Особенности нарушений носового дыхания у пациентов с назальной обструкцией

Abstract

The objective of the study is to examine the specific features of the aerodynamic processes in the nasal cavity of patients with subjective nasal obstruction, and to make a differentiated analysis of the causes of its formation. Materials and methods: the authors examined 72 patients aged 18 to 64 years with subjective complaints of nasal breathing obstructions. Of these, 36 patients had not previously undergone surgical correction of external nose and intra-nasal structures. The other 36 patients have undergone septoplasty, rhinoplasty, turbinotomy or inferior nasal concha vasotomy over the period of 2.7±0.6 years. All subjects were surveyed, nasal obstruction was assessed using VAS scale, otorhinolaryngological examination and anterior active rhinomanometry with calculation of nasal resistance and volumetric nasal flow and acoustic rhinometry with the measurement of MCA 1 before and after α2-adrenomimetic test was performed. Results: in the patients with subjective nasal breathing obstructions, who had not previously undergone surgical correction of the external nose and intra-nasal structures, the most frequently identified causes of nasal obstruction are functional (38.9%) and structural (38.9%). The combined structural and functional changes in airflow circulation were found in 22.2% (8 patients). According to the modified VAS scale, 12 patients (32.6%) in this group had an underestimation of subjective degree of nasal obstruction, compared with objectively recorded aerodynamic respiratory function parameters. Among patients who had previously undergone surgical correction of intra-nasal structures, according to objective assessment of aerodynamic parameters, 11.1% have no nasal breathing disorders, in 47.2% of patients, the main cause of nasal obstruction is the nasal mucosa reactive edema, and 36.1% of patients have unsatisfactory functional results of surgical treatment due to incomplete correction of structural disorders. Conclusion: the anterior active rhinomanometry in combination with acoustic rhinometry should be conducted if the patients have subjective nasal breathing obstructions both at the stage of planning the surgical correction of intra-nasal structures and in the remote postoperative period for differentiated analysis of the nasal obstruction causes and provision of optimal functional result.