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.

 
 
 
 

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

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 - 2013 year

The relevance of the topic caused by the increase in the World today, the global epidemic of noncommunicable diseases, including and respiratory diseases (V.I. Skvortsov - 2012), which according to the world health organization (WHO), even in the years expressed influenza epidemics reach at least 60% and manifest themselves in the form of seasonal acute respiratory diseases (ARD) with rhinosinusitis (RS), which also grow around in the World, which is of great social importance and causes more carefully consider the causes and mechanisms of these phenomena, which, being of noninfectious origin, from the point of view of pathophysiological analysis must have been a structural character.
Among these structural causes the closest was the nasal aerodynamics, consisting of two parallel respiratory structures as in the Main respiratory structure, consisting of the nasal sinuses with their nasal passages, adapted for breathing during sleep and the Reserve respiratory structure, consisting of the common with inferior nasal passages which compensatory opened at activation of the human organism, when bandwidth of the nasal sinuses becomes insufficient.
However, maintaining the Reserve breathing during dormant naturally leads to an overload of the inferior nasal passage that provokes the development of the seasonal (ARD), while, in the nasal sinuses of the Main respiratory structure stagnant sinusitis develops, forming the RS.
Nature, as it turned out, successfully copes with such disorders of the nasal aerodynamics preparing in the first, of the Main respiratory structure in the form of the ethmoidalis labyrinth with his nasal passages even in utero, that provides the basic and the most secure breathing in newborns, warming the cold air from 20 degrees below zero up to 25 degrees Celsius with moistening it up to 100%, due to the particularly intense mechanism airing nasal sinuses through their narrow anastomosis, like the mechanism of Henri Louis Bergson sprayer (Henri Lui Bergson - 1859-1941).
And with the active awakening when bandwidth the rigid design of the nasal sinuses of the Main respiratory structure breathing becomes not enough open the common nasal passage using a reflex contraction of its cavernous bodies, acting as the Reserve respiratory structure of which is fully developed only to a two-year age, with the opening of the inferior nasal passage, which then takes on a leading role in the Reserve respiratory structure, of the nasal breathing as the shortest and most direct route to the nasopharynx.
At activation of the human organism such income untreated air back through the Reserve respiratory structure naturally leads to an overload of the mucous membranes, with which mucociliary system copes as a result of the respective activation and protective properties of the organism itself, allowing skiers even move to the oral breathing during the cold for 20 degrees Celsius.
Consequently, the cavernous bodies of the nasal mucosa in fact serve as Primary Valve of the nose, which redirects the air flow between the Main and Rerserve nasal respiratory structures.
At the same time as a key area of the Primary Valve of the nose, according to different authors and our research, the area between the anterior ends of the inferior turbinates and nasal septum, which is now considered as the posterior valve nose.
In connection with the above, it becomes obvious programmed total blockade (overlap) the inferior and middle nasal passages by Primary Valve of the nose during sleep, which is extremely important to consider in rhinology, how to protect from seasonal ARD with RS, the curvature of the nasal septum, the night snoring, etc..
Because Primary Valve of the nose are in fact his cavernous bodies, the most careful study of their state should be recognized as a Priority in Rhinology.