Evaluation Of Nasal Patency Research Articles

Evaluation of Nasal Patency Among Patients With Unilateral Cleft Lip and Palate: Cleft Versus Non-Cleft Side.

To evaluate the nasal patency using acoustic rhinometry (AR) in patients with unilateral cleft lip and palate (UCLP) and to ascertain the rhinological importance of the same. Eccovision Acoustic Rhinometer system was used for assessment of nasal cross-sectional area (CSA) and volume in 15 patients with UCLP. The CSA1, CSA2, and CSA3, which represent the CSA at the nasal valve area and anterior end of the inferior turbinate, the anterior half of the inferior turbinate and the anterior end of the middle turbinate, and the region of middle portion of middle turbinate, respectively, were compared on the cleft and non-cleft side. The mean ± SD of CSA1, CSA2, and CSA3 as well as the overall nasal CSA were significantly higher on non-cleft side compared to cleft side (P value < .001). The mean ± SD of nasal volume was also significantly higher in non-cleft side compared to cleft side (P value < .001). The nasal patency among patients with UCLP demonstrates a range of impairments that can be objectively measured using acoustic rhinometry. The orthodontic, orthopedic, or orthosurgical management of maxillary deficiency in these patients can affect the nasal area and volume and can have an impact on breathing, speech, and sleep. The pretreatment assessment may be useful to identify patients who are at potential risk of deterioration of nasal patency and airway post-intervention. Taking into consideration the multiple diagnostic procedures in the course of long-term multidisciplinary treatment of patients with cleft lip and palate, a noninvasive investigation technique such as AR may be the preferred mode of investigation to ascertain nasal patency.

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.

A UK survey of current ENT practice in the assessment of nasal patency.

Nasal obstruction is a common ENT complaint; however, decisions on its management are challenging, with high rates of dissatisfaction following surgery. This study investigated the practice of UK clinicians in the evaluation of nasal patency. Seventy-eight UK-based rhinologists were surveyed at the 2015 British Academic Conference in Otolaryngology. Clinical history and examination are almost universally used to evaluate nasal blockage. The most commonly used test was the nasal misting pattern (73 per cent), followed by peak nasal inspiratory flow (19 per cent). The Sino-Nasal Outcome Test 22 or 23 was utilised by 29 per cent of respondents. Sixty-three per cent of respondents reported that a lack of equipment was the principle reason for not using objective measures, followed by time constraints and a lack of correlation with symptom scores. British clinicians rely on clinical skills to evaluate nasal blockage. There is a desire for a simple, non-invasive device that objectively measures airflow for nasal breathing during physiological resting and correlates with subjective symptom scores.

Optical rhinometry - new challenges and possibilities of rhinitis diagnostics and not only.

Optical rhinometry is the only diagnostic tool in rhinitis for assessing real-time changes in nasal occlusion. It illustrates lumen changes of nasal mucosa vessels in response nonspecific/specific factors and not only. The first attempts to standardize the method conducted by German researchers show the potential of optical rhinometry not only as regards challenge tests, but also vice versa, in respect of the anemization of the mucosa it evaluates the extent of the oedema which occurred in the pathomechanism of non-allergic rhinitis. The relatively small number of publications in the domain of interest demonstrates there is a need to conduct further research on the suitability of the above-mentioned technique for the evaluation of nasal patency in the field of rhinological diagnostics.

Evaluation of nasal patency by visual analogue scale/nasal obstruction symptom evaluation questionnaires and anterior active rhinomanometry after septoplasty: a retrospective one-year follow-up cohort study.

To assess the efficacy of septoplasty and the correlation between the subjective evaluations of a visual analogue scale (VAS) and the Nasal Obstruction Symptom Evaluation (NOSE) questionnaire and active anterior rhinomanometry of the nasal airway after septoplasty. A retrospective, individual cohort study. Ear, Nose and Throat Department, Taipei City Hospital, Taipei, Taiwan. Fifty patients with chronic nasal obstruction were enrolled in the study. All 50 patients underwent septoplasty because of nasal septal deviation. Another 28 patients without nasal symptoms served as controls. VAS, NOSE and active anterior rhinomanometry were used to measure the sensation of nasal obstruction. All measurements were performed in both groups preoperatively and then repeated on three postoperative visits (3, 6 and 12 months). The mean VAS score, NOSE score and the nasal resistance in the narrow side of the nose in the study group showed reduced symptoms at 3, 6 and 12 months postoperatively compared with the respective preoperative measurements (P < 0.001, all). The VAS and NOSE scores did not significantly correlate with total nasal resistance preoperatively or postoperatively. The VAS and nasal resistance in the obstructed nasal cavity correlated significantly preoperatively (P < 0.05), but not postoperatively. The subjective and objective symptoms of nasal obstruction had improved 1 year after septoplasty. A significant correlation between VAS scores and nasal resistance in the narrow side of the nose was found before surgery. The subjective and objective measurements of nasal obstruction lacked significant correlation postoperatively.

Evaluation of nasal patency by acoustic rhinometry after repair of complete unilateral cleft lip and palate

Purpose: The aim of the current study was to evaluate nasal patency by acoustic rhinometry in children aged 4–8 years with repaired complete unilateral cleft lip and palate (UCLP) compared with an age-matched control group without cleft lip and palate (CLP). Methods: This comparative cross-sectional study was conducted at a tertiary care teaching hospital and a private ENT clinic in Porto Alegre, southern Brazil. The case group consisted of 38 children who had undergone surgery for complete UCLP (mean age, 6.44 years), and the control group of 21 children without CLP (mean age, 6.21 years) recruited among patients seeking medical care for ear diseases at the private clinic. Acoustic rhinometry was performed in all children after administration of oxymetazoline hydrochloride (2 × 0.25 mg/mL) for nasal vasoconstriction. Results: The minimal cross-sectional area and nasal volume of the cleft side were smaller than those of the non-cleft side in the case group (p = 0.001). When the two groups were compared, the non-cleft side in the case group did not differ from the control group (p = 0.175), but the minimal cross-sectional area and volume of the cleft nasal cavity were smaller than the mean values of the two nostrils of controls (p = 0.001). Conclusion: In conclusion, our findings show that nasal patency on the cleft side is impaired in children surgically treated for complete UCLP.

The clinical value of peak nasal inspiratory flow, peak oral inspiratory flow, and the nasal patency index.

The aim of this study was to ascertain the most reliable objective measurement for the assessment of nasal patency by investigating the relationship between peak nasal inspiratory flow, peak oral inspiratory flow, and the nasal patency index in relation to the patient's subjective perception regarding nasal obstruction. Prospective cohort study. This study included 131 volunteers of both genders, aged 18 years or older, with or without nasal symptoms, who were able to give informed consent, completed the study protocol, and could speak and write Dutch fluently. Peak nasal inspiratory flow and peak oral inspiratory flow were performed and nasal patency index was computed. The results were evaluated and compared with the subjective perception of nasal passage, using the validated Nasal Obstruction Symptom Evaluation scale and visual analog scale for nasal passage. Our study showed that peak nasal inspiratory flow, nasal patency index and nasal patency visual analog scale correlate with the Nasal Obstruction Symptom Evaluation scale in contrast to peak oral inspiratory flow. Peak nasal inspiratory flow and nasal patency index also showed significant association with the Nasal Obstruction Symptom Evaluation scale after adjustment for confounders. Peak nasal inspiratory flow is the most reliable method for the assessment of nasal patency. It is quick, inexpensive, and easy to perform, and correlates significantly with the subjective feeling of nasal obstruction. There is no clinical need to measure peak oral inspiratory flow or to calculate the nasal patency index in the evaluation of nasal patency. 4

Evaluation of Nasal Patency with 4‐Phase Rhinomanometry

Objective: Objective assessment of nasal patency in patients with nasal septal deviation should be required to determine the severity of the symptoms. The purpose of this study was to compare results of nasal sound spectral analysis (NSSA) with results of 4-phase rhinomanometry. Method: NSSA and 4-phase rhinomanometry were performed on 53 patients with nasal septal deviation and 55 healthy subjects. Cutoffs for NSSA and 4-phase rhinomanometry were defined by receiver operating characteristic analysis. Results: A significant difference was observed in either NSSA values or 4-phase rhinomanometry values between the nasal deviated patients and the control group ( P &lt; .001). A correlation was observed in patients between NSSA results of nasal intensity (dB) and its frequency (Hz) at a frequency range of 2 to 4 kHz and 4-phase results of effective resistance and verteresistance. No significant differences in terms of sensitivity of NSSA and 4-phase rhinomanometry (79.3% versus 75.5%), specificity (80.0% versus 85.5%) and diagnostic accuracy (79.6% versus 80.6%) were found. Conclusion: Use of NSSA and the 4-phase rhinomanometry both for assessment of patients with nasal septal deviation provides objective information to aid in clinical decision making.

Comparison of Odiosoft-Rhino and rhinomanometry in evaluation of nasal patency

To conduct a preliminary study testing the validity of the Odiosoft-Rhino (OR) in the evaluation of nasal patency in patients with nasal septal deviation and compare the results with visual analogue score (VAS) of nasal obstruction and rhinomanometry (RMM). OR and RMM were performed on 68 patients with nasal septal deviation and 61 healthy controls. VAS, nasal resistance values and nasal sound analysis were noted for the left and right nasal cavities. There are statistically significant differences between VAS, RMM and nasal endoscopic findings between the patient and the control group. The OR results at expiratory and inspiratory 2000 - 4000 Hz and 4000 - 6000 Hz intervals for both nasal cavities show a statistically significant difference between the patient and control groups. Nasal endoscopic findings, RMM, OR results of the deviated sides in the 2000 - 4000 Hz interval correlate well with VAS. OR may be a practical test in assessment of nasal patency. OR at the 2000 - 4000 Hz interval shows a correlation with VAS. However, showing a correlation between a test and a variable is not the same as proving that it is a useful diagnostic test. Therefore, more studies with larger series are needed.

Evaluation of nasal patency in patients with vasomotor rhinitis

To measure the nasal patency in patients with vasomotor rhinitis (VMR) and healthy controls and to assess its correlation with visual analogue scale (VAS). A total of 105 patients with VMR and 71 healthy controls were included in this study. By using nasal rhinomanometry, the pressure-flow curve and got total nasal resistances of 75 Pa and 150 Pa were measured. By means of acoustic rhinometry, the area-distance curve before and after using nasal vasoconstrictor substance was obtained, got the nasal minimum cross-sectional area (MCA), then calculated nasal congestion index (NCI). The outcomes of nasal resistance and acoustic rhinometry in two groups were compared. The correlation between VAS and nasal patency of VMR was evaluated. The correlation between the outcomes with nasal resistance and acoustic rhinometry and VAS of nasal symptom showed no statistical significance in VMR patients (all P > 0.05). MCA before and after decongestion showed no difference (Z value were -1.541 and -0.626, each P > 0.05), NCI had statistic differences in two groups (Z = -2.707, P < 0.05). Nasal resistance of 75 Pa had statistic differences in two groups (Z = -4.334, P < 0.05), 150 Pa showed no difference (Z = -1.314, P > 0.05). Vasomotor rhinitis is one of the most common non-allergic rhinitis. Subjective symptoms has no correlation with objective nasal patency tests. In clinical practice, comprehensive evaluation of subjective symptoms and objective test results of the patient is required.

Evaluation of Nasal Patency and Nasal Nitric Oxide Levels in Subjects with Allergic Rhinitis After Pharmacologic or Physiologic Stimuli: a Two Parallel Groups Study

RATIONALE: Physical exercise is associated with an increase in nasal volume (NV) in patients with allergic rhinitis. Nasal nitric oxide (nNO) levels have been found high in these patients. Our aim was to determinate the NV after two different stimuli (exercise and topical vasoconstrictor) and to evaluate the relationship between nasal response and nNO levels in these subjects.

An Improved Device for Posterior Rhinomanometry to Measure Nasal Resistance

Rhinomanometry is a method for measuring nasal resistance for the purpose of providing an objective evaluation of nasal patency. Posterior rhinomanometry is accomplished without the use of a mask, thus allowing the patient to breathe naturally. Here, we report on the improvements we have made to the existing posterior rhinomanometry system. In this system, nasal airflow is measured indirectly by measuring the pressure differential across a small mesh window in the body plethysmograph. We have calibrated this measurement and developed software that automatically provides the correct values for all airflow rates. Also, we have developed software that automatically corrects for the phase shift caused by the plethysmograph structure. These refinements should provide more accurate values for nasal resistance.

Evaluation of Nasal Patency: Comparison of Patient and Clinician Assessments with Rhinomanometry

The correlation between the objective measurement of nasal resistance and nasal airflow sensation is usually regarded as poor. The aim of the study was to assess the relation between objective indices of nasal patency, as assessed by the occlusion method (RN) and the Youlten peak nasal inspiratory flow meter (PNIF), with subjective sensations of nasal blockade by either the patient or the clinician in groups of patients with rhinitis, asthma, rhinitis and asthma, nasal septal deformity and in normal controls. We studied nasal airway patency in 254 subjects (37 women, 217 men), mean age 21 years (range 14-78) by RN and PNIF. Nasal resistance was also measured by the application of Ohm's law for parallel resistors (NRO) by estimating the unilateral resistance separately. Subjective sensation of nasal blockade was assessed either by the patient on a 10-point Borg scale (SUB), or the clinician (CLN) on a 6-point scale (3 for each side of the nose). The latter was done in a controlled fashion with the aid of reference sensations. Adjusting for age, height, smoking status and airway calibre, we found good correlation between RN and CLN (r=0.57, p=10

Evaluation of nasal patency by fiberoptic rhinoscopy

A novel method of assessing anterior nasal patency by flexible fiberoptic rhinoscopy was evaluated in two centers by comparison with active anterior rhinomanometry. Rhinoscopy and rhinomanometry were performed 20 times on each of 14 subjects during 14 to 26 minutes. The procedure was videotaped, and nasal airway area was measured from a video monitor. The mean coefficients of variation for rhinoscopy and rhinomanometry were 14% and 19%, respectively. Another investigator examined five subjects by rhinoscopy 30 times in 15 minutes; the mean coefficient of variation was 9%. These means were not significantly different. Rhinoscopy and rhinomanometry were performed at 30-minute intervals for a 6-hour period in 13 subjects. Three investigators independently evaluated results for changes in nasal function characteristic of the nasal cycle. Rhinoscopy detected the nasal cycle in an average of 72% of subjects and rhinomanometry in 49%. Both methods detected the response to topically applied oxymetazoline and methacholine. Results indicate that, whereas the two procedures evaluate different aspects of nasal function, their precision is similar. Rhinoscopy additionally permits evaluation of nasal mucosal changes occurring from disease or treatment.