Acoustic Rhinometry Measurements Research Articles

The Impact of Scroll Ligament Preservation on Nasal Airway Patency in Rhinoplasty: An Objective Study with Rhinomanometry and Acoustic Rhinometry.

Rhinoplasty is a critical surgical intervention aimed at enhancing nasal form and function. However, traditional approaches often compromise the integrity of nasal scroll ligaments, vital for the functionality of the internal nasal valve, leading to potential postoperative nasal dysfunction. Despite the importance of scroll ligaments in maintaining nasal structure and function, the literature lacks objective, quantifiable evidence of their role. This study sought to objectively compare nasal functionality and anatomy between patients undergoing rhinoplasty with bilateral preservation of scroll ligaments and those with bilateral sacrifice of these ligaments, employing computerized rhinomanometric and acoustic rhinometric measurements as evaluative tools. This retrospective, double-blind study was conducted at Tekirdağ Namık Kemal University's Plastic Reconstructive and Aesthetic Surgery and Ear, Nose, and Throat Clinics. The study population comprised patients who underwent rhinoplasty between May 1, 2018, and October 1, 2019. Patients were rigorously selected based on their medical history, including previous nasal surgeries, aesthetic dissatisfaction, and minimal nasal septum deviation. They were then categorized into two distinct groups: one undergoing rhinoplasty with an emphasis on preserving the scroll ligaments (n = 31) and the other where these ligaments were intentionally sacrificed (n = 30). A comprehensive analysis involving preoperative and six-month postoperative computerized rhinomanometry and acoustic rhinometry measurements was conducted to assess the surgical impact on nasal functionality and structure. The statistical comparison focused on evaluating the changes in air pressure and airflow rates, aiming to delineate the functional outcomes attributable to the differing surgical techniques. Our findings reveal a stark contrast in postoperative nasal functionality between the two groups. In the group with preserved scroll ligaments, there was a significant improvement in postoperative computerized rhinomanometric measurements, indicating enhanced nasal airflow and reduced airway resistance. Conversely, the group with sacrificed scroll ligaments exhibited deteriorated postoperative outcomes, with increased nasal airway resistance and decreased airflow. These differences underscore the pivotal role of scroll ligaments in maintaining nasal airway patency and functionality. The study unequivocally demonstrates that the preservation of scroll ligaments during rhinoplasty significantly benefits nasal airway function, as evidenced by improved postoperative rhinomanometry and acoustic rhinometry measurements. This objective data provide a compelling argument for the functional importance of scroll ligaments, advocating for surgical techniques that prioritize their preservation. By highlighting the positive correlation between ligament preservation and enhanced nasal functionality, this research contributes valuable insights into rhinoplasty practices, suggesting a paradigm shift towards approaches that safeguard nasal structural integrity for optimal functional outcomes. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Correlational Analysis of Nasal Resistance and Acoustic Rhinometry Measurements With the Localization of Fungus Balls in the Paranasal Sinuses.

Objective: To investigate the reason for fungal balls (FBs) being localized in paranasal sinuses, we analyzed the clinical presentations of patients with FB rhinosinusitis (FBS). Methods: Clinical data, anatomical variation (ie, nasal septal deviation, concha bullosa, and Haller cell), as well as measurements of nasal resistance (NR), nasal cavity volume (NCV), and nasal cross-sectional area (NCA) using active anterior rhinomanometry and acoustic rhinometry were collected from FBS patients hospitalized in our hospital between January 2021 and December 2022. A retrospective analysis was conducted using IBM SPSS 19.0 to perform the Shapiro-Wilk test, t-test and logistic regression analysis. Results: A total of 95 FBS patients, including 33 male and 62 female patients, were included in this study. FBs in maxillary sinus were the most common (83, 87.4%), followed by sphenoid sinus (9, 9.5%). Logistic multivariate regression analysis revealed that a higher left-to-right NR ratio was associated with an increased likelihood of FBs being present in the left sinus [Odds ratios (OR) = 0.185; 95% CI, 0.061-0.558; P < .01]. When the ratio of the left-to-right second-minimum NCA was higher and the FB was more in the right sinus (OR = 3.194; 95% CI, 1.593-6.405; P = .001). Additionally, when the difference between left and right NCV was greater and FB occurred more commonly in the right sinus (OR = 1.435; 95% CI, 1.196-1.721; P < .001). Nonetheless, the presence of nasal septum deviation and concha bullosa did not significantly contribute to FB formation. Conclusions and significance: The differences in NR, NCA, and NCV between the affected and unaffected sides of nasal cavity are risk factors for the FB formation. To reduce FBS recurrence, it is important to focus on improving nasal ventilation during the surgical treatment.

Outcome of nasal measurements in patients with OSA – Mounting evidence of a nasal endotype

BackgroundIncreased nasal resistance as measured by 4-phase rhinomanometry is associated with a paucity of apneas relative to hypopneas in obstructive sleep apnea (OSA) patients. The ratio of hypopneas to apneas for a given apnea hypopnea index (AHI) may influence treatment choice. This study aimed to investigate if OSA patients with an elevated hypopnea apnea ratio are associated with differences in acoustic rhinometry measurements. MethodsOne hundred and thirty-nine (n = 139) OSA patients (AHI >5) were enrolled in this prospective case-control study (all male). OSA Diagnosis was established through a type three sleep study. Both acoustic rhinometry and 4-phase rhinomanometry were performed on all patients at baseline and after decongestion. Possible associations between apnea-hypopnea index, oxygen desaturation index, nadir oxygen saturation, apnea index, hypopnea index, hypopnea to apnea ratio and body mass index and were analysed using multiple logistic and linear regression models. ResultsThe acoustic rhinometry measurements minimal cross-sectional area, total volume and minimal cross-sectional areas are significantly smaller in patients with increased nasal resistance as measured by 4-phase rhinomanometry (P < 0.01). No consistent statistically significant associations were found between the acoustic rhinometry variables, and the respiratory variables analysed in the sleep studies. OSA patients with an elevated hypopnea apnea ratio are more than 4 times more likely to present with increased nasal resistance measured by 4-phase rhinomanometry (OR = 4.4, 95% CI [1.5–13.2], P < 0.01). ConclusionsAcoustic rhinometry is significantly associated with 4-phase rhinomanometry. However, acoustic rhinometry measurements are not associated with the respiratory indices routinely measured in OSA in a clinical setting. 4-phase rhinomanometry is a more suitable method for detecting clinically relevant nasal obstruction in obstructive sleep apnea patients.

The effect of oral guaifenesin on pediatric chronic rhinitis: A pilot study

ObjectivesTo investigate the effectiveness of guaifenesin in the relief of nasal symptoms in children with chronic rhinitis (CR). We hypothesized that guaifenesin use over a 14-day study period would improve subjective nasal complaints in pediatric patients with chronic rhinitis, as measured by the SinoNasal-5 (SN-5) survey. We also hypothesized improvement in nasal volume and cross-sectional area with guaifenesin. Study designRandomized, placebo-controlled, parallel group, masked clinical trial. MethodsThe study consisted of a 14-day, randomized, placebo-controlled, parallel group, masked clinical trial of oral guaifenesin for CR in children aged 7–18 years. A 2:1 ratio of subjects on active medication to placebo was used. The study was approved by the Western Institutional Review Board. On initial enrollment and at the conclusion of therapy, the SN-5 was completed by parents, acoustic rhinometry measurements performed, and mucus sampling for rheology was obtained. Results30 subjects were enrolled in the study, with 20 receiving guaifenesin and 10 placebo. Treatment with guaifenesin for 14 days produced a significant mean change towards clinical improvement in SN-5 scores compared with placebo (p = 0.013). There was no significant difference in quality of life assessment scores between the two groups or in any of the acoustic rhinometry parameters. Many of the study subjects had difficulty producing a mucus sample sufficient for analysis. ConclusionsBased upon our pilot data, it appears that guaifenesin treatment may produce objective improvements in pediatric patients with CR. Further research with larger samples sizes, inclusion of children younger than 6, and biophysical mucus analyses is warranted. Level of evidenceLevel 2b.

A comparison of transversal changes occurring in the treatment of rapid maxillary expansion with acoustic rhinometry

Aim: The aim of this study was to determine the relationship between cephalometric transversal measurements and nasal patency before and after rapid maxillary expansion (RME) treatment applied to patients with maxillary transversal deficiency. Methodology: The records of 30 patients with maxillary transversal insufficiency and 20 patients without normal dentofacial and nasal symptoms were used. Acoustic rhinometry (MCA1, MCA2, VOL1, VOL2) and cephalometry measurements (JR–JL, MMTI, nasal width) were analyzed before (TO) and six months after (T1) RME. Results: There were no significant differences in age and gender between the groups. After the RME treatment of the patients in the study group, there was a significant increase in the cephalometric measurement (JL–JR, MMTI, nasal width) and acoustic rhinometry measurement parameters (MCA1, MCA2, VOL1, VOL2). Cephalometric measurements showed consistent changes in the patients in the study group, suggesting that RME treatment increased the maxilla’s growth capacity. The postero-anterior cephalometry results improved after RME treatment and approached those of the control group. Conclusion: Significant improvement was observed in the cephalometric transversal measurements after RME treatment. This improvement indicated that RME increases maxillary growth capacity. There was no correlation between cephalometric and acoustic rhinometry. This result may be due to the inability of postero-anterior cephalometry to effectively evaluate the maxilla-related part of the nasal structures. How to cite this article: Metli ŞN, Yıldırım M, Erdur EA, Erdur Ö. A comparison of transversal changes occurring in the treatment of rapid maxillary expansion with acoustic rhinometry. Int Dent Res 2022;12(Suppl.1):97-102. https://doi.org/10.5577/intdentres.434 Linguistic Revision: The English in this manuscript has been checked by at least two professional editors, both native speakers of English.

Effect of IL-4, IL-5, IL-13, and IgE on Nasal Congestion in Patients with Allergic Rhinitis

Objective&#x0D; Allergic rhinitis is a symptomatic nasal disease provoked by exposure of the nasal mucosa to allergens, resulting in IgE-mediated inflammation. Swelling of the nasal mucosa is caused by interstitial mucosal edema due to leakage of plasma fluid and congestion of the nasal mucosal vessels and imbibition of the perivascular space. The method for determining the cross-sectional area as a function of airway distance is known as acoustic rhinometry. By using this approach, it is possible to determine the area as a function of the distance in the airways.&#x0D; Methods &#x0D; IL and IgE levels were measured in serum and nasal lavage with enzymelinked immunosorbent assay (ELISA) - Invitrogen ELISA kit. The results were expressed as optical density (OD) at 450 nm and calculated according to the OD of the standart.&#x0D; For our study A1 Acoustic Rhinometer, GM instruments Ltd., Kilwining, Scotland was chosen. Data analysis was performed after two measurements were taken: before and after nasal decongestion, with drops containing 0.1% Xylometazoline hydrochloride.&#x0D; Statistical analyses were performed using SPSS 16.0 for Windows (SPSS Inc.).&#x0D; All participants, after detailed presentation of the aims, tasks and methodology of the study and the opportunity for discussion, signed an informed consent form.&#x0D; Results&#x0D; The study was conducted on the territory of the University Hospital in Stara Zagora, Bulgaria and 111 participants, aged from 19 to 84 years, were examined. Data analysis was performed after two acoustic rhinometry measurements, respectively, before and after nasal decongestion.&#x0D; Conclusion&#x0D; The published results show that there is an inverse relationship between the degree of nasal congestion (determined by acoustic rhinometry) and the serum concentration of proinflammatory cytokines.&#x0D;

Factors Affecting Optimal Titration Pressure of Continuous Positive Airway Pressure Device in Patients with Obstructive Sleep Apnea Syndrome.

To assess the effects of anatomical, clinical parameters, and pulmonary respiratory function on the therapeutic titration pressure of continuous positive airway pressure (CPAP) device in obstructive sleep apnea syndrome (OSAS). The study comprised 41 OSAS patients whose optimum CPAP titration pressures were measured. Each patient underwent an otorhinolaryngologic and thoracic examination, and data was recorded for height, weight, body mass index, neck-waist circumferences, Mallampati classification, tonsillar hypertrophy, hypopharyngeal collapse, soft palate-tongue base obstruction scores, peak nasal inspiratory flow and acoustic rhinometry measures, and CPAP device therapeutic pressures. Forced vital capacity, forced expiratory volume, FEV1/FVC ratio and peak expiratory flow values were noted. Median CPAP optimal pressure cut-off value was determined as 9 mmH2O. Statistical analysis was made in two groups as CPAP titration optimal pressure ≤9 and >9 mmH2O. In the optimal pressure >9 group, neck and waist circumferences, hypopharyngeal collapse score, retropalatal and retrolingual lateral wall collapse scores were significantly higher (p<0.05). In multivariate and univariate model analysis, neck and waist circumferences, hypopharyngeal collapse score, retropalatal and retrolingual lateral wall collapse scores were observed to be significant in predicting high and low pressures in univariate model. For the prediction of optimal CPAP titration pressure in OSAS treatment, wide neck and waist circumferences, high hypopharyngeal collapse score and retropalatal and retrolingual lateral wall collapse grades may be determinative.

Ginger extract versus Loratadine in the treatment of allergic rhinitis: a randomized controlled trial

BackgroundAllergic rhinitis (AR) is a non-infectious immune disease and incidents of the disease has continuously increased in Thailand. Ginger, a Thai herb, is used in food and Thai traditional medicine. This study was designed to assess efficacy and safety of ginger extract in comparison with loratadine for AR treatment.MethodsAR patients were treated with ginger extract 500 mg (n = 40) against those treated with loratadine 10 mg (n = 40) in a randomized, double-blind, controlled trial for 3 and 6 weeks. The efficacy was evaluated from clinical examinations i.e. total nasal symptom scores (TNSS), cross-sectional area of the nasal cavity with acoustic rhinometry (ARM) and rhinoconjunctivitis quality of life questionnaire (RQLQ). The safety of treatment was measured by blood pressure, blood analysis and history-taking for side effects.ResultsThe results showed both ginger extract and loratadine treated groups significantly decreased TNSS scores but there was no significant difference between the two groups. In acoustic rhinometry measurement, the ginger treated group significantly gradually increased the estimated volume of the nasal cavity and decreased distances from the nostril, but the loratadine treated group did not cause a change. Both groups gave significantly improvement in every aspect of the RQLQ at third weeks. The treatment with ginger extract was as safe as loratadine as shown by renal and liver function results obtained from blood analysis. Both treatments had no effect on blood pressure of the patients.ConclusionsThe ginger extract is as good as loratadine in improving nasal symptoms and quality of life in AR patients. However, ginger extract caused less side effects especially, drowsiness, fatigue, dizziness and constipation. Therefore, the ginger extract could be used as alternative treatment for patients with AR.Trial registrationRegistered with ClinicalTrials.gov (Registration number: NCT02576808) on 15 October 2015.

Evaluation of Olfactory Sensation, Acoustic Rhinometry, and Quality of Life of the Patients With Nasal Septal Deviation

Nasal septum deviations are deformities that occur in the cartilage and bones of the septum. The aim of the present study is to evaluate the patients with septum deviation according to the acoustic rhinometry measurements in terms of changes in smell function and the effects on quality of life. Twenty patients with septum deviation between the ages18 to 75 years old and 20 subjects without septum deviation were included in the study. Control group consisted of the 20 subjects with no septal deviation. After ENT examinations, acoustic rhinometry measurements, the SF-36 quality of life scale, and the Brief Smell Identification Tests were applied to all patients. Type of septum deviation is classified according to Mladina classification by anterior rhinoscopy examination, nasal endoscopy, and paranasal computed tomography. The study indicated that the most common deviation type was Mladina Type 3 (65%). Bilateral total smell score of the women in the septum straight group is significantly lower than the men in terms of total smell scores by gender (P < 0.05). The total smell score values in septum group were significantly lower than those of the control group (P < 0.05). According to the individual smell values, cinnamon, banana, and soap odors of the septum deviation group were seen to be significantly lower than the septum straight group (P < 0.05). The results of the study indicated that olfactory dysfunction occurs in patients with septum deviation. Therefore, treatment of septum deviation is necessary for the improvement of nasal obstruction besides the treatment of the smell dysfunction.

Nasal response to stress test in healthy subjects: an experimental pilot study.

Stress has been suspected to play a role in rhinitis. The role of stress on nasal patency has been not yet elucidated. The aim was to evaluate the potential effects of stress on nasal patency in healthy subjects. We conducted a prospective pilot study including 12 healthy subjects. Experimental protocol was divided in three periods (pre-task, task and recovery). In the task period, subjects were exposed to the "Trier Social Stress Test" (TSST), a standardized laboratory stressor. Different parameters including Spielberger State Anxiety Inventory (SSAI) score, visual analogic scale (VAS) of nasal patency feeling, heart rate, acoustic rhinometry measurements have been compared between the three different periods. The study population was divided into two groups according to the Spielberger Trait Anxiety Inventory (STAI) score: A "non anxious" group and a "weakly anxious" group. Seven subjects were in the "non anxious" group and five in the "weakly anxious" group. TSST significantly increased heart rate in all volunteers. SSAI score was significantly increased (p = 0.04) after the task period (36.6 ± 11.3) when compared to the SSAI score in pre-task period (31.9 ± 12.6). VAS score of nasal patency feeling significantly decreased from pre-task to task and recovery periods. Mean minimal cross-sectional areas and mean volumes of the nasal cavities were not significantly different between the three periods, except in "weakly anxious" group, but the small number of subjects does not allow to draw a definite conclusion. We observed that stress influenced the feeling of nasal patency in healthy subjects. However, the objective effects of stress on nasal geometry were globally non-significant except in "weakly anxious" group. This latter result of our pilot study needs to be confirmed in a larger cohort.

Effect of Turbinate Intervention on Nasal Functions in Septorhinoplasty Surgery.

This study was performed to evaluate the effect of inferior turbinate reduction on nasal function. A total of 32 patients who underwent septorhinoplasty (SRP) operation were included in the study and assigned into 2 groups as group I who received inferior turbinate reduction during SRP operation consisted of 17 patients and the group II who consisted of 15 patients without inferior turbinate reduction. For 2 groups before and after surgery, visual analogue score and findings of the acoustic rhinometry were recorded both before and after decongestion of the nasal mucosa. Postoperative mean visual analogue scale (VAS) scores revealed a statistically significant reduction compared with preoperative values on right and left side of the nasal cavity, both before and after topical decongestion in group I (P < 0.005). Also in group II, the differences of VAS scores for both sides before and after topical decongestion were statistically significant (P < 0.05). Postoperatively, the increase of the volume measurements at the level of pyriform sinüs (VOL2) value on the right side of the nasal cavity before and after decongestion and volume measurements at the level of the nasal valve (VOL1) values on both sides after topical decongestion were found to be statistically significant in group I. When the VAS scores and acoustic rhinometry measurements of group I and group II patients were compared the difference, for before and after topical decongestion, postoperative mean MCA1 (minimal cross-sectional area at the level of the nasal valve) values for left side and right side of nasal cavity were higher in group I than group II and these differences were statistically significant (P < 0.005). As a result, in the SRP operations, turbinoplasty should be implemented by taking into account the function as well as aesthetic concern. Similar results were obtained in other studies that were carried on.

Evaluation of olfactory function in children with seasonal allergic rhinitis and its correlation with acoustic rhinometry

ObjectivesSeasonal allergic rhinitis (SAR) is common in children and hyposmia is a major symptom affecting the quality of life. The aim of the present study is to assess olfactory dysfunction in pediatric patients with SAR and correlate the results with acoustic rhinometry measurements. MethodsForty children, diagnosed as moderate and severe SAR based on clinical findings, ARIA (Allergic rhinitis and it's impact on asthma) classification and prick test results were enrolled in the study. Endoscopic nasal examination, acoustic rhinometry, total nasal symptom score (TNSS) and Connecticut Chemosensory Clinical Research Center (CCCRC) tests were performed 'in season' (May–August) and 'out season' (November–February). Three patients who did not show up in 'out season' examinations were excluded from the study. ResultsThe ages of the children ranged between 8 and 18 years with a hyposmia increased and odor identification decreased (p < 0.005, p = 0.003, respectively), whereas no differences were found between odor thresholds and the discrimination values (p > 0.05). Mean CCCRC value was obstruction score (r =−0.340, p = 0.04), subjective hyposmia (r = −0.44, p = 0.007) and TNSS (r = −0.494, p = 0.02). Although some of the acustic rhinometry parameters were lower during allergy season, there were no correlations between acoustic rhinometry parameters and CCCRS values. ConclusionNearly half of the children with AR reported a mild to moderate hyposmia during pollen season and there was a decrease in odor identification, which can be easily shown using a CCCRC test.

Acellular Human Dermal Allograft as a Graft for Nasal Septal Perforation Reconstruction

Nasal septal perforations pose a troubling source of morbidity for patients and a difficult problem for the otolaryngologist. Multiple surgical techniques have been tried, with inconsistent success. Prosthetic nasal buttons also have limitations, including patient intolerance and dissatisfaction. Acellular human dermal allograft (AlloDerm) has been described as an alternative material for septal perforation repair. The authors studied objective and subjective outcomes, including quantification of the patient's symptoms in septal perforation repair with AlloDerm. The authors performed a prospective cohort study of 12 patients with 1- to 2-cm anterior septal perforations who were recruited from a tertiary care practice. Patients with admitted smoking or cocaine use in the previous 3 months or vascular or granulomatous diseases were excluded. Subjective scores on the Sino-nasal Outcome Test-22, along with objective nasal endoscopy and acoustic rhinometry measures, were collected at baseline and 2, 4, and 12 weeks postoperatively. Patients were followed for reperforation 9 to 20 months postoperatively. Data were normalized to baseline values and analyzed using analysis of variance and Bonferroni correction. Successful closure of the septal perforation was obtained in 10 of 12 patients and confirmed with rigid nasal endoscopy. Nasal symptom scores (Sino-nasal Outcome Test-22 ) were significantly reduced to 52.8 percent (95 percent CI, 35.1 to 70.5 percent; p < 0.01) of baseline symptoms at 4 weeks postoperatively. At 12 weeks postoperatively, symptoms were measured at 26.6 percent (95 percent CI, 10.9 to 42.1 percent; p < 0.01) of baseline symptoms. Acoustic rhinometry confirmed perforation closure, demonstrating a reduction in cross-sectional nasal area from baseline of 55.1 percent (95 percent CI, 37.7 to 66.8 percent; p < 0.01). This is the first study to use objective and subjective measurements to confirm success with acellular dermis allograft as an adjunct for septal perforation repair, demonstrating a statistically significant reduction in patient nasal symptoms following repair. Therapeutic, IV.

Nasal resistance asymmetry as a predictor of satisfaction following nasal airway obstruction surgeries

Patients’ subjective assessment of nasal patency often does not correspond to the objective results of functional and imaging examinations. The objective of this study was to identify the rhinometry (AR) and rhinomanometry (RMM) parameters that were best correlated to patients’ self-evaluation of nasal patency before and after nasal airway obstruction surgery. The study material consisted of RMM and AR results as well as SNOT-20 self-evaluation questionnaires completed by 233 patients presenting with rhinological problems and routinely diagnosed at the RMM Lab of the Department and Clinic of Otolaryngology of the Medical University of Warsaw. Data were collected from 70 females (31.4%) aged 18 through 81 years and 153 males (68.6%) aged 16 through 81 years. The results were subjected to statistical analysis by a licensed statistician using the Statistica 10 software package. A statistically significant relationship was demonstrated between the subjective perception of nasal patency and RMM results. The higher the asymmetry of air flow within the left and the right nasal cavity, the higher the perceived restriction of nasal patency. Significant differences were observed between patients reporting maximum discomfort regarding impaired nasal patency and the remaining patients: the former were characterized by nasal resistance values being several-fold higher than that observed in the latter while nearly always improving after nasal airway obstruction surgeries. No significant reflection of patients’ self-evaluation of nasal patency was found in the acoustic rhinometry measurements.

Effect of Spreader Graft on Nasal Functions in Septorhinoplasty Surgery.

The authors aimed to investigate the effect of spreader grafts on nasal function in septorhinoplasty (SRP). A prospective randomized double-blind study was conducted. Thirty patients who underwent SRP operation between October 2011 and January 2013 were divided into 2 equal groups randomly. Fifteen patients underwent SRP surgery without spreader graft technique (Group I) and 15 patients underwent SRP surgery with spreader grafts (Group II). Preoperative and postoperative evaluation included visual analog score (VAS) and acoustic rhinometry test. Visual analog scores and acoustic rhinometry measurements of Group I and Group II patients were compared. Statistically significant difference was found for VAS scores of both the sides of the nasal cavity (both before and after topical decongestion) (P < 0.05), except for the VAS on the right side of the nasal cavity before decongestion (P > 0.05). On acoustic rhinometry test the difference was statistically significant for minimal cross-sectional area (MCA) and volumetric values (VOL)-MCA1, MCA2, VOL1, VOL2 values on the left side of the nasal cavity (both before and after topical decongestion) (P < 0.05) but not on the right side of the nasal cavity (P > 0.05). Performing spreader graft technique in SRP surgery can prevent the narrowing of the internal nasal valve area after surgery and maintain adequate airway for respiration.

THE EFFECTS OF SEVOFLURANE AND PROPOFOL ON ACOUSTIC RHINOMETRIC MEASUREMENTS

ABSTRACT Objective: The aim of the study was to compare nasal mucosal vasodilation induced by two different anesthetic used to provide controlled hypotension with the aid of acoustic rhinometry (AR). Methods: This study is prospective randomized clinical study. Fifty patients were randomized into propofol (Group P; n=25) and sevoflurane (Group S; n=25) groups. During anesthesia induction, Group P received propofol (2 mg kg -1 IV) and Group S was administered sevoflurane at a minimal alveolar concentration of 6-8%. Anesthesia was maintained with propofol (4 mg kg h -1 ) in Group P and 2% sevoflurane in Group S. Both groups received the analgesic remifentanil at a dose of 0.025 µg kg min -1 . Patients were performed nasal acoustic rhinometry (AR) measurements. Anesthetic doses were adjusted so as to ensure intraoperative hypotension by maintaining mean arterial pressure at 20-25% lower than the baseline value. Results: In both groups, a significant difference was detected between AR and nasal minimal cross-sectional areas (MCA) measurements taken from the patients in the supine position, both during the preoperative period and at 30 minutes after the induction of anesthesia, but a meaningful decrease in MCA1 and MCA2 values after the induction of anesthesia was observed for both groups. In addition, differences in measurements taken before and after the induction of anesthesia were greater in amplitude for the sevoflurane group versus the propofol group. Conclusion: Controlled hypotension induced using sevoflurane anesthesia might result in higher degrees of vasodilation relative to propofol anesthesia. Keywords: acoustic rhinometry, vasodilation, sevoflurane, propofol, controlled hypotension.

Comparison of the effects of radiofrequency ablation and microdebrider reduction on nasal physiology in lower turbinate surgery.

This study aims to compare the effects of radiofrequency ablation and microdebrider reduction in lower turbinate surgery on nasal physiology. Between January 2009 and March 2010, 40 patients with the complaint of nasal obstruction, who were diagnosed with lower turbinate hypertrophy, were randomly assigned into two groups to undergo either radiofrequency (group 1, n=20) or microdebrider (group 2, n=20) treatments. Nasal obstruction, the grade of turbinate hypertrophy and other symptoms were evaluated with subjective nasal obstruction scale and anterior rhinoscopy before the operation, and three days, seven days, four weeks, and eight weeks after the surgical intervention. The patients in group 2 had a significantly greater symptomatic improvement based on subjective nasal obstruction scale (SNOS) scores than the patients in group 1 (p<0.01). Acoustic rhinometry (ARM) measurements without decongestant application showed significant increase in postoperative MCA2 (Minimum Cross-sectional Area/cm2 2) and Vol 2 (Volume/cm3 2) (p<0.01), while there was no significant change in MCA1 (Minimum Cross-sectional Area/cm2 1) and Vol 1 (Volume/cm3 1). There was no statistically significant difference between the two groups with respect to ARM and anterior rhinoscopy (AnR) parameters (p>0.05). Based on these results, both radiofrequency ablation and microdebrider reduction may be considered as minimally invasive, straightforward, and reliable methods that provide sufficient airway passage without disruption of the nasal physiology.

Effects of lateral osteotomy on nasal sound intensity levels in patients who underwent rhinoplasty.

We investigated the effects of lateral osteotomy on nasal sound intensity levels in 34 patients who underwent rhinoplasty. Four groups were evaluated: group 1, preoperative rhinoplasty with lateral osteotomy (Preop-RPwithLO); group 2, postoperative rhinoplasty with lateral osteotomy (Postop-RPwithLO); group 3, preoperative rhinoplasty without lateral osteotomy (Preop-RPwithoutLO); and group 4, postoperative rhinoplasty without lateral osteotomy (Postop-RPwithoutLO). By sound analysis, low-frequency (Lf; 500-1000 Hz), medium-frequency (Mf; 1-2 kHz), and high-frequency (Hf; 2-4 and 4-6 kHz) nasal sound intensities were defined. Mf-left values of Postop-RPwithLO were significantly lower than those of Preop-RPwithLO, and Mf-left values of Postop-RPwithoutLO were significantly higher than those of Postop-RPwithLO and Preop-RPwithoutLO. Hf-right values of Preop-RPwithoutLO were significantly higher than those of Postop-RPwithLO and Postop-RPwithoutLO. Hf-total values of Postop-RPwithoutLO were significantly lower than those of Preop-RPwithoutLO. Nasal airway width decreased and nasal sounds, especially Mf sound intensities, increased in the nonlateral osteotomy group (group 4). When lateral osteotomy is performed, the nasal air passage may be adjusted as required by the surgeon, the air passage in the nasal valve region may not be narrowed, and nasal sound intensities may decrease. During postoperative follow-ups, increased Mf and Lf nasal sound intensities should be considered for the narrowness of the nasal passage and lower patency of the nasal cavities. Nasal sound analysis is a noninvasive technique and can also be used to evaluate nasal patency in septoplasty and rhinoplasty patients and children and for cases in which official reports are needed in addition to acoustic rhinometry measurements.

Effect of the nasal cycle on congestive response during bilateral nasal allergen provocation.

Bilateral nasal allergen provocation usually produces more pronounced obstruction of one nasal passage. It was found that this could be related to the stage of the nasal cycle before the provocation. To discover whether the stage of the nasal cycle is decisive for asymmetry in congestive response observed during bilateral allergen nasal provocation. methods. Two bilateral nasal allergen provocations were performed in a group of 26 pollen-sensitive volunteers. Acoustic rhinometry measurements were taken during the nasal cycle, and then after the provocation. A cross-sectional area at the level of the inferior turbinate (CSA-2) was measured. Consecutive challenges were performed in the opposite phase of the nasal cycle: the side which had been wide just before the first challenge, was narrow before the second provocation. Asymmetry in CSA-2 reduction between the nasal passages was observed in most cases. Significant difference was observed between mean CSA-2 reduction rate (reactivity) of the side that responded with greater congestion, and the opposite side. No significant difference was found in mean CSA-2 reduction rate between the side which was narrow, and the side which was wide before provocation. Asymmetry of congestive response during bilateral nasal allergen provocation is not dependent on the stage of the nasal cycle preceding the challenge.

Accuracy evaluation of a numerical simulation model of nasal airflow

Conclusion: Our numerical simulation model provides an accurate reflection of nasal airflow, and the results were validated by clinical measurements. Objectives: To evaluate the accuracy of a numerical simulation model of nasal airflow. Methods: Ten volunteers with normal nasal cavities underwent CT, acoustic rhinometry, and rhinomanometry. CT data were uploaded into Mimics, ICEM-CFD, Fluent, and CFD-Post software for three-dimensional modeling, finite element grid division, transient calculations, and analysis, respectively. Velocity and pressure data of airflow were obtained during the normal respiratory cycle. The accuracy of the simulation was evaluated by two methods: acoustic rhinometry measurements were used to evaluate the accuracy of the anatomic model, and rhinomanometry measurements were used to evaluate the accuracy of the nasal resistance values obtained by numerical simulation. Results: There were no significant differences between the values describing the model and the acoustic rhinometry measurements, the nasal resistance values obtained by numerical simulation. The airflow through the nasal cavity was mainly laminar. The maximum velocities were measured at the nasal valve, the amplitudes of all velocity curves at locations beyond the nasal valve were reduced. The amplitudes of the pressure curves increased from the front to the back of the airway.