Outcome measures calculated by CFD include: (1) heat transfer rate for the entire nasal cavity with the choana as the posterior boundary; (2) heat transfer rate across the nasal vestibule; (3) surface area of nasal mucosa where heat flux exceeds a stimulation threshold; (4) heat fluxes averaged along the perimeter of coronal cross-sections and plotted as a function of distance from the nostrils; and (5) peak heat fluxes, defined as the value above which only 1 cm2 of mucosa is exposed to. To compute the distance from the nostrils, the most posterior edge of the nostrils was defined as origin of our coordinate system (Figure 1 ). The nasal vestibule was defined posteriorly by the piriform aperture and superiorly by a plane that crossed a notch into the nasal cavity (Figure 1 ). More specifically, the posterior boundary of the vestibule was located 3.4 ± 1.2 mm from the origin, while the superior boundary was located 15.0 ± 2.0 mm above the origin.
Patients were administered the Nasal Obstruction Symptom Evaluation (NOSE) to collect information on patient-reported symptoms before and after surgery.34 (link) The NOSE scale is a disease-specific quality-of-life instrument for NAO that has been validated for septoplasty and nasal valve repair, and is used to measure surgical success.35 (link) The NOSE scale was selected because (a) it is simple and quick, (b) it is the quality-of-life (QOL) instrument most frequently used to assess surgical outcomes in NAO, and (c) it is more specific for NAO than other rhinological QOL instruments.36 ,37 (link) It is a five item scale where each patient scores, over the past month, their symptoms of nasal congestion, nasal blockage, trouble breathing through the nose, trouble sleeping, and air hunger sensation using a scale from 0 (not a problem) to 4 (severe problem). These numbers are summed and multiplied by 5 to give a score that ranges from 0 – 100.
Finally, unilateral visual analog scale (VAS) scores for nasal airflow were collected before and after surgery. Patients were asked to cover one nostril and rate their ability to breathe through the uncovered nostril on a scale of 0 (completely obstructed) to 10 (no obstruction). The VAS score was a subjective measure of instantaneous airflow at the time of consultation, while the NOSE score was used to assess the symptoms of nasal obstruction during the past month.
Patients were administered the Nasal Obstruction Symptom Evaluation (NOSE) to collect information on patient-reported symptoms before and after surgery.34 (link) The NOSE scale is a disease-specific quality-of-life instrument for NAO that has been validated for septoplasty and nasal valve repair, and is used to measure surgical success.35 (link) The NOSE scale was selected because (a) it is simple and quick, (b) it is the quality-of-life (QOL) instrument most frequently used to assess surgical outcomes in NAO, and (c) it is more specific for NAO than other rhinological QOL instruments.36 ,37 (link) It is a five item scale where each patient scores, over the past month, their symptoms of nasal congestion, nasal blockage, trouble breathing through the nose, trouble sleeping, and air hunger sensation using a scale from 0 (not a problem) to 4 (severe problem). These numbers are summed and multiplied by 5 to give a score that ranges from 0 – 100.
Finally, unilateral visual analog scale (VAS) scores for nasal airflow were collected before and after surgery. Patients were asked to cover one nostril and rate their ability to breathe through the uncovered nostril on a scale of 0 (completely obstructed) to 10 (no obstruction). The VAS score was a subjective measure of instantaneous airflow at the time of consultation, while the NOSE score was used to assess the symptoms of nasal obstruction during the past month.
