Active Anterior Rhinomanometry Research Articles

Comparative study of the efficacy of combined nasal topical drug and topical decongestants in the treatment of acute rhinosinusitis

To evaluate the efficacy of the drug Frinozol (nasal spray phenylephrinein 0.25% + cetirizine 0.25%) comparison with Rinostop Extra (nasal spray oxymetazoline 0.05%) in relation to nasal symptoms of rhinosinusitis, evaluated on rating scales, when using these drugs intranasally for 7 days in patients with acute viral and post-viral rhinosinusitis of mild (VAS 0-3) and moderate (VAS 3-7). The randomized open-label study included 60 ambulatory patients (men and women aged 18 to 60 years) with a verified diagnosis of acute rhinosinusitis (ARS) lasting no more than 120 hours. 1 group of patients took Frinozol (nasal spray phenylephrinein 0.25% + cetirizine 0.25%) for 2 sprays per each nostril 3 times a day for 7 days; 2 group - Rinostop Extra (nasal spray oxymetazoline 0.05%) at the same dose and the therapy regimen. We evaluated 3 visits (day 1, day 3, and day 7) with an ENT examination on each of them; questionnaires on the 1st and 3rd visits of nasal symptoms (nasal obstruction, rhinorrhea, hyposmia) on the visual analog scale (VAS) and Clinical Global Impression Scale-CGI. Active anterior rhinomanometry (AAR) was performed on the 1st, 2nd and 3rd visits using the PTS-14P-01 rhinomanometer Rinolan before and 20 minutes after the use of the drugs Frinozol and oxymetazoline 0.05%.

Can nasal acetylsalicylic acid challenge predict the severity of non-steroidal anti-inflammatory drugs (NSAIDs)-exacerbated respiratory disease (N-ERD)? .

Background: Non-steroidal anti-inflammatory drugs (NSAIDs)-exacerbated respiratory disease (N-ERD) complicates the clinical course of chronic rhinosinusitis with nasal polyps (CRSwNP) and severe asthma. We aimed to determine the detection rate of NERD in patients with CRSwNP, asthma, and history of NSAID intolerance using nasal challenge with acetylsalicylic acid (ASA) and the relationship between the severities of response to ASA challenges and the grade of N-ERD. Materials and methods: Three groups of patients were included: CRSwNP with asthma and clinical history of analgesics intolerance (CRSwNP-AAI n = 18), CRSwNP with asthma but without a clinical history of analgesics intolerance (CRSwNP-A n = 20), and CRSwNP without asthma or analgesics intolerance (n = 18). All subjects were challenged nasally with 16 mg ASA and monitored with active anterior rhinomanometry. Rhinological (nasal polyp score), pulmonary (spirometry, Asthma Control Test (ACT), and asthma treatment), and psychometric questionnaire scores were recorded and correlated with rhinomanometric data following nasal challenges (flow depressions and symptom scores). Results: Nasal ASA challenge detected N-ERD in 96.7% of CRSwNP-AAI patients and 45% of CRSwNP-A patients. No N-ERD was seen in the CRSwNP group. The control grade of asthma measured with ACT scores was significantly lower in the groups CRSwNP-AAI (MV 18.22) and CRSwNP-A (MV 19.75) when compared to the CRSwNP group (MV 24.39) (p = 0.000). In the CRSwNP-AAI group, 11 patients had uncontrolled asthma (61%), and in the CRSwNP-A group, 9 patients had uncontrolled asthma (45%). No correlation was found between rhinology and pulmonary parameters, nasal symptoms, and the severity of nasal ASA challenges. Specific reactions were detectable under the therapy of prednisolone and omalizumab. Conclusion: N-ERD might not always be detected by screening a patient’s medical history. Nasal ASA challenges are recommended in patients with CRSwNP and asthma. The nasal challenge with ASA positively confirms the N-ERD diagnosis. Moreover, N-ERD is a differential diagnosis in patients with severe asthma with the need for prednisolone or omalizumab therapy. The severity of the reaction to the ASA challenge in controlled and uncontrolled asthma patients is independent of the grade of N-ERD.

Лечение больных хроническим риносинуситом в условиях санатория и меры профилактики

The objective of the research is to study of clinical and functional disorders of the nasal mucosa and paranasal sinuses of patients with chronic rhino sinusitis, as well as to make the choice of the optimal treatment method in a sanatorium using natural factors. A survey of 145 patients (94 men and 51 women) with chronic rhinosinusitis at the age of 18 to 65 years was conducted. Of these, male accounted for 64.8%, female – 35.2%. In patients with pathology of the paranasal sinuses, functional disorders of the nasal mucosa and paranasal sinuses were revealed. Particularly, violations of mucociliary clearance, acid-base balance of the nasal mucosa, and a decrease in nasal patency according to the data of active anterior rhinomanometry were defined. The use of natural factors as a treatment: inhalation of natural mineral water Maibalyk and mud applications on the paranasal sinus area significantly improved the course of way of chronic rhinosinusitis and led to normalization of the functional parameters of the nasal mucosa, in contrast to the comparison group (60 people). The comparison group did not use with Maibalyk natural water inhalations and mud applications from Lake Maybalyk, but used only ordinary alkaline inhalations.

Experience of using herbal medicine sinupret for patients with chronic maxillary sinusitis during the post-surgery period

The choice of an optimal tactic for chronic rhinosinusitis treatment is a very topical issue in otorhinolaryngology. Several pieces of existing literature report a positive impact of a herbal-based remedy Sinupret for patients in the post-rhinosurgical period. Objectives of the study: The investigation of the effect of Sinupret on patients with chronic maxillary sinusitis in the early postoperative period.Materials and methods: 15 patients with chronic rhinosinusitis were examined. The age of patients ranged from 20 to 57 years. The examination of patients was carried out right before the surgery and three months after it. The examination also included general otorhinolaryngological examination, assessment of the overall severity of the disease on the VAS scale, endoscopy of the nasal mucosa, assessment of nasal breathing function based on the analysis of the main indicators of anterior active rhinomanometry and computed tomography of the paranasal sinuses. Two days before their surgery, each patient was prescribed to take two tablets of Sinupret 3 times a day up to 14 days.Results: By day 10 of the post-surgery period, all patients reported noteworthy improvement in nasal breathing, a significant decrease in nasal discharge and no discomfort in the projection of the paranasal sinuses. There was a substantial decrease in the severity of oedema, exudation and formation of crusts, fibrin in all examined patients with rhinoscopy. According to the anterior active rhinomanometry, a statistically significant increase in the total nasal flow and a decrease in nasal resistance to physiological values were established 3 months after surgery. Conclusion: This article presents the results of Sinupret usage in the combined therapy before and after surgical treatment of patients with chronic rhinosinusitis and abnormal development of nasal structures. The results of that 14-day treatment evidenced an acceleration of epithelialization and restoration of drainage; as well as an improvement of ventilation function of the nasal cavity and paranasal sinuses. In addition to that, the chosen treatment contributed to the reduction of the rehabilitation period and the absence of relapses of chronic maxillary sinusitis was observed.

Objective Comparison Between Spreader Grafts and Flaps for Mid-Nasal Vault Reconstruction: A Randomized Controlled Trial.

The goal of rhinoplasty is not exclusively aesthetic and the nasal function should always be considered. Several rhinoplasty techniques can participate in nasal valve dysfunction (eg, dorsal hump reductions). Therefore, mid-nasal vault reconstruction by spreader grafts or flaps is mandatory in these cases. To date, there is a literature gap in comparing both techniques objectively. This study shows an objective comparison between spreader grafts and flaps for mid-nasal vault reconstruction. This study was a double-blind randomized controlled trial including 40 patients who were randomly divided into 2 groups. Group 1 (20 patients) underwent spreader grafts insertion, whereas group 2 (20 patients) underwent spreader flap placement technique. Pre-operative active anterior rhinomanometry measurements were compared to 6-month post-operative measurements. Data were summarized as mean (standard deviation) for the quantitative variables. Comparisons between the 2 groups were done using unpaired t test. In both groups, a significant decrease in nasal resistance was noted in both the right and left sides 6 months post-operatively (P < .001). However, the comparison between the 2 both groups showed no statistical significance. Both spreader grafts and flaps, which are used for the mid-nasal vault reconstruction, have comparable and effective results in reducing the nasal resistance as evidenced by active anterior rhinomanometry measurements.

Impact of adenotonsilectomy on nasal airflow and pulmonary blood pressure in mouth breathing children

IntroductionAdenotonsillar hyperplasia (ATH) causing upper airway obstruction (UAO) may increase pulmonary artery systolic pressure (PASP). Early diagnosis and mouth breathing (MB) management may help in cases of high PASP. Total inspiratory nasal airflow (TINAF) obtained by active anterior rhinomanometry (AARM) is a means to quantify nasal patency. This study aimed to correlate TINAF with high PASP. MethodsThis is a prospective study involving 30 children between two and twelve years of age, with indication for adenotonsillectomy due to ATH, evaluated before and six months after surgery; and 29 nasal breathing (NB) children in the same age group. We obtained the PASP, calculated for tricuspid regurgitation, by means of a transthoracic echocardiography. We assessed nasal patency using the AARM to estimate the TINAF. ResultsThe mean PASP among mouth breathing children was 25.99 mmHg, with a Standard Deviation of (±) 3.27, p = 0.01 in the preoperative period; and 21.79 mmHg (±2.48; p = 0.01) in the postoperative period. Among nasal breathers, this mean value was 21.64 mmHg (±3.87, p = 0.01). The mean pre-operative TINAF was 266.76 cm3/s (±112.21, p = 0.01); and 498.93 cm3/s (±137.80, p = 0.01) after surgery. Among nasal breathers it was 609.37 cm3/s (±109.16; p = 0.01). The mean nasal patency in the preoperative period was 42.85% (±17.83; p = 0.01); and 79.33% (±21.35; p = 0.01) in the post-op. Among nasal breathers it was 112.94% (±15.88, p = 0.01). There was a significant Spearman correlation value between TINAF and PASP (r = −0.459; p = 0.01) when we analyzed all the groups. ConclusionPASP and TINAF values improved postoperatively and had an inverse correlation. This study suggests that by improving TINAF there was a decrease in PASP.

Messverfahren zur objektiven Beurteilung der nasalen Durchgängigkeit

The need for objective assessment of nasal patency in the fields of rhinosurgery and allergy has led to the development of various methods for the evaluation of nasal patency. These methods include active anterior rhinomanometry, PNIF, acoustic rhinometry, rhinostereometry, optical rhinometry, minimal cross-sectional area endoscopy, nasal sound spectral analysis, magnetic resonance imaging and numerical flow simulation. This article provides a brief overview of currently common procedures.

Особенности нарушений носового дыхания у пациентов с назальной обструкцией

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.

Применение полупроводникового лазера для редукции Nasal Swell Body

The nasal swell body (NSB) is a structure in the form of mucosa thickening from the nasal cavity bottom up to the middle nasal concha. The septal swell body was first described by Wustrow in the 17th century, he indicated it as an “intumescentia septi nasi anterior”; later, in 1900, P. Schiefferdecker studied the vasculature of the first third of the nasal septum and called it “septal turbinate”. The objective of our study is to assess the nasal breathing condition before and after nasal septal swell body laser reduction in the patients with vasomotor rhinitis. The study was performed in the Clinic of Otorhinolaryngology of Pavlov First Saint Petersburg State Medical University. We examined 32 patients aged 21–44 years (13 males and 19 females). All the patients were performed a set of examinations: endoscopic examination of the nasal cavity and nasopharynx, anterior active rhinomanometry, computer-aided tomography of paranasal sinuses. The subjective evaluation of the nasal obstruction was based on Nasal Obstruction Symptom Evaluation (NOSE) scale. The patients were divided into 2 groups. The 1st group patients (n-17) underwent surface contact laser vasotomy of inferior nasal concha and reduction of NSB area by means of 970nm injection laser. The second group (n-17) consisted of patients with the same pathology after laser vasotomy without the nasal swell body area, they formed a control group. The comparative analysis between the 1st and the 2nd group of patients didn’t reveal any significant difference in the measurement of VFR and NR in the postoperative period. Besides, the 2nd group patients in 47% (8) of cases mentioned the nasal airflow deficiency according to NOSE scale. The necessity of NSB area reduction is extremely important for achievement of favorable results of the nasal obstruction surgical treatment.

Гипертонический раствор морской воды как альтернатива топическим деконгестантам

The authors performed a comparative study of the efficacy and safety of irrigation elimination therapy (IET) a hypertonic solution of sea water (and other means-Forte) and a topical decongestant 0.1% solution of Xylometazoline (0.1% Glycine Ksilo) in the treatment of children with acute infectious rhinosinusitis. The article presents the results of evaluation of the dynamic clinical picture and the data of objective study of anterior active rhinomanometry (PARM) using the rhinomanometer ATMOS 300 from the moment of entering the study to the 7th day of treatment. Obtained by the authors of the subjective (clinical) and objective (results of PARM) data to prove the comparative efficacy and high safety of the IEP of hypertonic saline solution in comparison with the use of topical vasoconstrictor for acute infectious rhinosinusitis in children.

Effect of Red Light Rhinophototherapy on Nasal Patency in Patients with Allergic Rhinitis.

Purpose The effect of red light rhinophototherapy (RLRPT) on nasal patency in patients with a clinical diagnosis of allergic rhinitis was investigated. Materials and Methods Subjects were randomly divided into 2 groups, with patients in one group given one treatment session of RLRPT, followed by medical treatment. Those in the second group were treated with medical treatment only. The rhinitis symptoms were evaluated both before and 30 minutes after RLRPT and 2 days later. The nasal patency was objectively measured through the use of both active anterior rhinomanometry and acoustic rhinometry before and 30 minutes after RLRPT. Results All rhinitis symptoms, including nasal congestion, significantly improved 30 minutes after a single RLRPT treatment, but worsened again, particularly for sneezing, 2 days later. Nasal resistance slightly decreased 30 minutes after RLRPT. The first minimal cross-sectional area did not change after RLRPT, but the second minimal cross-sectional area with the volume of the nasal cavity between 2.0 and 5.0 cm from the tip of the nosepiece significantly lessened. Conclusions This study showed that RLRPL did not objectively improve patient's nasal patency. Registration Number The trial is registered with NCT03752645.

Nasal Functions in Three-Dimensional Endoscopic Skull Base Surgery.

Endoscopic transnasal transsphenoidal surgery has become the standard procedure for the majority of skull base diseases, including sellar, parasellar, and clival pathologies. The aim of this study was the objective evaluation of nasal airflow resistances and olfactory function in 3-dimensional (3D) endoscopic transnasal transsphenoidal surgery. One hundred patients who underwent 3D transnasal endoscopic surgery for sellar, parasellar, and clival diseases were enrolled. Active anterior rhinomanometry and Sniffin' Sticks tests were performed before endoscopic surgery and at 3 and 6 months postoperatively. No significant difference about nasal airflow resistance and olfactory function was observed between preoperative and postoperative subjective and objective scores. In the group of patients with sellar and parasellar diseases, a worst nasal respiratory function was seen when crusting was present, and a worst olfactory function was observed in patients with synechiae. Nasal functions returned to previous levels when crusting or synechiae solved. No statistically significant correlation was observed between the evaluated nasal functions and the reconstruction with flaps. The 3D endoscopic transnasal transsphenoidal surgery represents a more and more important tool in skull base surgery. It does not determine nasal respiratory and olfactory alterations after the treatment, without an increase in nasal complaints that could worsen quality of life.

Computational Fluid Dynamics in the assessment of nasal obstruction in children

ObjectivesNasal obstruction is a highly subjective symptom. It can be evaluated by combining clinical examination, imaging and functional measurements such as active anterior rhinomanometry (AAR). In pediatrics, AAR is often impossible because it requires the participation of the child. Airflow modeling by Computational Fluid Dynamics (CFD) has been developed since the early 1990s, mostly in adults. This study is the first to describe a methodology of “numerical rhinomanometry” in children using CFD and to evaluate the feasibility and the clinical interest of this new tool. Materials and methodsFive children aged from 8 to 15 years, complaining of nasal obstruction, underwent routine management including clinical evaluation, AAR, and CT-scanning. CT acquisitions were used for CFD calculations and numerical rhinomanometry. Results and conclusionsIn the 5 children, the results of CFD were concordant with clinical complaints and examination. In 3 children, AAR and CFD were concordant. In one patient, CFD corrected the results of AAR. In one patient, AAR was not feasible, unlike CFD, which contributed to diagnosis. This study highlighted the feasibility of CFD in children and that it can support or refute diagnosis of nasal obstruction with good reliability. These results indicate that CFD modeling could be widely used for functional exploration in pediatric rhinology.

Is acupuncture effective in reducing overall symptomatology in chronic rhinosinusitis?

Is acupuncture effective in reducing overall symptomatology in chronic rhinosinusitis?

The inhalation antibioticotherapy of acute bacterial rhinosinusitis

Epidemiological studies conducted throughout the world show that the inflammatory diseases of the nasal cavity and paranasal sinuses are the leading cause of otorhinolaryngology (ENT) hospital admissions and outpatient clinic referral. Although the most common cause of acute rhinosinusitis is viral infection, antibiotics are prescribed in more than 80% of cases, which may lead to the development of antimicrobial resistance. The topical inhalation therapy with the inhalation Complex «PARI SINUS device» (сompressor and nebulizer) may provide better treatment options for patients who suffer from the diseases of the nasal cavity and paranasal sinuses. Purpose of the study is to evaluate the efficacy of topical inhalation treatment of acute bacterial rhinosinusitis using pulsating aerosol in comparison with systemic antibiotic therapy. Materials and methods. 60 adult patients at the age from 19 to 62 years with the diagnosis uncomplicated moderate acute bacterial rhinosinusitis has been included in opened randomized controlled trial. 30 patients have been with the inhalation therapy by the combined drug Fluimucil® antibiotic IT (thiamphenicol glycinate acetylcystein, Zambon) using PARI SINUS device during 7 days. Controls – 30 patients have been treated with antibiotic therapy of acute bacterial rhinosinusitis using 875/125 mg oral amoxicillin/clavulanate twice daily for 7 days. The result was evaluated by the dynamics of the symptoms of acute bacterial rhinosinusitis (nasal congestion, blockage, facial pain and reduction of smell), active anterior rhinomanometry and nasal endoscopy. Results. For main symptoms of acute bacterial rhinosinusitis was no significant benefit of antibiotic therapy as compared to topical inhalation therapy using pulsating aerosol. Both treatment options were effective against acute bacterial rhinosinusitis, which is confirmed by the improvement of symptoms, active anterior rhinomanometry and nasal endoscopy. Conclusion. The topical nebulizer therapy of acute bacterial rhinosinusitis may provide better treatment options, because systemic antibiotics can be associated with different adverse effects.

Assessment of nasal functions and their relationship with cholesteatoma formation in patients with unilateral chronic otitis media.

To evaluate the nasal functions of patients with unilateral chronic otitis media using rhinomanometry, comparing chronic otitis media sides with healthy sides, chronic otitis media patients with cholesteatoma and without cholesteatoma, and patients with healthy individuals. This prospective study included 102 patients with unilateral chronic otitis media (48 with and 54 without cholesteatoma). The control group comprised 40 individuals without any ear or nasal pathologies. All patients underwent active anterior rhinomanometry to measure nasal airway resistance and a saccharin test to measure mucociliary transport times. There were no significant differences in nasal airway resistance and mucociliary transport time between the chronic otitis media sides and unaffected sides in the 102 patients (p = 0.72 and p = 0.28, respectively), between the non-suppurative chronic otitis media patients (without cholesteatoma) and chronic otitis media with cholesteatoma patients (p > 0.05), or between the study and control groups (p > 0.05). The present study, with a larger sample size compared to previously published literature, supports the conclusion that unilateral nasal obstruction is unlikely to lead to chronic otitis media on the same side. The results also suggest that nasal functions do not contribute to the development of cholesteatoma.

Nasal function before and after rapid maxillary expansion in children: A randomized, prospective, controlled study

ObjectivesChildren can well detect and respond to odours in order to have information about food and environment.Rapid Maxillary Expansion seems to improve dental and skeletal crossbite and increase nasal patency correcting oral respiration in children. A previous pilot study suggested that Rapid Maxillary Expansion may lead to improved N-Butanol olfactory thresholds, and peak nasal inspiratory flow values (PNIF). The aim of the present study was to prospectively evaluate olfactory threshold, nasal flows and nasal resistances in children aged from 6 to 11 years before and after Rapid Maxillary Expansion, comparing treated children with a control group of similar age, growth stage (prepubertal) and transversal skeletal deficiency. MethodsN-butanol olfactory thresholds, anterior active rhinomanometry (AAR) and PNIF were measured in 11 children (6–11 years) before (T0), immediately and 6 months after Rapid Maxillary Expansion application (T1 and T2 respectively), and in a control group of 11 children (6–11 years) whose members remained under observation for the period of the study. ResultsConsidering the study group, PNIF values improved at T1 respect to the T0 values (p = 0.003), while T2 values were significantly higher than T0 ones (p = 0.0002). N-Butanol Olfactory Threshold significantly improved at each control (p = 0.01, p = 0,01 and p = 0.0003, for T1 vs T0, T2 vs T1, T2 vs T0 respectively). No differences on AAR values were found during the six months follow-up in this group.Considering the control group, no significant differences were found for any of the considered variables during the time of the study.Comparing the two groups, there was a significant increase of PNIF values in the study group compared to the control group (p = 0.003) at T1, which was even more evident six months after Rapid Maxillary Expansion (p = 0.0005). This improvement was not shown by AAR values. N-Butanol Olfactory Threshold showed a significant improvement at T2 respect to T1 (p = 0.002) and T0 (p = 0.0005). ConclusionRapid Maxillary Expansion seems to significantly improve the respiratory capacity of treated patients, at least in terms of PNIF, and their olfactory function, measured by N-Butanol Olfactory Threshold Test. Further studies should be performed to evaluate if also changes in nasal resistances, measured by AAR, could occur, maybe considering a larger group of subjects and possibly using 4-phase rhinomanometry in order to evaluate the effective resistances during the entire breath.

Adenoid hypertrophy affects screening for primary ciliary dyskinesia using nasal nitric oxide

AimIn patients with primary ciliary dyskinesia (PCD), the release of nitric oxide (NO) is extremely low by epithelia of the nasopharynx and sinuses. Measurement of nasal NO (nNO) is recommended as a screening test for PCD. The study aimed to evaluate if adenoids affects nNO and may deteriorate the performance of the test. MethodsIn 48 nonallergic patients between 5 and 18 years of age with chronic symptoms of nasal obstruction and indications for adenoidectomy, the measurements of nNO by chemiluminescence analyser and nasal patency by active anterior rhinomanometry were performed both before and after adenoidectomy. Adenoidal tissue size was graded during surgery under general anaesthesia using transoral endoscopy. ResultsPatients were stratified into groups with adenoids grades 1, 2 and 3 (<1/3, 1/3–2/3 and > 2/3 of the choana and post-nasal space covered by adenoids). Before adenoidectomy, the median of nNO decreased with the increasing grade of adenoids (920, 663, and 491 ppb, P < 0.05). The rhinomanometry results were comparable and showed no correlation with nNO. Seven patients (14.6%) were incorrectly classified to have PCD based on a subthreshold value of the volume flow of nNO (FnNO < 77 nL/min). Following adenoidectomy, nNO of the grade 3 patients increased by 107 ppb (P < 0.05) and no differences were found between groups (P = 0.40). All patients had the postadenoidectomy FnNO >77 nL/min.Conclusions: nNO and FnNO are reduced in nonallergic children with obstructive adenoids. Adenoid hypertrophy can potentially cause a false positive result of the test for PCD.

Comparison of nasal obstruction symptom evaluation, peak nasal inspiratory flowmeter, and rhinomanometry in patients with nasal deformities

Nasal obstruction is the most common symptom in daily otolaryngology practice that correlates with quality of life. Nasal obstruction etiology is multifactorial and can result from mucosal or structural factors. Subjective and objective evaluation approaches are a significant challenge in its diagnosis. This study aimed to evaluate correlations among the nasal obstruction and symptom evaluation (NOSE) and peak nasal inspiratory flowmeter (PNIF) scores and active anterior rhinomanometry values for nasal obstruction diagnosis in subjects with nasal deformities including crooked nose, saddle nose, nasal valve incompetence, and deviated septum. Furthermore, the correlation of nasal obstruction with sleep-disordered breathing was evaluated. Data in this cross-sectional analytical study in 52 consecutive subjects with nasal deformities and 10 consecutive normal subjects were analyzed with the bootstrapping method. Mean nasal resistance in normal subjects and those with nasal deformities were 0.172 and 0.173 Pa/cm3/s, respectively, on 75 Pa. The NOSE score was not significantly correlated with the PNIF score or the nasal airflow resistance determined by rhinomanometry. However, there was a significant correlation between PNIF and nasal airflow resistance.

Functional results of septoplasty conducted with the evaluation of aerodynamic characteristics and anatomical features of the nose region

The nasal breathing disorders is leading problem in otolaryngological practice. Despite the modern development of diagnostic methods of nasal breathing disorders and septum surgery, there are a number of patients who have violations of nasal breathing in the late period. The development of rhinomanometry methods and tomographic studies allow to improve the functional results of septoplasty. The aim of the study: Based on the data of anterior active rhinomanometry with a complex of functional samples, as well as data analysis of the anatomical correlation of the nasal cavity, to determine the main principles in planning and performing remodeling of the nasal septum, to evaluate their effectiveness. Materials and methods: In the results of a study of 64 patients who were previously questioned on the NOSE scale were examined in the article, they were examined rhinomanometrically (anterior active rhinomanometry in combination with functional samples) and an in-depth analysis of the correlation between the anatomical structures of the nasal cavity was carried out. Later, at the time of 2 months, 6 months and 12 months after surgical treatment, taking into account the survey data and the geometric analysis, they were re-examined. Results: In a primary rhinomanometric study, there are 38 (59.38%) patients with structural anatomical disorders accounted, 12 (18.75%) patients with edematous mucosal, 14 (21.88%) patients with a combination of structural and oedematous mucosal disorders accounted. A further study of rhinomanometric and anatomical correlation showed that, depending on the localization of the area of pathological nasal resistance, the front sections of the nasal cavity and the anterior nose valve region prevail making 37 (71.15%) people. Localization of pathological nasal resistance in the posterior sections of the nasal cavity 4 (7.69%), a combination of the anterior and posterior parts was noted in 11 (21.15%) people. At repeated examination at the time of 12 months, the number of unsatisfactory functional results was observed in 6.1% of cases. Conclusion: Anatomical correlation in the nasal cavity are key in ensuring normal aerodynamic processes in the nasal cavity. A comparative analysis of the indices of unsatisfactory functional results in terms of 12 months show, determined that after carrying out septoplasty, taking into account the rhinomanometry with functional tests in combination with the above analysis of the anatomical formations of the nasal cavity, this indicator is 6.1% and 8% if in the planning stage of surgery the results of these studies are not taken into account