0000000000019527
AUTHOR
Klaus Vogt
Teaching Technology Usage in the ENT Medical Subdomain via a Flipped Classroom Approach
The flipped classroom approach is supporting a continuous interaction of students and instructors via online communication and strengthens the ability to solve problems by self-organization. This is especially important in medical domains, like the one of ENT-Head/Neck (ENT: Ear-Nose-Throat) surgeries and treatment. Surgical corrections of the nasal airways, like FESS (Functional Endoscopy Sinus Surgery) or in the field of plastic surgery, are the second frequent surgical interventions in otorhinolaryngology. They have to be prepared very carefully and airflow simulation with Computational Fluid Dynamics (CFD) is gaining importance for diagnostics here. New in silico procedures, like imagin…
The new agreement of the international RIGA consensus conference on nasal airway function tests.
The report reflects an agreement based on the consensus conference of the International Standardization Committee on the Objective Assessment of the Nasal Airway in Riga, 2nd Nov. 2016. The aim of the conference was to address the existing nasal airway function tests and to take into account physical, mathematical and technical correctness as a base of international standardization as well as the requirements of the Council Directive 93/42/EEC of 14 June 1993 concerning medical devices. Rhinomanometry, acoustic rhinometry, peak nasal inspiratory flow, Odiosoft-Rhino, optical rhinometry, 24-h measurements, computational fluid dynamics, nasometry and the mirrow test were evaluated for importa…
Clinical Assessment of Nasal Airway Obstruction
For the evaluation of nasal airway obstruction physical examination, anterior rhinoscopy, laboratory workup, imaging studies, and rhinomanometric studies may be required. Laboratory workup may consist of counts of neutrophil investigating infectious diseases, eosinophil for allergy-related disorders, and mast cell in food allergy. Imaging workup contains computed tomography (CT) and magnetic resonance imaging. Physically based studies involve rhinomanometry and acoustic rhinometry techniques. Nasal resistance is responsible for more than 50% of the resistance of the total airway. Nasal resistance is made up of two layers: the deeper layer consists of underlying bone, cartilage, and muscle, …
Four-phase rhinomanometry: a multicentric retrospective analysis of 36,563 clinical measurements
Rhinomanometry can still be considered as the standard technique for the objective assessment of the ven- tilatory function of the nose. Reliable technical requirements are given by fast digital sensors and modern information technology. However, the xyimaging of the pressure-flow relation typically shows loops as a sign of hysteresis, with the need for resolution of the breath in four phases. The three pillars of 4-phase rhinomanometry (4PR) are the replacement of estimations by measurements, the introduc- tion of parameters related to the subjective sensing of obstruction, and the graphical information regarding the disturbed function of the nasal valve. In a meta-analysis of 36,563 clini…
Airway assessment by four-phase rhinomanometry in septal surgery
PURPOSE OF REVIEW This article updates the state of the art in functional ventilation tests of the nasal airway. Multidisciplinary international cooperation has led within the last years to the development of four-phase rhinomanometry (4PR) by eradicating the errors of the 'classic' rhinomanometry. RECENT FINDINGS Physical experiments, mathematical models and comprehensive statistical analyses implicate that the nasal breath consists of four phases of different diagnostic importance. Presuming the motility of the nasal entrance, it is necessary to depict the elastic behavior within the rhinomanometric curve, as well as to use new parameters for the clinical evaluation of the nasal obstructi…
Relationships among nasal resistance, age and anthropometric parameters of the nose during growth
Background: Children generally have a higher nasal resistance than adults. Growth changes the size and different anthropometric parameters of the nose. Logarithmic effective resistance and logarithmic vertex resistance were introduced as physically correct parameters for nasal obstruction. The previously published classification of obstruction derived from 36,500 measurements is missing data for patients aged 7 to 19 years. Methodology: Rhinomanometry was performed before and after decongestion with 9 different anthropometric measurements in 225 children and adolescents. Correlations among age, anthropometric measurements, and logarithmic effective and vertex resistance were determined for …
Comparison of the thermal effects of Coblation and Radiofrequency waves in a porcine turbinate model
Abstract BACKGROUND. Radiofrequency reduction and Coblation are widely used procedures for the treatment of functionally enlarged turbinates with an appropriate outcome. Bleeding and crusting are postoperative complications for Coblation. Thermographic measurements and histological analyses were used to elucidate the causes. MATERIAL AND METHODS. In a porcine turbinate model, double-needle electrodes of different lengths were tested using a 4MHz radiofrequency current with either automatic energy limitation or a predetermined energy amount of 200 J. Coblation, according to the manufacturer’s instructions, was carried out with a Reflex Ultra 45 wand. The generated temperature was measured wi…
Performance and work of nasal breathing
Abstract OBJECTIVE. To evaluate performance (Q) and work (W) of nasal breathing as potential parameters in functional diagnostic of nasal obstruction. MATERIAL AND METHODS. We included in our study 250 patients and we measured by 4-phase-rhinomanometry with decongestion test. We calculated performance Q of the “representative breath” in inspiration and expiration and in total breath, maximal performance Q (Qmax), Work W of nasal breathing in mJ and in mJ/litre and Q in J/min. RESULTS. The interquartile range of Win for representative breath before decongestion is 356 mJ/l, Wex 308 mJ/l, while after decongestion Win is 264 mJ/l and Wex 220 mJ/l. There is no significant difference between wor…