Individual anatomical features of the paranasal sinuses and dentoalveolar system, the complexity of physiological and pathophysiological processes in this area, and the absence of actual standards of the norm and typical pathologies lead to the fact that differential diagnosis and assessment of the severity of the course of odontogenic sinusitis significantly depend on the measurement methods of significant indicators and have significant variability. Therefore, an urgent task is to expand the diagnostic capabilities of existing research methods, study the significance of the measured indicators, and substantiate the expediency of their use in the diagnosis of specific pathologies in an automated mode. Methods of digital filtering, image segmentation and analysis, fluid dynamics, and statistical and discriminant analysis were used. Preliminary differential diagnosis of odontogenic sinusitis can be performed by densitemetric analysis of tomographic images of the maxillary sinuses, performed using frontal multiplanar reconstructions according to a given algorithm. The very manifestation of the characteristic changes in the densitography of the maxillary sinus allows for the initiation of certain pathological processes and permits the development of the effectiveness of the diagnosis of the pathology of the sinus sinuses, which can be realized automatically in real life.

This study analyzes the existing methods for studying nasal breathing. The aspects of verifying the results of rhinomanometric diagnostics according to the data of spiral computed tomography are considered, and the methodological features of dynamic posterior active rhinomanometry and the main indicators of respiration are also analyzed. The possibilities of testing respiratory olfactory disorders are considered, the analysis of errors in rhinomanometric measurements is carried out. In the conclusions, practical recommendations are given that have been developed for the design and operation of tools for functional diagnostics of nasal breathing disorders. It is advisable, according to the data of dynamic rhinomanometry, to assess the functioning of the nasal valve by the shape of the air flow rate signals during forced breathing and the structures of the soft palate by the residual nasopharyngeal pressure drop. It is imperative to take into account not only the maximum coefficient of aerodynamic nose drag, but also the values of the pressure drop and air flow rate in the area of transition to the turbulent quadratic flow regime. From the point of view of the physiology of the nasal response, it is necessary to look at the dynamic change to the current mode, given the hour of the forced response, so that it will ensure the maximum possible acidity in the legend. When planning functional rhinosurgical operations, it is necessary to apply the calculation method using computed tomography, which makes it possible to predict the functional result of surgery.

Analysis of data of the SCT of the upper respiratory tract is the basis not only for the diagnosis, but also for the subsequent computer planning of rhinosurgical surgeries. For this, the process of automated segmentation of the anatomical structures of the nasal cavity is necessary, which significantly simplifies the preparation of geometric data for subsequent biophysical modeling. Segmentation of anatomical objects in this area should be carried out in two stages: selection of areas by density threshold values, subsequent marking of detected objects and post-processing -to eliminate artifacts and degenerate objects using morphological processing and logical filtering according to the geometric features of the analyzed objects. The arising segmentation errors are eliminated by the expert in an interactive mode.

The project "Implementation of rapid prototyping for modelling the upper respiratory tract in normal and typical pathologies" investigates the urgent problem of improving the reliability of diagnosis and effectiveness of treatment of disorders of the nasal breathing. Possibilities of modern 3D-printing technology for creation of individual natural anatomical models of the upper respiratory tract and determination of their aerodynamic characteristics are considered. The characteristics of the laminar boundary layer of the air flow in the parietal region of the nasal cavity are investigated under different modes of breathing in normal and with typical disorders of the nasal breathing. The concept of investigation of the aerodynamic indices of the anatomical structures of the respiratory system by the results of test tests of individual full-scale 3D models, obtained by the data of spiral computed tomography, is being developed. Theoretical bases of the method of computer planning of restorative rhinosurgical interventions in patients with chronic diseases of the nasal cavity are grounded, based on the change of the configuration of the anatomical structures of the nasal cavity taking into account the aerodynamic parameters of respiration. Modern distance learning and testing tools are being created to demonstrate the technology developed, to provide theoretical knowledge, practical skills and to solve situational tasks for a wide range of specialists. Development and research of natural patterns of the upper respiratory tract allows for supplementing and expanding the knowledge about the aerodynamic characteristics of the nasal cavity, to make decisions about therapy in a short period of time. Experience of the Laboratory of the Institute for Multiphase Processes (IMP) of the Leibniz Universität Hannover (LUH) in the development and use of rapid prototyping capabilities in biotechnology will provide technical support to the project.

Background. Approximately 30% of the general human population suffers from chronic pathology of intranasal structures, the main manifestations of which are impaired nasal breathing and sense of smell. The main instrumental diagnostic methods for this pathology are X-ray computed tomography (CT), which allows obtaining data on the architecture of the anatomical structures of the upper respiratory tract, and rhinomanometry, based on the results of which it is possible to assess the functional capacity of the nasal cavity during breathing. Also, a thorough study of the cytological material of the mucous membrane of the upper respiratory tract is an important component in determining the functional state of the nasal cavity, clarifying the diagnosis and choosing a treatment method. This allows the doctor to determine the composition and number of cellular elements in the material, assess their condition (destruction, proliferation, dystrophy, necrosis, etc.), ascertain the intensity of the body’s reactive abilities, monitor the dynamics of tissue recovery or the healing process in them, and encourages researchers to study in more detail and comparing the materials of clinical, radiological and cytological studies with the aim of developing a pathogenetically directed complex treatment of patients with nasal breathing disorders. Therefore it is necessary to know aspects of correlation between the results of rhinocytography and CT data in typical pathological conditions with nasal congestion are considered. Purpose – is to study the clinical aspects and cytomorphological and functional features of the nasal mucosa in patients with pathology of intranasal structures with respiratory and olfactory disorders and research their independent verification based on the CT data. Materials and Methods. Clinical examination of patients included the study of complaints, anamnesis of the disease, examination of the ENT organs, rhinomanometry, endoscopic examination of the nasal cavity and nasopharynx, The CT of the paranasal sinuses using 3D cone beam tomography on the Vatech PaX-i3D device, as well as cytological examination of the nasal mucosa. The criteria for participation in the study were the absence of chronic diseases of the cardiovascular, respiratory, digestive, urinary systems, as well as heredity burdened by these diseases. Results. Formation of a different nature of the course and severity of disorders is associated with inflammatory, dyscirculatory and trophic disorders in the nasal mucosa, which weaken both mucociliary clearance and local immunity. This applies mainly to the I group of observations. The consequence of a decrease in local immunity factors in the nasal mucosa is microbial contamination, which is associated with a long-term nasal breathing disorder in the I and II groups of observations, up to five years and six months, respectively. The results of rhinocytography mostly correspond with the aerodynamic models data of nasal сavity from the CT datasets. Conclusions. Despite the reliability of the examinations carried out by us, the cytological examination of the nasal mucosa is only an additional analysis, the interpretation of which should be based on the clinical picture of a particular patient. Proposed aerodynamic model from CT-datasets actually provides an independent verification of the aerodynamic characteristics of the nasal cavity, obtained from rhinomanometry data, and may indicate a violation of nasal breathing according to changes in the internal anatomical configuration of the nasal chanel.

The paper examines the features of segmentation of the upper respiratory tract to determine nasal air conduction. 2D and 3D illustrations of the segmentation process and the obtained results are given. When forming an analytical model of the aerodynamics of the nasal cavity, the main indicator that characterizes the configuration of the nasal canal is the equivalent diameter, which is determined at each intersection of the nasal cavity. It is calculated based on the area and perimeter of the corresponding section of the nasal canal. When segmenting the nasal cavity, it is first necessary to eliminate air structures that do not affect the aerodynamics of the upper respiratory tract - these are, first of all, intact spaces of the paranasal sinuses, in which diffuse air exchange prevails. In the automatic mode, this is possible by performing the elimination of unconnected isolated areas and finding the difference coefficients of the areas connected by confluences with the nasal canal in the next step. High coefficients of difference of sections between intersections will indicate the presence of separated areas and contribute to their elimination. The complex configuration and high individual variability of the structures of the nasal cavity does not allow segmentation to be fully automated, but this approach contributes to the absence of interactive correction in 80% of tomographic datasets. The proposed method, which takes into account the intensity of the image elements close to the contour ones, allows to reduce the averaging error from tomographic reconstruction up to 2 times due to artificial sub-resolution. The perspective of the work is the development of methods for fully automatic segmentation of the structures of the nasal cavity, taking into account the individual anatomical variability of the upper respiratory tract.