gerda, Vitiello Massimo, Ortiz Ramiro, Stockklauser Jutta, Benda Odo Abstract The NOSE Pilot study evaluated the technical and scientific environment required for establishing a service portfolio that includes CFD simulation and 3D visualization services for ENT specialists. For this purpose the state-of-the-art of these technologies and their use for upper airways diagnostics were analysed. Keywords Rhinology, Computational Fluid Dynamics, 3D Visualization, Clinical Pathways, Service Center, Knowledge Base Document Revisions Version Date Author(s) Description of Change 1.0 2018-08-30 Koch Walter, Koch Final Version Gerda, Vitiello Massimo, Ortiz NOSERamiro, Stockklauser Jutta, Benda Odo 2018-08-30 Seite 3 / 82 Copyright © AIT ForschungsgesmbH NOSE_PS_FINAL_v1 NOSE Pilot Study Investigating the Practical Use of Computational Fluid Dynamics Simulation Version 1.0 of Airflow in the Nasal Cavity and Paranasal Sinuses Table of Contents Acknowledgments ................................................................................... 7 Preamble ................................................................................................. 8 Introduction ............................................................................................ 9 1 Diseases of the upper respiratory tract .......................................... 10 1.1 Definition and pathologies .........................................................................10 1.2 Treatment methods ..................................................................................11 1.3 Costs ......................................................................................................12 1.4 Number of cases ......................................................................................12 1.4.1 D-A-CH area ..................................................................................................... 12 1.4.2 Europe and US .................................................................................................. 12 2 International Context ..................................................................... 14 2.1 State of the art ........................................................................................14 3 Pilot Study ...................................................................................... 16 3.1 Motivation for the Pilot Study ....................................................................16 3.2 Research Method .....................................................................................16 4 Results ........................................................................................... 18 4.1 Preparatory phase (AP1) ...........................................................................20 4.1.1 Desk Research .................................................................................................. 20 4.1.2 Analysis of Tools and Methods ............................................................................. 21 4.1.3 Data Collection (CT Images) ............................................................................... 21 4.1.4 Medical Analysis ................................................................................................ 21 4.1.5 Selection of 3D Printer ....................................................................................... 21 4.1.6 Selection of IT-Resources ................................................................................... 24 4.2 Workflow Concept (AP2) ...........................................................................25 4.2.1 WorkflowNOSE Development ....................................................................................... 25 4.3 Mesh Generation (AP3) .............................................................................33 4.3.1 Mesh Generation and Refinement ........................................................................ 34 4.3.2 In Vivo Model .................................................................................................... 36 2018-08-30 Seite 4 / 82 Copyright © AIT ForschungsgesmbH NOSE_PS_FINAL_v1 NOSE Pilot Study Investigating the Practical Use of Computational Fluid Dynamics Simulation Version 1.0 of Airflow in the Nasal Cavity and Paranasal Sinuses 4.4 CFD Simulation (AP4) ...............................................................................37 4.4.1 In Silico Model ................................................................................................... 37 4.4.2 CFD Simulation.................................................................................................. 38 4.5 CFD Analysis (AP5) ..................................................................................41 4.5.1 In Vitro Model ................................................................................................... 43 4.6 Validation (AP6) .......................................................................................45 4.6.1 Validation and Interpretation ............................................................................... 45 4.7 Concept Development NOSE Service (AP7) ..................................................45 4.7.1 Business Plan Development................................................................................. 46 4.7.2 Development of Service Platform ......................................................................... 48 4.8 Knowledge Base (AP8) ..............................................................................48 4.8.1 Development of Knowledge Base ......................................................................... 49 4.9 Networking and Dissemination (AP9) ..........................................................51 4.9.1 Definition of Service Platform .............................................................................. 51 5 Summary ........................................................................................ 54 5.1 Workflow Concept (AP2) ...........................................................................54 5.2 Mesh generation (AP3) .............................................................................54 5.3 CFD Simulation and Analysis (AP4 and AP5) ................................................55 5.4 Validation (AP6) .......................................................................................57 5.5 Concept Development NOSE Service (AP7) ..................................................58 5.6 Knowledge Base (AP8) ..............................................................................59 5.7 Networking and Dissemination (AP9) ..........................................................59 6 Discussion and Outlook .................................................................. 61 6.1 Diagnostic Procedures ..............................................................................61 6.2 Surgery Preparation .................................................................................62 6.3 Training ..................................................................................................63 6.4 Center of Excellence .................................................................................65 6.5 Legal Framework and Patentability .............................................................66 I. List of Entities doing Research on CFD in the Upper Respiration System ................................NOSE.................................................................. 67 II. Conference Participation and Presentations (2016-2018) .............. 70 III. Glossary ......................................................................................... 71 2018-08-30 Seite 5 / 82 Copyright © AIT ForschungsgesmbH NOSE_PS_FINAL_v1 NOSE Pilot Study Investigating the Practical Use of Computational Fluid Dynamics Simulation Version 1.0 of Airflow in the Nasal Cavity and Paranasal Sinuses IV. Protection of Data Privacy .............................................................. 75 V. List of Figures ................................................................................. 76 VI. List of Tables .................................................................................. 78 VII. Bibliography ................................................................................... 79 NOSE 2018-08-30 Seite 6 / 82 Copyright © AIT ForschungsgesmbH NOSE_PS_FINAL_v1 NOSE Pilot Study Investigating the Practical Use of Computational Fluid Dynamics Simulation Version 1.0 of Airflow in the Nasal Cavity and Paranasal Sinuses Acknowledgments