Does Nasal Obstruction Mean That the Nose Is Obstructed?

Abstract

It is still a matter of controversy to what extent the sense of nasal obstruction is associated with objective measures for nasal space and airflow. Knowledge about this is important in the evaluation of nasal complaints and the planning of its treatment. In this study, we evaluated the relationship between subjective nasal obstruction and the corresponding anatomic and physiological nasal parameters using acoustic rhinometry (AR) and peak nasal inspiratory flow (PNIF). Two thousand five hundred twenty-three consecutive patients were included in this cross-sectional study. Eligible subjects were adults referred to the Ear, Nose, and Throat Department, Sørlandet Hospital, Kristiansand, Norway, for evaluation of chronic nasal or sleep related complaints. Subjects underwent AR and nasal flow measurements. Subjective grading of nasal obstruction was obtained by a nasal obstruction visual analogue scale. Associations between nasal obstruction visual analogue scale scores, AR, and PNIF were assessed using multiple linear regression, adjusting for age, gender, body mass index, and asthma, allergy, and smoking history. The sense of nasal obstruction was associated with nasal cavity volumes in both anterior and middle segments of the nasal cavities, with minimal cross-sectional areas in middle segments and for the nasal cavity as a whole, and with PNIF. Associations with minimal cross-sectional areas in anterior segments did not reach significance. The present study demonstrates highly significant associations between the subjective sensation of nasal obstruction and corresponding measures for nasal cavity volume, area, and airflow. We conclude that AR and PNIF are valuable objective instruments for evaluation of subjective nasal obstruction.