{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T11:15:40Z","timestamp":1788347740567,"version":"build-2803163510"},"reference-count":13,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2017,1,16]],"date-time":"2017-01-16T00:00:00Z","timestamp":1484524800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000055","name":"National Institute on Deafness and Other Communication Disorders","doi-asserted-by":"publisher","award":["NIDCD R01 DC013626"],"award-info":[{"award-number":["NIDCD R01 DC013626"]}],"id":[{"id":"10.13039\/100000055","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2017,5]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>After sinus surgery, patients are commonly instructed to irrigate with saline irrigations with their heads over a sink and noses directed inferiorly (nose\u2010to\u2010floor). Although irrigations can penetrate the sinuses in this head position, no study has assessed whether sphenoid sinus penetration can be improved by irrigating with the nose directed superiorly (nose\u2010to\u2010ceiling). The purpose of this study was to use a validated computational fluid dynamics (CFD) model of sinus irrigations to assess the difference in sphenoid sinus delivery of irrigations after irrigating in a nose\u2010to\u2010floor vs nose\u2010to\u2010ceiling head position.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Bilateral maxillary antrostomies, total ethmoidectomies, wide sphenoidotomies, and a Draf III frontal sinusotomy were performed on a single fresh cadaver head. CFD models were created from postoperative computed tomography maxillofacial scans. CFD modeling software was used to simulate a 120\u2010mL irrigation to the left nasal cavity with the following parameters: flow rate 30 mL\/second, angle of irrigation 20 degrees to the nasal floor, and either nose\u2010to\u2010floor or nose\u2010to\u2010ceiling head positioning.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>In the postoperative CFD models, the sphenoid sinuses were completely penetrated by the irrigation while in a nose\u2010to\u2010ceiling head position. However, no sphenoid sinus penetration occurred in the nose\u2010to\u2010floor position. Other sinuses were similarly penetrated in both head positions, although the ipsilateral maxillary sinus was less penetrated in the nose\u2010to\u2010ceiling position.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>CFD modeling demonstrated that the nose\u2010to\u2010ceiling head position was superior to the nose\u2010to\u2010floor position in delivering a 120\u2010mL irrigation to the sphenoid sinuses.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alr.21908","type":"journal-article","created":{"date-parts":[[2017,1,16]],"date-time":"2017-01-16T11:39:53Z","timestamp":1484566793000},"page":"474-479","source":"Crossref","is-referenced-by-count":42,"title":["Computational fluid dynamic modeling of nose\u2010to\u2010ceiling head positioning for sphenoid sinus irrigation"],"prefix":"10.1002","volume":"7","author":[{"given":"John R.","family":"Craig","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Henry Ford Hospital  Detroit MI"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James N.","family":"Palmer","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University of Pennsylvania  Philadelphia PA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kai","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Ohio State University  Columbus OH"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2017,1,16]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otc.2009.07.005"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2008.04.020"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2009.23.3265"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21092"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.20002"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1177\/0003489416671532"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e31818208c1"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21686"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajr.2008.22.3221"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.mlg.0000149463.95950.c5"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/alr.21677"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.25666"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/chemse\/bjh033"}],"container-title":["International Forum of Allergy &amp; Rhinology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Falr.21908","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/alr.21908","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,7]],"date-time":"2023-10-07T02:46:22Z","timestamp":1696646782000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/alr.21908"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,1,16]]},"references-count":13,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2017,5]]}},"alternative-id":["10.1002\/alr.21908"],"URL":"https:\/\/doi.org\/10.1002\/alr.21908","archive":["Portico"],"relation":{},"ISSN":["2042-6976","2042-6984"],"issn-type":[{"value":"2042-6976","type":"print"},{"value":"2042-6984","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,1,16]]}}}