Abstract
SummaryNasal obstruction when lying down frequently brings patients to the otolaryngologic clinic. There are several explanations for the problem. The nasal mucosa reaction to venous changes that alter local blood flow, secondary to compression of the neck veins or hydrostatic pressures, is the most accepted explanation. Acoustic rhinometry is a new non-invasive technique to assess nasal patency. Aim: The purpose of this study was to assess the effect of posture change from sitting to supine position applying acoustic rhinometry. Study design: clinical prospective. Material and method: 10 volunteers with no nasal disorders, aged 19 to 30 years old, and 10 volunteers with symptoms of rhinitis, aged 18 to 27 years old, were selected for the study. Nasal sensation was tested by means of a visual analogue scale. Nasal area and volume were assessed by acoustic rhinometry in the following positions: seated and 15 minutes after lying down. Results: Both groups showed significant nasal obstruction on the visual analogue scale and on acoustic rhinometry. The perception of nasal obstruction was significantly higher in subjects with rhinitis symptoms compared to normal. Conclusion: We conclude that the effect of posture change from sitting to supine position produces a decrease in nasal cross-sectional area and volume in both normal and in subjects with symptoms of rhinitis. However, the impact on the perception of nasal obstruction induced by lying down seems to be higher in subjects with symptoms of rhinitis.
Highlights
The sensation of nasal obstruction upon lying down is a commonly related experience by patients in daily ENT care
Among them we can refer to: 1. Possibility of a feedback loop processed by the central nervous system (CNS), alternating the information of patency of nasal cavity to modify the vascular ingurgitation of the structure; 2
The study was conducted in the private office of the author in which the acoustic rhinometry device was located
Summary
The sensation of nasal obstruction upon lying down is a commonly related experience by patients in daily ENT care. Possibility of a feedback loop processed by the central nervous system (CNS), alternating the information of patency of nasal cavity to modify the vascular ingurgitation of the structure; 2. Venous pressures that affect the blood content of the nasal mucosa differently on one side than on the other, by compression of neck vein, rather than hydrostatic differences; 3. The induction in lateral position of active reflex responses that determine the resistances to airflow of each nasal cavity; 4. The pressure to the lateral of trunk and limbs that follow posture asymmetry in decubitus and the indication of nasal congestion on the side of the higher pressure and contralateral decongestion; 5. The hydrostatic increase of venous pressure and relaxation of vasomotor tone; 6. The response of nasal mucosa for both local and systemic conditions (hydrostatic), probably induced by vascular and cutaneous reflex
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