Nasal Obstruction: What to Know Before Surgery (CFD)

Before nasal surgery

Turbinate reduction, septoplasty: any surgery that removes tissue in your nose is permanent, and none of them is free of risk.

Before going under the knife, look for the option that touches your nose the least. And if surgery is really needed, find the smallest correction that does the job.

See a real case Airflow simulation

First, expand instead of cutting

In case of nasal obstruction, maxillary expansion (MSE) is often the option to consider first: it widens the nasal cavity without touching the turbinates or the mucosa. It is usually done by a maxillofacial surgeon.

It does not suit every case, and it has its own constraints. But it keeps all the tissue that warms, humidifies and senses the air you breathe.

Nasal obstruction? Don't cut turbinates! Expand the maxilla instead →

Cross-section of a nasal cavity before and after maxillary expansion: the nose is wider (A to B) and the airway opens, without removing any turbinate — Push the walls of the room instead of removing the furniture.

Every millimetre counts

Reducing the volume of the turbinates, even a tiny bit, can lead to symptoms of Empty Nose Syndrome: the nose is open, but the air no longer feels right.

There is always a risk, however minimally invasive the surgery is. Nobody can predict who will develop ENS.

If surgery is really needed: as little as possible

01 Locate

Find where the air is blocked

An airflow simulation (CFD) of your own nose, from your CT scan, shows exactly where the airflow is obstructed. It is not always where you would expect.

02 Test

Try the smallest correction

With a virtual surgery, I modify the 3D model of your nose at that precise spot, instead of removing tissue "just in case".

03 Compare

See the before and after

A second simulation shows what the correction would change. You bring an objective document to your surgeon.

A real case

A patient with a blocked nose. The simulation showed that the airflow was obstructed at one precise spot. A small, localised reduction of the septum at that spot was tested with a virtual surgery, without touching the turbinates. The opening is only 2 to 3 mm wide and 20 mm long: a minimally invasive correction.

Never reduce the volume of the turbinates. The tissue of the septum plays a smaller role than the turbinates, which warm, humidify and sense the air you breathe. And the reduction must be submucosal: the mucosa itself must never be removed.

The whole case in 44 seconds: the narrow passage, the virtual opening and the results. Watch on YouTube →

Inside of the nasal cavity before the correction: the air rubs hard on the walls (red areas) in a narrow passage — Air friction on the walls: low high Drag the bar to compare. Red means the air rubs hard on the walls of the nose, as it does when it squeezes through a tight passage. After the virtual widening, the red almost disappears in the circled area: the air flows through more freely.

Same view after the virtual correction: the red areas have mostly disappeared — Air friction on the walls: low high Drag the bar to compare. Red means the air rubs hard on the walls of the nose, as it does when it squeezes through a tight passage. After the virtual widening, the red almost disappears in the circled area: the air flows through more freely.

Cross-section of the airflow before the correction: on one side, the air speeds up in a narrow passage at the bottom — Before

Same cross-section after the virtual correction: the passage is wider and the air flows more slowly — After the virtual correction

Air velocity: slow fast

Figure	Before	After
Nasal resistance	Reference	−19%
Airflow right / left	65% / 35%	60% / 40%

In this simulation, widening one precise spot by 2 to 3 mm would lower the nasal resistance by about 19%, and the air would split more evenly between both sides. Even a correction this small is not free of risk: it is a basis for discussion with a surgeon, not a recommendation.

What the simulation does not do. It is not a diagnosis, and it does not tell you whether you need surgery. It describes how the air flows in your nose. The decision belongs to you and your surgeon.

How it works

Airflow simulation + virtual surgery

From your CT scan to a before-and-after report

1You share your CT scan (DICOM). I check it for free.

2I simulate the airflow in your nose and locate the blockage.

3We discuss a correction, I simulate it and send you the before-and-after report.

See prices and request a simulation

Questions

Is maxillary expansion (MSE) an option for adults?

Often, yes. In adults, the expansion is usually anchored in the bone with mini-screws, sometimes with surgery. It is done by a maxillofacial surgeon. It does not suit every case, but it does not remove any nasal tissue. Read more →

Can a small turbinate reduction cause ENS?

It can. ENS has been reported after all kinds of turbinate surgery, including the least invasive ones. Nobody can predict who will develop it, which is why every millimetre counts.

Can a simulation tell me if I need surgery?

No. It shows where the air flows and what a correction would change. Only a doctor can decide whether you need surgery.

Nasal obstruction: what to know before surgery