Nasal Airflow Research Articles

COMPARATIVE HISTOLOGICAL ANALYSIS OF THE NASAL SEPTAL SWELL BODY AND THE POSTERIOR NASAL SEPTAL MUCOSA

Introduction: The nasal septal swell body is an area in the nasal septum located superior to the inferior turbinate, and anterior to the middle turbinate. It is closely associated with the internal nasal valve, in addition to being included among the expansile tissues of the anterior nose, which suggests that it significantly interferes with nasal airflow resistance. Objective: The present study aimed to histologically evaluate the composition of the septal mucosa in the septal body area, while comparing it with the posterior septal region, and to discover its role in nasal physiology. Methods: To perform the histological analysis, samples of the septal body mucosa and of the posterior septal mucosa of 20 patients were collected, and then the differences regarding cellular constitution, blood vessels (sinusoid and arterial) and connective tissue were outlined. Results: A larger number of venous sinusoids was noticed in the nasal septal body area, compared to the posterior septal mucosa, and less glandular-like tissue in the nasal septal body. Conclusion: The erectile tissue characteristic of the nasal septal body may play a role in the physiology of nasal obstruction, but new studies with different groups of patients are needed to define its actual role.

Development of Respiratory Signal Monitoring System Based on Photoplethysmography

Breathing is of great significance in the monitoring of patients with obstructive sleep apnea hypopnea syndrome, perioperative monitoring and intensive care. In this study, a respiratory monitoring and verification system based on optical capacitance product pulse wave (PPG) is designed, which can synchronously collect human PPG signals. Through algorithm processing, the characteristic parameters of PPG signal are calculated, and the respiratory signal and respiratory frequency can be extracted in real time. In order to verify the accuracy of extracting respiratory signal and respiratory rate by the algorithm, the system adds the nasal airflow respiratory signal acquisition module to synchronously collect the nasal airflow respiratory signal as the standard signal for comparison and verification. Finally, the root mean square error between the respiratory rate extracted by the algorithm from the pulse wave and the standard respiratory rate is only 1.05 times/min.

Functional Nasal Surgery.

After studying this article, the participant should be able to: (1) understand the functional significance of nasal anatomy as it relates to rhinoplasty and perform a comprehensive functional nasal assessment. (2) Identify the anatomical level of obstruction based on the authors' algorithmic approach and understand the current evidence supporting operative techniques for correcting nasal airway obstruction from septal deformity, inferior turbinate hypertrophy, internal nasal valve collapse, external nasal valve collapse. (3) Understand the current evidence supporting operative techniques for correcting nasal airway obstruction from septal deformity, inferior turbinate hypertrophy, internal nasal valve collapse, and external nasal valve collapse. (4) Appreciate the objective assessment tools for functional nasal surgery from a clinical and research perspective. The intent of functional rhinoplasty is to improve nasal airflow (and the perception thereof) by surgically correcting the anatomical sources of obstruction in the nasal airway. Cosmetic and functional rhinoplasty are not mutually exclusive entities, and the techniques that address one area, inevitably may affect the another. The rate of functional problems after cosmetic rhinoplasty range from 15 to 68 percent with nasal airway obstruction found to be the most common indication for secondary surgery. The objective of this CME article is to provide readers with an understanding of the (1) functional components of nasal anatomy, (2) clinical functional assessment, and (3) the current evidence supporting corrective maneuvers for each component.

Rhinomanometry with and without decongestant used to select children for adenoidectomy: a cohort study.

Adenoid hypertrophy may coexist, and often does, with rhinitis. Therefore, in some cases, adenoidectomy alone, despite the fact that it reduces nasal resistance, may be insufficient to restore nasal breathing. Juliusson et al. suggested using rhinomanometry with and without nasal decongestant as a method for selecting patients for adenoidectomy. In this study, we aim to assess whether the decongestant test, when using normative data, is useful to select children for adenoidectomy. Children between 4 and 15years old undergoing adenoidectomy were selected from two tertiary referral university hospitals. Participants underwent anterior active rhinomanometry with and without nasal decongestant before and after surgery. Parents fill in the sinus and nasal quality-of-life survey (SN5). 47 participants were included, and mean age 6.5 ± 2.15. 2 cohorts were defined according to the result of the nasal decongestant test (> 40% improvement in nasal resistance or not). There is a statistically significant difference between groups, with a higher improvement in nasal resistance and airflow after adenoidectomy in the group with less than 40% improvement in nasal resistance. In conclusion, this study supports the use of the decongestant test with rhinomanometry to select children for adenoidectomy; especially as it has proven to be a simple technique, harmless, fast, and easily performed on collaborative children.

Nasal drug delivery for Chronic Rhinosinusitis: An Overview

Nasal delivery is the logical choice for topical treatment of local diseases in the nose and Paranasal sinuses such as allergic and non-allergic rhinitis and sinusitis. The nose is also considered an attractive route for needle-free vaccination and for systemic drug delivery, especially when rapid absorption and effect are desired. In addition, nasal delivery may help address issues related to poor bioavailability, slow absorption, drug degradation, and adverse events in the gastrointestinal tract and avoids the first-pass metabolism in the liver. However, when considering nasal delivery devices and mechanisms, it is important to keep in mind that the prime purpose of the nasal airway is to protect the delicate lungs from hazardous exposures, not to serve as a delivery route for drugs and vaccines. The narrow nasal valve and the complex convoluted nasal geometry with its dynamic cyclic physiological changes provide efficient filtration and conditioning of the inspired air, enhance olfaction, and optimize gas exchange and fluid retention during exhalation. However, the potential hurdles these functional features impose on efficient nasal drug delivery are often ignored. With this background, the advantages and limitations of existing and emerging nasal delivery devices and dispersion technologies are reviewed with focus on their clinical performance. The role and limitations of the in vitro testing in the FDA guidance for nasal spray pumps and pressurized aerosols (pressurized metered-dose inhalers) with local action are discussed. Moreover, the predictive value and clinical utility of nasal cast studies and computer simulations of nasal airflow and deposition with computer fluid dynamics software are briefly discussed. New and emerging delivery technologies and devices with emphasis on BiDirectional™ delivery, Keywords Drug delivery Nasal Device Paranasal sinuses Topical Systemic Vaccine Nasal valve Particle deposition Clearance

Mometasone Furoate in Non-Allergic Rhinitis: A Real-Life Italian Study

Background: In order to evaluate the efficacy of intranasal mometasone furoate in patients with non-allergic rhinitis (NAR), a real-life, observational, prospective study is performed. Methods: Thirty-one patients (age 18–64 years) receive intranasal (mometasone furoate, 200 µg b.i.d. for 15 consecutive days per month for 6 consecutive months), plus isotonic nasal saline. The cytologic pattern of local inflammation, nasal airflow, through peak nasal inspiratory flow (PNIF), quality of life (QoL), through the rhinitis quality of life questionnaire (RQLQ), the sinonasal outcome test (SNOT-22), the short-form 36-item health survey (SF-36v2), and the combined symptom medication score (CSMS), and, finally, olfactory function, through Sniffin’ sticks-16 identification test (SSIT-16), are evaluated at baseline and after treatment. Results: NARNE is the most frequent cytological pattern (48% of the total sample). The therapeutic response shows improvement in olfactory function and QoL. Conclusions: The results of this study confirm that intranasal mometasone furoate is an effective treatment for patients with NAR.

Non-Surgical Devices for Nasal Obstruction.

Nasal obstruction is a common presenting complaint in most otolaryngology practices. A reduction of nasal airflow can contribute to exercise intolerance, snoring, obstructive sleep apnea (OSA), and an overall decreased quality of life. When medical management for non-anatomical issues fails to resolve the obstruction, surgeries targeting nasal obstruction-namely septorhinoplasty and/or inferior turbinate reduction are often considered. A frequently overlooked alternative for these patients is the wide array of non-surgical and minimally invasive appliances available to address nasal obstruction. This article attempts to provide a basic overview of these devices, benefits, and limitations, and the evidence supporting their efficacy in alleviating nasal obstruction.

Comparative Functional Effect of Alternative Surgical Techniques Used in Rhinoplasty.

The purpose of this investigation is to compare the functional effect of the different surgical techniques used for addressing each section of the nose. Prospective study of 57 consecutive rhinoplasty patients. Patients were evaluated with peak nasal inspiratory flow (PNIF), Nasal Obstruction Symptom Evaluation (NOSE), and Visual Analog Scale (VAS) for nasal obstruction before and 1 year after rhinoplasty. Additionally, esthetic evaluation of the nose was obtained with Rhinoplasty Outcomes Evaluation (ROE). According to the surgical technique used to address each portion of the nose, groups of patients were created and the functional improvement of these groups was compared. Using the TukeyHSD multiple pairwise-comparison test, the estimated difference of the increase of PNIF between using spreader grafts and using spreader flaps was 94.9 (95% CI 24.3, 165.5, P = .004) between spreader grafts and neither grafts or flaps was 79.2 (95% CI 5.8, 152.6, P = .03), between spreader grafts and bilateral spreader flaps plus a unilateral spreader graft was 90.2 (95% CI 22.1, 158.2, P = .005). In all other portions of the nose, no significant difference was found in the functional improvement between different surgical techniques. Spreader grafts increase PNIF more significantly than other surgical techniques used for dorsal mid-vault reconstruction. Spreader grafts should be preferred over other techniques whenever an improvement of nasal airflow is required. No significant differences were found between the functional effect of alternative techniques used in other sections of the nose. Additional cohort studies will be necessary to further confirm data from this investigation.

Extramedullary plasmacytoma of the nasal cavity with kappa light chains in a young person: A case report

Abstract BACKGROUND. Extramedullary plasmacytoma is a rare tumor, representing less than 1% of head and neck tumors. This specific type of tumor occurs in 90% of cases in the upper aero-digestive tract, with more frequent location in 80% of cases in the submucosa. CASE REPORT. We report the case of a 39-year-old young man who presented for bilateral nasal obstruction with swelling of the left nasal region and intermittent epistaxis of moderate abundance. The clinical examination revealed a tumor mass in the nasal cavity bleeding on contact, with the absence of nasal airflow. The cranio-facial CT and MRI imaging with contrast agent showed a large, locally advanced tumor in the left nasal cavity, with destruction of the surrounding osteo-cartilaginous structures. The anatomopathological study of the biopsy specimen returned in favour of a plasmacytoma of the nasal cavity with kappa light chains. The biological assessment of the multiple myeloma confirmed that it was an extramedullary plasmacytoma. Radiotherapy treatment was proposed. CONCLUSION. In the light of this case of extramedullary plasmacytoma, we will discuss the clinical, therapeutic and evolutionary characteristics of this tumour.

Respiratory influence on brain dynamics: the preponderant role of the nasal pathway and deep slow regime.

As a possible body signal influencing brain dynamics, respiration is fundamental for perception, cognition, and emotion. The olfactory system has recently acquired its credentials by proving to be crucial in the transmission of respiratory influence on the brain via the sensitivity to nasal airflow of its receptor cells. Here, we present recent findings evidencing respiration-related activities in the brain. Then, we review the data explaining the fact that breathing is (i) nasal and (ii) being slow and deep is crucial in its ability to stimulate the olfactory system and consequently influence the brain. In conclusion, we propose a possible scenario explaining how this optimal respiratory regime can promote changes in brain dynamics of an olfacto-limbic-respiratory circuit, providing a possibility to induce calm and relaxation by coordinating breathing regime and brain state.

Long-term outcomes following repair of nasal valve collapse with temperature-controlled radiofrequency treatment for patients with nasal obstruction.

Long-term outcomes following repair of nasal valve collapse with temperature-controlled radiofrequency treatment for patients with nasal obstruction.

Interest of miniscrew-assisted rapid palatal expansion on the upper airway in growing patients: A systematic review

This systematic review aimed to identify, evaluate, and provide an overview of the available literature regarding the use of miniscrews in the rapid maxillary expansion (RME) on the upper airway. The eligibility criteria were prospective trials that compared RME and miniscrew-assisted rapid maxillary expansion (MARPE) regarding airways. A search of studies in Medline (via PubMed), the Cochrane Library, Scopus and Scielo that measured the effects on the upper airway was conducted until May 8, 2022. Two reviewers independently selected the studies, extracted the data, and assessed the risk of bias for systematic reviews thanks to the Cochrane Risk of Bias tool. Reporting of this review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. Out of 160 potentially eligible studies, 7 were considered for systematic review. The measurement of MARPE on airway was done with CBCT, rhinometry, and acoustic rhinomanometry. In total, 344 patients were assessed. Two included studies showed high risk of bias and the rest showed low to moderate risks of bias. Tooth-bone-borne RME significantly improved nasal airflow [(Mean difference (MD) 52.7cm3/s, 95% confidence interval (95% CI) (9.0-96.4), P=0.020)], reduced nasal resistance (MD 0.20Pa/cm3, 95% (0.38-0.02), P=0.028), Skeletal expansion at the level of the nasal cavity was significantly greater in the MARPE group. The magnitude of the expansion at the posterior level of the nasal cavity was almost two times higher in the tooth-bone-borne group [(MD) 1.75mm, 95% (1.16-2.35) and (MD) 0.78mm, 95% (0.11-1.45), P<0.001] CONCLUSIONS: The short-term airflow changes after MARPE seems promising. Additionally, MARPE is associated with greater skeletal maxillary expansion after retention, at various levels of the nasal cavity, compared to conventional RME.

Producing and perceiving socially structured coarticulation: Coarticulatory nasalization in Afrikaans

Most theories of phonetics assume a tight relation between production and perception, and recent years have also seen increasing evidence for such a relation at the level of the individual. For the most part, however, this evidence comes from socially homogeneous speech communities where the targeted pattern of variation is mostly socially neutral. What implications might socially structured phonetic variation in the speech community have for the perception-production link? If listeners can predict the phonetic patterns of a talker based on the talker’s actual or assumed identity, would they adjust their perceptual strategies accordingly, possibly weakening the link between their own production and perception patterns? This study reports the results of a pair of experiments that investigate the production and perception of coarticulatory vowel nasalization in Afrikaans, a language for which variation in coarticulatory nasalization is socially structured. Relying on nasal airflow measures, the production experiment showed that speakers of White Afrikaans produce more extensive coarticulatory nasalization than speakers of Kleurling Afrikaans. The perception experiment used an eye-tracking paradigm to assess listeners’ perceptual reliance on coarticulatory nasalization, and found (i) that Afrikaans speakers’ use of coarticulatory nasalization in production predicts their perceptual reliance on this information, (ii) that they rapidly adjust to the coarticulatory timing patterns in the speech of other speakers, but also (iii) that they do not adjust their perceptual reliance on coarticulation in response to the assumed identity of the speaker. The link between perception and production therefore persists, even in this situation of socially structured variation in coarticulatory timing.

A Case of Empty Nose Syndrome Developed After Septal Spur Removal

Empty nose syndrome (ENS) is a rare complication of turbinate surgery, in which patients suffer from symptoms such as paradoxical nasal obstruction, nasal dryness, facial pain and feeling excessive nasal openness. Its occurrence is generally attributed to excessive turbinate reductive procedures. However, theoretically, any procedure which can cause increased nasal airflow and decreased nasal resistance may have a risk of causing ENS. We recently experienced a case of ENS developed after septal spur removal without turbinate reduction, which has not previously been reported in the literature. Here we present the case history of this unusual occurrence.

Evaluation of septal perforation size using a novel measuring device.

Nasal septal perforations can be managed with a septal button prosthesis. While they do not restore the physiological function of the septal mucosa, they are able to improve laminar nasal airflow. With the development of septal buttons sized specifically to perforations, accurate measurement of perforations has become more important for patient satisfaction and comfort. This task can be difficult to accomplish in the clinical setting. In this study, 2 new instruments developed to measure septal perforations were evaluated for accuracy and ease of use. Two types of measuring devices ("sizers") were created via 3D printing. One type included six serial, progressively sized instruments (serial sizers) and the other included two instruments with several size gradations (graded sizers). Septal perforations of varying sizes were surgically created in five fresh-frozen cadaver heads. Using a headlight and nasal speculum, 15 otolaryngology trainees and consultants were asked to measure the perforations (length × height) via four different methods: "eyeball" estimation, a ruler, the serial sizers, and the graded sizers. They were also asked to evaluate the methods themselves. An accurate measurement was defined as ± 1mm of the true measurement. A combination of Chi-square analysis and ANOVA was used to assess the accuracy and ease of use of the four methods. Chi-square analysis showed that the sizers were more accurate than the two traditional methods (eyeball and ruler) for measuring perforation length (73% vs. 44%, p = 4.8 × 10-7) and height (71% vs. 50%, p = 0.0003). ANOVA showed that the eyeball method overestimated perforation length significantly more than the other three methods (p = 0.002), and was also significantly less accurate than the other three methods (p < 0.001). Chi-square analysis did not show any correlation between participant training experience and measurement accuracy for any of the three methods. Participant comments and scores demonstrated a clear preference for the two sizers over the traditional methods. The two novel sizers studied here were significantly more accurate and easier to use than traditional methods for measuring nasal septal perforations. With broader implementation and study of these devices, there is potential to improve patient care surrounding septal perforations.

Persistent pediatric obstructive sleep apnea treated with skeletally anchored transpalatal distraction

The aim of this study was to evaluate the impact of nasomaxillary expansion using skeletally anchored transpalatal distraction (TPD) in children without transverse maxillary deficiency that were previously treated by rapid palatal expansion (RPE). Twenty-nine consecutive children were treated by TPD. Twenty-five children, aged 10-16 years completed pre- and post-operative clinical evaluations, questionnaires (OSA-18), cone beam computed tomography (CBCT), and polysomnography (PSG). The pre- and post-operative CBCT data were used to reconstruct the 3-dimensional shape of the upper airway. Two measures of airflow function (pressure and velocity) were simulated by using computational fluid dynamics (CFD) at four different airway segments (nasal, nasopharyngeal, oropharyngeal and hypopharyngeal). Twenty-three patients (92%) experienced improvement based on PSG. The apnea hypopnea index (AHI) improved from 6.72 ± 4.34 to 3.59 ± 5.11 (p<0.001) events per hour. Clinical symptoms based on OSA-18 scores were improved in all patients. Twenty-five patients (100%) had successful expansion defined as separation of the midpalatal suture at least 1mm from anterior nasal spine (ANS) to posterior nasal spine (PNS). The nasal sidewall widening was 2.59 ± 1,54 mm at canine, 2.91 ± 1,23 mm at first molar and 2.30 ± 1,29 mm at PNS. The ratio of dental expansion to nasal expansion was 1.12:1 (2.90mm:2.59mm) at canine and 1.37:1 (3.98mm:2.91mm) at first molar. The nasal airflow pressure reduced by 76% (-275.73 to -67.28 Pa) and the nasal airflow velocity reduced by over 50% (18.60 to 8.56 m/s). Nasomaxillary expansion by skeletally anchored TPD improves OSA in children without transverse maxillary deficiency that were previously treated by RPE. A nearly parallel anterior-posterior opening of the mid-palatal suture achieves enlargement of the entire nasal passage with improvement of the airflow characteristics in the nasal and pharyngeal airway. The improved airflow characteristic is significantly correlated with the improved polysomnographic findings, thus demonstrating that nasomaxillary expansion in previously expanded patients is a viable treatment option.

0741 Nasal airflow shape on home sleep studies predicts epiglottic collapse

Abstract Introduction Obstructive sleep apnea (OSA) is characterized by collapse of various portions of the pharynx. Epiglottic collapse can be difficult to diagnose and can affect a patient’s tolerance to continuous positive airway pressure (CPAP) or oral appliances (OA). Previous research shows a distinct nasal airflow pattern during periods of epiglottic obstruction. We sought to determine if primary epiglottic collapse noted on drug induced sleep endoscopy (DISE) would correlate with nasal airflow signals seen on home sleep studies. Methods We retrospectively analyzed the home sleep studies and DISE of 13 patients being considered for surgical therapies due to intolerance to CPAP. Characterization of nasal airflow signals as epiglottic collapse and non-epiglottic collapse was based on previously published data.[1] Airflow signals were individually scored as either epiglottic type collapse (type 1) and non-epiglottic type collapse (type 2). Total number of breaths and number of flow limited breaths were calculated by the algorithm in the home study device. Results Patients included had either complete (n=6) or no epiglottic collapse (n=7). The mean AHI 18 and 19.6, respectively. There was no difference in the fraction of type 1 breaths over total flow limited breaths between the two groups (1.1% for each group). When comparing type 1 breaths to the total number of type 1 and type 2 breaths counted, patients with complete epiglottic collapse on DISE showed a higher percentage of type 1 breaths (33%) compared to those without epiglottic collapse (23%) Conclusion Nasal airflow signal shape on home sleep studies can suggest the presence of epiglottic collapse. This type of analysis can provide a noninvasive assessment of physiology and improve treatment decisions. Support (If Any) Azarbarzin, A., et al., Predicting epiglottic collapse in patients with obstructive sleep apnoea. Eur Respir J, 2017. 50(3).

Limbic and paralimbic respiratory modulation: From inhibition to enhancement.

Increased understanding of the role of cortical structures in respiratory control may help the understanding of seizure-induced respiratory dysfunction that leads to sudden unexpected death in epilepsy (SUDEP). The aim of this study was to characterize respiratory responses to electrical stimulation (ES), including inhibition and enhancement of respiration. We prospectively recruited 19 consecutive patients with intractable epilepsy undergoing stereotactic electroencephalography (EEG) evaluation from June 2015 to June 2018. Inclusion criteria were patients ≥18years in whom ES was indicated for clinical mapping of ictal onset or eloquent cortex as part of the presurgical evaluation. ES was carried out at 50Hz, 0.2msec, and 1-10mA current intensity. Common brain regions sampled across all patients were amygdala (AMY), hippocampus (HG), anterior cingulate gyrus (CING), orbitofrontal cortex (OrbF), temporal neocortex (TNC), temporal pole (TP), and entorhinal cortex (ERC). Seven hundred fifty-five stimulations were conducted. Quantitative analysis of breathing signal, that is, changes in breathing rate (BR), depth (TV), and minute ventilation (MV), was carried out during ES using the BreathMetrics breathing waveform analysis toolbox. Electrocardiography, arterial oxygen saturation, end-tidal and transcutaneous carbon dioxide, nasal airflow, and abdominal and thoracic plethysmography were monitored continuously during stimulations. Electrical stimulation of TP and CING (at lower current strengths <3mA) increased TV and MV. At >7-10 mA, CING decreased TV and MV. On the other hand, decreased TV and MV occurred with stimulation of mesial temporal structures such as AMY and HG. Breathing changes were dependent on stimulation intensity. Lateral temporal, entorhinal, and orbitofrontal cortices did not affect breathing either way. These findings suggest that breathing responses other than apnea can be induced by ES. Identification of two regions-the temporal pole and anterior cingulate gyrus-for enhancement of breathing may be important in paving the way to future development of strategies for prevention of SUDEP.

Improving Nasal Airflow with a Novel Nasal Breathing Stent.

Nasal obstruction requires close attention, as it is a risk factor for obstructive sleep apnea (OSA). This study evaluated airflow rates of our newly designed nasal breathing stent (NBS) compared with those of existing nasal dilators in 10 adult men. We hypothesized that the NBS would expand the nasal passage more than the other nasal dilators by means of airflow measurements. We compared airflow measurements between the NBS and three existing appliances and no appliance. Velocity measurements were recorded by analyzing 499 videographic images when each appliance was placed next to a steam generator at 0, 5, and 10 mm from the outlet port for airflow visualization. The peak nasal inspiratory flow (PNIF) rate was measured using an inspiratory flow meter. The NBS resulted in significantly higher airflow velocity measurements at all distances from the outlet port and a higher PNIF rate than the other appliances. Thus, the NBS offers a significantly decreased resistance to air movement compared with other appliances. Future in-depth investigations are required to demonstrate the use of NBS as a nasal dilator in conjunction with continuous positive airway pressure/oral appliance treatments in patients with OSA.

Evaluating the changes in nasal airway volume and nasal airflow after surgically assisted rapid maxillary expansion

This study aims to compare the changes in the nasal airway volume and nasal airflow using acoustic rhinometry (AR), rhinomanometry (RMN), and dental volumetric tomography (DVT) after surgically assisted rapid maxillary expansion (SARME). Our study consists of 13 adults, 3 male and 10 female patients, aged between 15 and 26, with completed skeletal development. In our study, DVT imaging was obtained twice, preoperation and 3 months after expansion. AR and RMN measurements were recorded, and Visual Analog Score (VAS) and Nasal Obstruction Symptom Evaluation (NOSE)Scale surveys were scored at preoperation and 3 months after expansion. Nasopharyngeal-oropharyngeal airway volume and areas were calculated using the Romexis 3.8.3.R (Planmeca,Helsinki, Finland) and Nemotec V2019 (Madrid, Spain) software programs. IBM SPSS Statistics 22 (SPSS IBM, Armonk, New York) was used for statistical analysis. Comparing the preoperation and postexpansion measurements by both software programs revealed a statistically significant increase in the nasopharyngeal airway volume. No statistically significant change was observed in the oropharyngeal airway volume. Furthermore, we found a statistically significant increase in VAS but a significant decrease in NOSE. According to our findings, nasal airway volume increased after SARME, and although there was no significant change in nasal resistance, patients' quality of life increased significantly.