Abstract:Objective To evaluate the efficacies of individually designed three-dimensional (3D) printed nasal vestibular support expansion and conventional support expansion on the recoveries of nasal ventilation function and anterior nostril morphology in nasal vestibular stenosis.Methods Seventy-three patients with traumatic unilateral nasal vestibular stenosis were randomly divided into control group of 35 cases (by conventional support expansion) and experimental group of 38 cases (by 3D printed nasal vestibular support expansion). Subjective evaluation indexes, morphological parameters and nasal airflow numerical simulation parameters were used to evaluate the local morphological and functional recoveries of the nasal cavity.Results The visual analogue scale (VAS) scores of subjective nasal patency and nostril symmetry satisfaction in the control group and the experimental group were both significantly improved after support expansion treatment compared with those before operation (P<0.05), while the VAS score of nostril symmetry satisfaction in the experimental group was higher than that in the control group (P<0.05). The cross-sectional areas of nasal valve in both groups after support expansion treatment[(0.86±0.29) cm2 in the control group and (0.71±0.26) cm2 in the experimental group) were significantly increased compared with those before operation (P<0.05), and the mean cross-sectional area of nasal valve in the control group was larger than that in the experimental group(P<0.05). However, the Δlong-axis ratio and Δshort-axis ratio of the experimental group were both lower than those of the control group after the support expansion treatment (P<0.05), which indicated that 3D-printed nasal vestibular support was better than conventional nasal vestibular support in restoring the nostril shape. The stenotic side nasal resistances in both groups after support expansion treatment were lower than those before operation (P<0.05). The stenotic side nasal resistance after support expansion in the experimental group[(0.022±0.008) Pa.s.mL-1]was smaller than that of the control group[(0.028±0.012) Pa.s.mL-1](P<0.05), but the difference of total nasal resistance between both groups was statistically insignificant (P>0.05). The intranasal airflow heating efficiencies were (94.55±2.54)% in the control group and (95.26±3.21)% in experimental group after support and expansion treatment, which were significantly decreased compared with those before operation[(95.45±2.93)% in the control group and (96.14±2.63)% in the experimental group](P<0.05). However, total nasal warming efficiency and total nasal humidification efficiency did not show significant differences between two groups (P all>0.05).Conclusions Individually designed 3D printed nasal vestibular support for postoperative support expansion in patients with anterior nostril stenosis can restore the anterior nostril shape, the nasal ventilation function as well as the nasal airflow temperature and humidity regulation function,which can reflect the advantages of personalized treatment and allow patients to obtain more satisfactory outcomes. With good prospect of clinical application, 3D printed nasal vestibular support can be used as supplement for the nasal vestibular local support expansion treatment.
