Evaluation Of Nasal Obstruction Research Articles

Evaluation of nasal obstruction in lowlander males in high altitude

BackgroundNasal symptoms are a major problem affecting the quality of life of lowlanders deployed at high altitude. Study was carried out in fresh male inductees inducted in high altitude of 11,500ft (3500m) above sea level to evaluate the nasal obstruction using the subjective Nasal obstruction and symptom evaluation (NOSE) score and rhinomanometry during the stay in high altitude. MethodsA prospective study was carried out in 100 males inducted into high altitude. The subjects were evaluated using the subjective assessment tool, NOSE scale and rhinomanometry on induction and after 2 months. The data were analysed for NOSE scale in the 1st and 2nd visit by test for equality of proportions and the total nasal airway resistance (Pa) has been expressed as mean±standard deviation and compared across severity of NOSE score using one way ANOVA and between 1st and 2nd visit using paired t test. Results and conclusionsOut of the 100 subjects, 77 came for the 2nd review after 2 months. There was statistically significant worsening in the subjective feeling of nasal obstruction during the stay in high altitude without any significant change in the nasal airway resistance.

High incidence of posterior nasal cavity obstruction in obstructive sleep apnea patients

BackgroundNasal obstruction is a common problem in patients with obstructive sleep apnea (OSA). Systematic evaluation of nasal obstruction remains challenging due to the high number of variables and factors that contribute to nasal obstruction. Nasal examination by means of anterior rhinoscopy is limited to the evaluation of anterior septal deviation, internal nasal valve angle, and inferior turbinate size, but obstruction due to posterior septal deviation and nasal polyposis may go undiagnosed. The primary objective of this study was to determine the incidence of posterior nasal obstruction in OSA patients. Specifically, we were interested in other causes of posterior nasal obstruction that were difficult to assess by anterior rhinoscopy examination alone, and that required nasal endoscopy for identification.MethodsThis is a retrospective case series study. Flexible fiberoptic examination of the nasal cavity was performed on 274 consecutive OSA patients evaluated at the Stanford Sleep Surgery Clinic. Examination video files were recorded and later reviewed and scored by a single investigator blinded to the patients’ subjective nasal complaints. Anatomic features that contribute to posterior nasal obstruction were noted.ResultsPosterior septal deviation was the most common incidental finding in OSA patients with posterior nasal obstruction. Other causes included nasal polyposis, nasal mucosal inflammation, and purulent mucosal discharge. In total, there were 73/274 (26.6%) patients for whom nasal endoscopy provided findings that directed management.ConclusionNasal endoscopy provides additional diagnostic information in a significant number of OSA patients who complain of nasal obstruction. Our findings suggest the use of nasal endoscopy for OSA patients who complain of nasal obstruction or CPAP intolerance, despite unremarkable anterior rhinoscopy examination.

Centripetal endoscopic sinus surgery in chronic rhinosinusitis: a 6-year experience.

Despite technical advances in the tools designed to facilitate endoscopic nasosinusal surgery, the approach used, functional endoscopic sinus surgery, has not undergone major modifications since it was first described in the late 1980s. Centripetal endoscopic sinus surgery (CESS) is a new approach based on taking the medial wall of the orbit and the anterior cranial base as constant dissection landmarks. The aim of this study was to evaluate the long-term outcome of CESS in chronic rhinosinusitis (CRS) by measuring clinical and objective improvement, the need for revision surgery, and the complication rate. We reviewed 114 patients with CRS with or without polyps who underwent CESS at our center between May 2006 and December 2011. CRS was assessed using the Lund-Mackay staging system. The follow-up period ranged from 18 to 84 months (May 2013). Of 114 patients, 83 presented CRS with nasal polyposis, 12 had CRS without nasal polyposis, 17 had Samter's triad, and 2 had antrochoanal polyps. Postoperative evaluation of nasal obstruction and olfaction showed a significant and lasting improvement in these symptoms. Only four patients (3.5%) have required revision surgery, to date. CESS provided a lasting improvement in patients with CRS, by dramatically reducing the number of reinterventions. This approach is especially indicated in difficult cases, such as recurrent nasal polyposis and massive polyposis, because the dissection is based on constant borders and not influenced by previous surgery or disease extension.

Peak nasal inspiratory flow: a useful and handy tool for the diagnosis of nasal obstruction in the elderly

The global population is aging, with the over-65 age group expected to double in the USA by 2030. Three subcategories of elderly people have been identified: "young old" (from 65 to 74 years), "older old" (from 75 to 84) and "oldest old" (85 or more). Rhinosinusitis is a common disease that affects more than 31 million people in the USA every year. Nasal obstruction is one of the most common symptoms in patients affected by rhinosinusitis. An accurate nasal obstruction evaluation in the elderly is becoming of increasing interest for medical doctors, especially for geriatricians. Peak nasal inspiratory flow (PNIF) is a cheap and easy method for assessing nasal patency. The purpose of the study was to compare young old normal PNIF values with older old normal PNIF values. Charts relating PNIF normal values in the elderly with various explanatory variables have been provided. PNIF measurements were performed in 113 volunteers aged 65-84 years. One hundred and five of them fulfilled the study criteria and were self-reported healthy elderly. None of them complained of nasal symptoms. Data were statistically analyzed and figures and tables were produced relating PNIF to height, sex and age. PNIF values decreased with age (p = 0.0053) and were significantly lower in the "older old" sub-cohort than in the "young old" group (p = 0.007). Nasal obstruction in the elderly is a common problem and appropriate diagnosis and treatment are important for improving their quality of life. The measurement of PNIF could be useful in evaluating elderly patients who complain of nasal obstruction.

Normal Range of Peak Nasal Inspiratory Flow and Its Role in Nasal Septal Surgery

Nasal obstruction can be evaluated by objective and subjective methods. We sought to determine normative peak nasal inspiratory flow meter (PNIF) measurements of a healthy population in Turkey and to investigate the importance of PNIF in surgery for nasal septal deviation as well as to investigate the correlation of PNIF with subjective methods. In a total of 269 patients, 50 patients underwent septoplasty and 219 control subjects were enrolled in the study. Data on preoperative and postoperative PNIF measurements, nasal septal indices, and subjective measurements (visual analogue scale, VAS) were recorded. Mean PNIF value was 137.8 L/min in control subjects. Postoperative PNIF, VAS, and nasal septal index data were statistically significantly higher in the study group as compared with those of preoperative data. We found PNIF, VAS, and nasal septal indices of the control group to be consistent with postoperative data and to be higher than preoperative data of the study group. We identified a normal PNIF range for the healthy Turkish population and we saw that the data were compatible with VAS scores. PNIF seems to be a very effective method in the evaluation of nasal obstruction and in deciding operation.

Recurrent Pindborg Tumor of the Maxilla: A Case Report and Review of the Literature

We report a case of recurrent Pindborg tumor (calcifying epithelial odontogenic tumor) of the maxilla. The patient was a 34-year-old woman who had been previously diagnosed with Pindborg tumor and treated with curettage. She was subsequently referred to us for evaluation of nasal obstruction. Examination revealed the presence of a mass lesion in the right nasal cavity and right maxilla, which was identified as a recurrence of her earlier Pindborg tumor. The patient was treated with maxillectomy with orbital preservation. Pindborg tumor is a rare odontogenic tumor; when it does occur, it is more often seen in the mandible than in the maxilla. While this tumor is often treated with curettage alone, the aggressive nature of the recurrence in our patient necessitated radical surgery. We report this case to highlight the need to be suitably aggressive in treating these types of tumors in order to avoid recurrence.

Role of spirometry in detection of nasal obstruction

A subjective feeling of nasal airflow obstruction is a common symptom. An objective method for quantitative measurement of nasal airflow has long been desired. Rhinomanometry and acoustic rhinometry have been developed for anatomical and physiological evaluation of nasal obstruction. This study was designed to determine the usefulness of a portable spirometer in assessing upper airway obstruction. One hundred and ninety-six patients were assessed with nasal inspiratory spirometry to determine nasal airflow. All patients also underwent paranasal sinus computed tomography to determine anatomical abnormalities. Spirometry was performed on each nostril separately. Sensitivity and specificity levels were high. This portable and easy to use device may be useful in respiratory assessment. Correlation between anatomical obstructions and subjects' complaints was statistically significant (p < 0.001), but no definite correlation between septal deviation severity and spirometric values was found. Portable spirometry is an objective and useful method of evaluating nasal obstruction, but needs more investigation to establish a standardised test.

Objective and subjective assessments of nasal obstruction in children and adolescents with allergic rhinitis

To correlate objective assessment of nasal obstruction, as measured by acoustic rhinometry (volume of the first 5 cm of the nasal cavity) and active anterior rhinomanometry (total nasal airway resistance), with its subjective evaluation (obstruction scores). Thirty patients, aged 7 to 18 years, with persistent allergic rhinitis and thirty controls were enrolled. The obstruction score was reported for the whole nasal cavity and for each nostril separately. The three variables were measured at baseline and after induction of nasal obstruction. There were significant and negative correlations between resistance and nasal volume in all groups and scenarios, except for the most obstructed nostril, in the control group, post-obstruction. For the whole nasal cavity, there was no significant correlation between objective and subjective variables except between score and total nasal cavity volume in the control group, post-obstruction. Regarding the most obstructed nostril, we found a significant negative correlation between score and resistance and a significant positive correlation between score and volume for the total group at baseline. There were no clear differences in the correlation coefficients found in patients and controls. The correlation coefficients did not change after induction of nasal obstruction. Objective assessment of nasal obstruction did not correlate significantly with subjective evaluation for the nasal cavity as a whole, but there was a correlation for unilateral assessments. There was correlation between the objective evaluations. Allergic rhinitis and acute induction of nasal obstruction did not affect the correlation between objective and subjective assessments of nasal obstruction. Addition of an objective method for evaluation of nasal obstruction could be useful in the research setting; if no such method can be used, each nostril should be evaluated separately.

The evaluation of the outcomes of nasal obstruction surgery by acoustic rhinometry measurements and effects of nasal obstruction on daytime sleepiness

In this study, we aimed to investigate the correlation between nasal obstruction findings of the patients who underwent nasal surgery, as assessed by analog scales for the patients and physician and acoustic rhinometry measurements and to establish the effect of nasal obstruction on daytime sleepiness. Between August 2007 and September 2008, 55 patients (40 males, 15 females; mean age 30 years; range 15 to 56 years) who admitted with the complaint of nasal obstruction and underwent nasal surgery were included. Pre- and postoperative acoustic rhinometry measurements for both nasal cavities were performed. Nasal obstruction was graded by the analog scales for patients and physicians. Epworth Sleepiness Scale (ESS) was used for the evaluation of nasal obstruction on daytime sleepiness. In the preoperative period, a statistically significant correlation between the analog scales for the patients and physicians, and acoustic rhinometry values was found, while no statistically significant correlation was available in the postoperative period. A statistically significant correlation was also observed between pre- and postoperative analog scales for the patients and physicians. There was a statistically significant difference between the pre- and postoperative ESS scores. Acoustic rhinometry is a reliable method which provides objective data regarding the effects and outcomes of surgery. The analog scales are also useful to establish the degree of nasal obstruction. Nasal obstruction has an effect on increased complaints of daytime sleepiness.

Quantitative measurement of radiofrequency volumetric tissue reduction by multidetector CT in patients with inferior turbinate hypertrophy

To objectively assess the efficacy of radiofrequency thermal ablation of inferior turbinate hypertrophy. Thirty-five patients with nasal obstruction secondary to inferior turbinate hypertrophy were prospectively enrolled. Radiofrequency energy was delivered to four sites in each inferior turbinate. Patients were evaluated before and 8 weeks after intervention. Subjective evaluation of nasal obstruction was performed using a visual analogue scale (VAS), and objective evaluation of the turbinate volume reduction was calculated using multidetector CT. Volumetric measurements of the preoperative inferior turbinate were compared with postoperative values on both sides. The great majority of patients (91.4%) exhibited subjective postoperative improvement. Mean obstruction (VAS) improved significantly from 7.45±1.48 to 3.54±1.96. Significant turbinate volume reduction was achieved by the surgery on both right and left sides [(preoperative vs. postoperative, right: 6.55±1.62cm(3) vs. 5.10±1.47cm(3), (P<0.01); left: 6.72±1.53cm(3) vs. 5.00±1.37cm(3), (P<0.01)] respectively. Radiofrequency is a safe and effective surgical procedure in reducing turbinate volume in patients with inferior turbinate hypertrophy. Multidetector CT is an objective method of assessment in detecting radiofrequency turbinate volume reduction.

Endonasal phototherapy in the treatment of allergic rhinitis

In this study, we assessed the effect of endonasal phototherapy on quality of life, nasal obstruction and the other symptoms in allergic rhinitis with visual analog scale (VAS), sinonasal outcome test-20 (SNOT-20), and acoustic rhinometry. Twenty-four patients (6 males, 18 females; mean age 41.3±13.0 years; range 20 to 60 years) suffering allergic rhinitis refractory to anti allergic drugs for at least two years were enrolled in the study. Each patient underwent a total of six sessions of endonasal phototherapy with Rhinolight (Rhinolight Ltd, Szeged, Hungary) performed three times a week for two weeks. During course of the investigation, additional therapy was not applied to any of the patients. Before and one month after treatment, patients completed visual analog scale and SNOT-20 forms and nasal obstruction was evaluated with acoustic rhinometry. After the treatment, the mean VAS score and the mean total SNOT-20 score were found lower than the results before the therapy (p=0.0001, p=0.0001). A significant decrease was found in the scores of sneezing, nasal discharge, postnasal drainage, coughing after treatment (p=0.0001). During objective evaluation of nasal obstruction with acoustic rhinometry, no statistically significant difference was found between pre- and post-treatment findings. Endonasal phototherapy is an effective modality in the treatment of symptomatology in allergic rhinitis patients refractory to antiallergic drugs. It is detected that endonasal phototherapy has positive effects on the quality of life. However, no effect on nasal obstruction was found with acoustic rhinometry which is an objective method.

Measurement of nasal resistance by rhinomanometry in 892 Japanese elementary school children

Objective The normal value of nasal resistance in adults has been reported (0.25 Pa/cm 3/s), but that in children has not. In this study, we measured nasal resistance in Japanese school children by employing rhinomanometry. Methods An otolaryngologist examined 939 Japanese school children with regard to the presence or absence of nasal diseases and tonsil size. Nasal resistance was measured by rhinomanometry employing the active anterior method in 892 children. A questionnaire concerning the condition during sleep, such as the presence or absence of snoring and sleep apnea syndrome, was performed. Results The mean nasal resistance was 0.43 ± 0.50 Pa/cm 3/s: 0.46 ± 0.65 and 0.39 ± 0.22 Pa/cm 3/s in boys and girls, respectively. Of the 892 children, Grade 3 and 4 tonsil hypertrophy was noted in 84 (9%), but the presence of tonsil hypertrophy did not influence nasal resistance. Nasal diseases were noted in 335 children (38%) and the nasal condition was normal (the normal group) in 557 (62%). Nasal resistance was 0.56 ± 0.75 Pa/cm 3/s in the nasal disease group and 0.36 ± 0.21 Pa/cm 3/s in the normal group, showing that the resistance was significantly higher in the nasal disease group. The resistance tended to decrease as the school grade increased. In the normal group, 290 children (33%) experienced no problem regarding the upper airway, such as snoring and sleep apnea syndrome, based on a questionnaire, and nasal resistance was 0.35 ± 0.17 Pa/cm 3/s. Conclusion This normal nasal resistance value may be adopted for the objective evaluation of nasal obstruction and effects of treatment in pediatric nasal diseases.

Comparison of ultrasound turbinate reduction, radiofrequency tissue ablation and submucosal cauterization in inferior turbinate hypertrophy

Chronic nasal obstruction owed to chronic hypertrophic rhinitis is a common cause of nasal airway obstruction. In cases unresponsive to conservative treatment, various surgical techniques are commonly performed, but the issue of the optimal surgical procedure is still controversial. The objective of the present study was to evaluate the effectiveness and safety of ultrasound treatment of the hypertrophied inferior turbinates, which is a technique recently applied in rhinologic surgery. We aimed, also, to compare this method with the radiofrequency cold coblation turbinate reduction and the traditional submucosal monopolar inferior turbinate cauterization. We studied prospectively 60 patients with chronic hypertrophic rhinitis of nonallergic etiology, who underwent different surgical methods of turbinate reduction, divided into two groups: (1) in 30 patients, inferior turbinate volume reduction using ultrasound procedure on the left side and monopolar diathermy on the right was performed; (2) in 30 patients, radiofrequency coblation technique on the left side and ultrasound turbinate reduction on the right side was undertaken. Subjective evaluation of nasal obstruction and pain was performed using visual analog scales and objective evaluation of the surgical outcome was obtained using active anterior rhinomanometry and acoustic rhinometry. Examinations were performed preoperatively, and 1, 3 and 6 months after surgery. Both subjective and objective evaluation showed significant postoperative improvement in all cases. The best results were obtained with the ultrasound procedure, and second with the radiofrequency technique. The least improvement was observed in the electrocautery group, although its results did not differ significantly from the radiofrequency group. It may be, thus, concluded that ultrasound turbinate reduction is an effective and safe procedure for the management of chronic hypertrophic rhinitis, in patients failing to respond to medical treatment. Using this method, better results were obtained in decreasing subjective symptoms and nasal obstruction, in comparison with radiofrequency and electrocautery.

Endoscopic Diode Laser Polypectomy and High-Dose Intranasal Steroids in Recurrent Nasal Polyposis

The aim of this clinical investigation was to determine the outcomes of an outpatient videoendoscopic diode laser polypectomy (DLPE) and subsequent topical high-dose corticosteroid application in chronic rhinosinusitis with recurrent nasal polyposis (NP). After ineffective revision sinus surgery and prolonged mometasone furoate application, 19 consecutive mild and moderate NP patients suffering from nasal obstruction (NO) and olfactory dysfunction (OD) were prospectively entered into the study to undergo DLPE under topical anesthesia. Beginning 1 week postoperatively, 250 microg of beclomethasone dipropionate aerosol spray (BDPAS) was self-administered into each nostril twice a day. Treatment efficacy was assessed after 1, 6, and 12 weeks and at quarterly long-term follow-ups based on objective parameters (videoendoscopic photodocumentation and rhinomanometry) and subjective evaluation of NO, OD, and satisfaction (visual analog scales [VASs]). VASs indicated very low values for intraoperative pain and discomfort and high postoperative satisfaction. After 6 weeks, subjective and objective data revealed a significant improvement of NO and OD (p < 0.0005). Topical BDPAS application was well tolerated. At a median follow-up of 32 months (range, 1-4 years), 21% of the patients developed NP disappearance, 53% had a stable disease, and 26% had a progressive disease. In therapy-refractory NP, endonasal DLPE represents a minimally invasive, symptom-oriented, safe and easily reapplicable outpatient treatment option that provides effective improvement of NO and OD. Compared with the pre-DLPE period, the proposed long-term quarterly follow-up combined with high-dose topical BDPAS application might reduce or delay the need for major surgery and appears to be suitable for disease control.

Intérêt du test au l-menthol dans le bilan d’une obstruction nasale chronique

Ojectives In normal and anosmic patients, l-menthol inhalation is responsible for the subjective sensation of increased nasal permeability, related to a stimulation of the internal nasal nerve (branch of trigeminal nerve) endings connected with cold pressor receptors. At present, routine assessment of nasal obstruction does not include the l-menthol test. The aim of this case report was to show the advantages of this test in chronic nasal obstruction evaluation. Material and methods The example of a patient with a medical history of facial trauma and anosmia for sequela is reported. This patient complained of chronic nasal obstruction that persisted despite several septorhinoplasties and that conflicted with clinical examination and rhinomanometry data. Results An l-menthol test did not induce any mint smell recognition, any improvement of nasal permeability sensation, or any freshness sensation. Conclusion The authors suggest that the nasal obstruction sensation could result, in this case, from post-trauma anesthesia of the trigeminal nerve, particularly its internal nasal nerve branch. The l-menthol test could be a predictive test that may prevent recurrent functional failures of surgical treatment proposed for nasal obstruction.

Expiratory nasal sound analysis as a new method for evaluation of nasal obstruction in patients with nasal septal deviation: comparison of expiratory nasal sounds from both deviated and normal nasal cavity

The reliability of nasal obstruction measurements could be improved, and several new techniques are being developed. Our objective was to investigate the use of a new software program, Odiosoft-Rhino, in the assessment of nasal obstruction via analysis of the sounds of nasal expiration. We compared the nasal symptom scores and Odiosoft-Rhino and acoustic rhinometry test results for 61 patients with known nasal septal deviation. We found a significant difference, and a correlation, between Odiosoft-Rhino results at 2000-4000 Hz and 4000-6000 Hz intervals, and the minimal cross-sectional area 2.2 cm from the nostril, in the right nasal cavity in patients with right-sided deviations. Similar results were observed for the left nasal cavity in patients with left-sided deviations. The Odiosoft-Rhino software test is noninvasive, requires minimal cooperation and experience, and provides results that can be saved as digital data. Additionally, data from the Odiosoft-Rhino test are strongly correlated with acoustic rhinometry results and visual analogue scores of nasal obstruction. It seems that sound intensity within the 2000-4000 Hz and 4000-6000 Hz intervals is more sensitive than other sound intensity intervals. Thus, we speculate that Odiosoft-Rhino testing could be used as a new diagnostic method in order to evaluate nasal airflow in clinical practice.

Nasal Sound Analysis: A New Method for Evaluating Nasal Obstruction in Allergic Rhinitis

Current measurements of nasal obstruction are unreliable and may be improved with the development of new techniques. The effectiveness of odiosoft-rhino (OR) in the evaluation of nasal obstruction was investigated in a blind comparison at a referral center, institutional practice. Forty-eight patients with perennial allergic rhinitis and 52 healthy subjects were studied. Nasal endoscopic examination, acoustic rhinometry (AR), and OR were performed and symptom scores compared. Assessment of nasal blockage with OR method was the main outcome measure. Using the OR technique, significant differences were observed between the patient and control groups. OR data correlated with symptom scores and endoscopic examination. However, this was not observed with AR. A 15.5-dB cutoff point for the left side and 14.5 dB cutoff point for the right side at the 2,000 to 4,000 Hz frequency interval resulted in 93.8% sensitivity and 92.3% specificity and 72.9% sensitivity and 80.8% specificity, respectively. A 8.5-dB cutoff point for the left and right sides at the 4,000 to 6,000 Hz frequency interval resulted in 87.5% sensitivity and 80.8% specificity and 70.8% sensitivity and 78.8% specificity, respectively. OR is a simple, noninvasive test for assessing nasal obstruction. The OR technique can detect nasal obstruction with high sensitivity and specificity, and these findings correlate with symptoms and physical examination.

A obstrução nasal e o diagnóstico ortodôntico

OBJETIVO: analisar a freqüência de obstrução nasal em pacientes submetidos a tratamento ortodôntico e verificar a correlação com achados faciais e problemas dentários. METODOLOGIA: oitenta pacientes de 7 a 23 anos (37M; 43F) atendidos no Curso de Especialização da SPO, escolhidos aleatoriamente, foram submetidos à avaliação otorrinolaringológica. RESULTADOS: observou-se incidência de 51,3 % de obstrução nasal. A principal causa do distúrbio respiratório foi a rinite inflamatória, provavelmente alérgica, sendo que cerda de 61% dos casos estavam associados à hiperplasia adenoamigdaliana. Observou-se uma maior freqüência de dolicofaciais dentre os pacientes com obstrução nasal, sem significância estatística. Houve uma associação significante entre a atresia maxilar e mordida cruzada e a presença de palato ogival. CONCLUSÃO: o diagnóstico da obstrução nasal é fundamental nos pacientes com más oclusões, principalmente os dolicofaciais. O tratamento da obstrução nasal deve ser precoce, durante a fase de crescimento e, em geral, conjunto ao ortodôntico.

Radiofrequency is a safe and effective treatment of turbinate hypertrophy.

To evaluate the safety and efficacy of radiofrequency for reduction of inferior turbinate volume. Prospective before-and-after trial. Fourteen patients complaining of chronic nasal obstruction and failing to respond to medical treatment were prospectively enrolled. All patients presented with inferior turbinate hypertrophy and no septal deformity. Radiofrequency inferior turbinate tissue reduction with three punctures in each turbinate (mean energy/puncture: 342 +/- 36 J, mean duration: 69 +/- 17 s, plateau tissue temperature: 75 +/- 6.4 degrees C). Patients were evaluated before and on days 3, 7, and 60 after intervention. No postoperative pain or complications were reported. Evaluation of nasal obstruction, quantified by visual analogue scale, showed a significant decrease of day time and nighttime obstruction after surgery. Acoustic rhinometry measurements showed that turbinate hypertrophy was significantly reduced in the sitting and supine positions on day 60 after surgery. Saccharin transit times decreased significantly on day 60 compared with preoperative measurements. Ciliary beat frequency, measured in vitro in nasal epithelial cells sampled from the inferior turbinate by brushing, was not significantly different before surgery and on day 60 after surgery. In the same samples, ciliated cells were the most abundant epithelial cell type before and after surgery, although in five cases, moderate numbers of squamous cells were detected on either day 7 or day 60 after surgery. Radiofrequency is a safe surgical procedure capable of reducing turbinate volume without altering the nasal mucosa, and causing minimal discomfort for the patient.

鼻腔通気度検査についてのアンケート調査結果

Information on rhinomanometry was obtained through questionnaires send to 2, 191 otorhinolaryngologist in the Japan Rhinologic Society June 1, 2000 with answers from 1, 236 within 1 month -a 56.4% response. About half have rhinomanometers in their hospital or clinic. Though many use the rhinomanometer as a clinical test, 17.0% of them did not. They mainly conducted rhinomanometry in patients with allergic rhinitis, chronic sinusitis, hypertrophic rhinitis, septal deviation, nasal polyposis, and sleep apnea. They also used it to assess nasal airway resistance in patients who reporting nasal obstruction but whose rhinoscopic findings were almost normal. Rhinomanometry was used for clinical evaluation of nasal obstruction both in surgical and in conservative treatment of nasal disease. The period between the diagnosis of nasal disease and surgical treatment was over 1 month for 81.6% of doctors. Moreover 93.5% answered that rhinomanometry must be done over 1 month after the surgery. Eighty three per cent of the doctors considered that rhinomanometry was useful in the diagnosis of nasal obstruction. These results strongly suggest that rhinomanometry is essential for otorhinolaryngologist in clinical evaluation of nasal obstruction associated with many nasal diseases.