The function of the nose and sinuses is complicated. Up to 100 individual sections are sometimes only connected with millimeter-small openings. The mucous membrane can swell up to 3 times the initial volume and thereby open or close entire sections. As a result, the nose, with its attached sinus system, regulates the production of up to one liter of nasal secretions per day, which simultaneously serves as a conditioner, moisturizer, antibiotic rug, and protection for the underlying mucosa. The function of the nose is a true medical marvel, but unfortunately also very error prone.
The assessment of the functionality of this system in the Cone Beam Computer Tomogram (CBCT, also DVT) is the high resolution for the first time in every detail possible. Unlike simple CT, there are no "wrong" openings or closures. However, the sheer amount of data is a problem for the evaluating physician. The risk of overlooking details or misinterpreting them in the three dimensions is great.
That is why KOPFZENTRUM® has developed a software together with SELCAL® that uses the Region Growing algorithms to evaluate the patient's data record. The computer "pours" a virtual fluid into the nasal system and analyzes in which sections it can penetrate without large pressure differences. The system simulates the real situation pretty well: millions of very fine ciliates (cilia) ensure a smooth and continuous transport of fluid secretions from cell to cell, from cavity to cell and finally through the nose into the throat. This self-cleaning function (mucociliary clearance, MCC) is perhaps the most important basic function of the human nose / sinuses. The Intranasal Drainage Index (IDI) describes the prerequisites for this function in 4 parameters:
> Volume nose / paranasal sinuses: how big is the whole system?
> Blocked cells: what is the volume of unconnected areas?
> Smallest measurable connections: where are the bottlenecks of the system concentrated?
> Drainage Index: What is the relationship between connected and
unconnected sections of the nose / sinus system?
The effort for this analysis is about 30 minutes of processing by a specially trained staff, about 3 hours of computing time on a high-performance computer and a current license of the software. For this, KOPFZENTRUM® calculates a co-payment of the patient of 95 Euro, in combination with a Cone-beam Computed Tomography (CBCT) of the nose of only 49 Euro. (As of July 2019).