Rhinomanometry Results Research Articles

Computational Rhinology: Unraveling Discrepancies between In Silico and In Vivo Nasal Airflow Assessments for Enhanced Clinical Decision Support.

Computational rhinology is a specialized branch of biomechanics leveraging engineering techniques for mathematical modelling and simulation to complement the medical field of rhinology. Computational rhinology has already contributed significantly to advancing our understanding of the nasal function, including airflow patterns, mucosal cooling, particle deposition, and drug delivery, and is foreseen as a crucial element in, e.g., the development of virtual surgery as a clinical, patient-specific decision support tool. The current paper delves into the field of computational rhinology from a nasal airflow perspective, highlighting the use of computational fluid dynamics to enhance diagnostics and treatment of breathing disorders. This paper consists of three distinct parts-an introduction to and review of the field of computational rhinology, a review of the published literature on in vitro and in silico studies of nasal airflow, and the presentation and analysis of previously unpublished high-fidelity CFD simulation data of in silico rhinomanometry. While the two first parts of this paper summarize the current status and challenges in the application of computational tools in rhinology, the last part addresses the gross disagreement commonly observed when comparing in silico and in vivo rhinomanometry results. It is concluded that this discrepancy cannot readily be explained by CFD model deficiencies caused by poor choice of turbulence model, insufficient spatial or temporal resolution, or neglecting transient effects. Hence, alternative explanations such as nasal cavity compliance or drag effects due to nasal hair should be investigated.

The influence of flowmeters on rhinomanometry results and detection of nasal airflow asymmetry.

<b><br>Introduction:</b> Rhinomanometry is an otolaryngological diagnostic method used to determine airflow as a function of the pressure drop through the left and right nasal cavities. Airflow is measured using orifice flowmeters that attenuate the flow.</br> <b><br>Aim:</b> This paper describes the results of a study into the effects of flowmeter design on rhinomanometry results and detection of nasal airflow asymmetry.</br> <b><br>Material and methods:</b> Four flowmeters were examined using a 3D printed model of a human nose.</br> <b><br>Conclusions:</b> Each flowmeter interfered with the rhinomanometry results.</br&gt.

Comparison of Dorsal Preservation and Dorsal Reduction Rhinoplasty: Analysis of Nasal Patency and Aesthetic Outcomes by Rhinomanometry, NOSE and SCHNOS Scales.

Dorsal preservation techniques have been preferred and gained popularity in recent years. The current study compares the effects of dorsal preservation and dorsal reduction rhinoplasty on nasal patency and aesthetic outcomes by using Patient-Reported Outcome Measures (PROMs) and rhinomanometry. To our knowledge, this is the first study to compare dorsal preservation and dorsal reduction techniques with rhinomanometry. This is a prospective study of 34 patients who underwent rhinoplasty between January 2021-June 2022. The patients were randomly selected preoperatively and divided into two groups as structural rhinoplasty (SR) and preservation rhinoplasty (PR). Nasal Obstruction and Symptom Evaluation (NOSE), Standardized Cosmesis and Health Nasal Outcomes Survey (SCHNOS) scales and rhinomanometric evaluation were performed preoperatively, at 3rd month and 12th month postoperatively. Nineteen patients (10 female, 9 male) were in SR group, 15 patients (7 female, 8 male) were in PR group. There was not significant difference in terms of age and gender between groups. In both groups, NOSE, SCHNOS-O and SCHNOS-C results were found to be significantly lower at postoperative 3rd and 12th month compared to preoperatively (p < 0.001 for the entire SR group, p = 0.001 for the entire PR group). There was no significant difference between groups in terms of PROMs. Mean total nasal volume (TNV) at 12th month were statistically higher than preoperative value in PR group (p = 0.031). Also there was no significant difference in SR group and between groups in terms of rhinomanometry results. Dorsal preservation with pushdown technique provides good functional and aesthetic results comparable with structural rhinoplasty. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 . A well-designed prospective clinical trial.

Correlation of Rhinomanometry Measurement and True Lateral Radiography towards the Degree of Upper Airway Obstruction in Patients with Adenoid Hypertrophy

Background: Adenoid hypertrophy is one of the most common disorders in children which may lead to upper airway obstruction. Various modalities to measure airway obstruction in patients with adenoid hypertrophy, including true lateral radiographs, nasoendoscopy, and rhinomanometry are available; however, the results from different studies are still controversial. This study aimed to determine the relationship between the results of rhinomanometry and the true lateral radiographs to the degree of upper airway obstruction in patients with adenoid hypertrophy. Methods: This cross-sectional study included a total of 33 patients with adenoid hypertrophy aged 5-18 years using a purposive sampling technique. Patients diagnosed with adenoid hypertrophy were subjected to a true lateral examination using lateral neck radiographs to measure the degree of airway obstruction. Subsequently, an active anterior rhinomanometry was performed by measuring resistance and nasal airflow and then measuring the degree of airway obstruction. Data analysis was done using Chi-Square test. Results: The rhinomanometric nasal resistance in the inspiratory phase was 0.4159 ± 0.15201 Pa/cm3/s and 0.3694 ± 0.13717 Pa/cm3/s in the expiration phase. The results showed a significant relationship between the true lateral radiographs and both nasal inspiratory (p=0.005) and expiratory resistance (p=0.004). Similarly, the relationship between the true lateral radiographs and nasal airflow on both inspiratory and expiratory rhinomanometry was significant (p&lt;0.05). Conclusion: Rhinomanometric measurements can be used as an additional objective examination in assessing the degree of upper airway obstruction in patients with adenoid hypertrophy prior to surgery.

Evaluation of the relationship between polysomnography parameters, physical examination findings and oxidative stress parameters in patients with obstructive sleep apnea syndrome

Background/Aim: Oxidative stress status in obstructive sleep apnea syndrome (OSAS) is well discussed in the literature. Oxidative stress levels increase, and antioxidant system activi-ty decreases in OSAS patients. However, the change in oxidative stress status in positional (pOSAS) and non-positional (npOSAS) OSAS has not been adequately examined. The aim of this study was to compare OSAS patients’ polysomnographic (PSG) parameters and oxidative stress capacities with the structural and functional properties of the upper respiratory tract. Methods: This study was designed as prospective case-control study and patients were divided into three groups as control, pOSAS and npOSAS according to their PSG findings. Ear nose throat examinations including rhinomanometry test and oxidative stress blood parameter tests were conducted to all patients. Variables among the groups were compared. Results: All PSG parameters were significantly worse in the OSAS groups than the control group (P<0.05). The mean AHIs of the pOSAS and npOSAS groups were 21.7 (16.5), and 31.2 (21.9), respectively. AHI, desaturation number and minimal SpO2 values of the pOSAS group were significantly lower compared to the npOSAS group (P=0.043, P=0.017 and P=0.006, respectively). TNF α was significantly lower and adiponectin was significantly higher in the pOSAS group compared to the npOSAS group (P=0.001, P<0.001 respectively). The two groups were similar in terms of rhinomanometry results (P=0.888). Conclusion: The lack of difference between pOSAS and npOSAS patients in terms of rhinomanometry results may indicate that the nose may not play a decisive role in the differentiation of these groups. Only OSAS severity may not be a determinant factor in oxidative stress balance in patients with pOSAS and np OSAS.

Determining the main reasons for difficult nasal breathing among children with primary and mixed dentition

Introduction: Difficult nasal breathing is the condition where there is a partial or full, temporary or permanent obstruction of the airways and the processes of inhalation and exhalation are carried out through the mouth. Aim: The aim of this paper is to define and analyse the reasons for mouth breathing among children with primary and mixed dentition. Materials and Methods: A total of 1 667 children between the ages 3 and 12 years were examined. We used the methods of anterior and posterior rhinoscopy, acoustic rhinometry, and rhinomanometry Results: Among all the studied mouth-breathing children with deciduous dentition, the main reason for the difficult nasal breathing was allergic rhinitis. The children with first degree of obstruction predominated (54.50%), The second cause in this studied age group was adenoid hypertrophy. In early mixed dentition, the percentage distribution of second and third degree of obstruction was the same (45.70%). In the early mixed dentition, the most common cause of difficult nasal breathing was adenoid hypertrophy. The percentage of children in late mixed dentition who were with adenoid hypertrophy was lower. Conclusion: The main reason for difficult nasal breathing in primary dentition is allergic rhinitis, but in early mixed dentition it is adenoid hypertrophy. Our results showed that of all the children with difficult nasal breathing 24% had first degree of nasal obstruction, 39.30% had second degree, followed by 36.70% children with third degree.

Retrospective audit of rhinomanometry results and CPAP outcomes

Retrospective audit of rhinomanometry results and CPAP outcomes

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.

Extracorporeal septoplasty with internal nasal valve stabilisation.

SUMMARYAmong various septoplasty techniques, the extracorporeal one is used for severe deformities of the caudal septum and consists essentially in removal of the nasal septum followed by correction of deformities. Reconstruction of the neo-septum is carried out by repositioning the septal fragments in a straight position. The disadvantages of this surgical technique are the septal haematoma, oedema of the mucosa in the valve area and some types of abnormalities of the middle third of the nose such as saddling of the dorsum. All of these conditions can be associated with various degrees of functional disorders. To prevent these possible complications, we developed a suture technique to fix the caudal portion of the neo-septum and avoid alterations or narrowing of the internal nasal valve. The purpose of this study is to describe extracorporeal septoplasty results with this suture technique in stabilising the internal nasal valve. From January 2011 to December 2013, a retrospective review of adult patients treated with extracorporeal septoplasty was performed at the ENT department of Imola Hospital. Pre- and post-operative evaluations were carried out by rhinomanometry and acoustic rhinometry. Statistical analysis was performed with commercially available software (IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp). 133 cases fulfilled inclusion criteria and were enrolled. A significant improvement was evident after surgery based on the results of rhinomanometry and acoustic rhinology. Extracorporeal septoplasty with stabilisation of the internal nasal valve is an effective and reproducible surgical technique that yields optimal functional results.

Gene and protein expression of CXCR4 in adult and elderly patients with chronic rhinitis, pharyngitis or sinusitis undergoing thermal water nasal inhalations

BackgroundChronic rhinitis, pharyngitis and sinusitis are common health problems with a significant impact on public health, and are suspected to be influenced by ageing factors. Nasal inhalation with thermal water may be used to reduce symptoms, inflammation and drug intake. A pre-post clinical study was conducted in 183 consecutive adult and elderly patients with chronic rhinitis, pharyngitis or sinusitis, to evaluate whether thermal water nasal inhalations could improve their symptoms, clinical signs and rhinomanometry measurements, and influence inflammatory biomarkers levels in nasal epithelial cells.ResultsParticipants profile revealed that they were aged on average (mean age and SD 60.6 ± 15.2 years, median 65, range 20–86, 86 aged ≤ 65 years (47%), 96 aged > 65 years (53%)) and extremely concerned about wellbeing. Older age was associated with better compliance to inhalation treatment. Total symptom and clinical evaluation scores were significantly ameliorated after treatment (p < 0.001), with no substantial difference according to age, while rhinomanometry results were inconsistent. Persistence of symptom improvement was confirmed at phone follow up 1 year later (n = 74). The training set of 48 inflammatory genes (40 patients) revealed a strong increase of CXCR4 gene expression after nasal inhalations, confirmed both in the validation set (143 patients; 1.2 ± 0.68 vs 3.3 ± 1.2; p < 0.0001) and by evaluation of CXCR4 protein expression (40 patients; 1.0 ± 0.39 vs 2.6 ± 0.66; p < 0.0001). CXCR4 expression was consistently changed in patients with rhinitis, pharyngitis or sinusitis. The increase was smaller in current smokers compared to non-smokers. Results were substantially unchanged when comparing aged subjects (≥ 65 years) or the eldest quartile (≥ 71 years) to the others. Other genes showed weaker variations (e.g. FLT1 was reduced only in patients with sinusitis).ConclusionsThese results confirm the clinical impact of thermal water nasal inhalations on upper respiratory diseases both in adults and elders, and emphasize the role of genes activating tissue repair and inflammatory pathways. Future studies should evaluate CXCR4 as possible therapeutic target or response predictor in patients with chronic rhinitis, pharyngitis or sinusitis.Trial registrationCommunication to Italian Ministry of Health - ICPOM 000461. Registered 10/11/2014.

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

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

Effect of Septoplasty on Voice Quality: A Prospective-Controlled Trial.

Objectives.The purpose is to investigate effect of septoplasty and widened nasal patency on voice quality.Methods.Fifty patients who undergone septoplasty were included in the study. Thirty-three people who had similar age and distribution were enrolled as control group. Before and 1 and 3 months after surgery, anterior rhinomanometry, voice analysis by Multi-Dimensional Voice Program, and spectrographic analysis were performed to patients. The recordings of /a/ vowel were used to evaluate average fundamental frequency (F0), jitter percent, and shimmer percent. In spectrographic analyses, F3–F4 values for the vowels /i, e, a, o, and u/, nasal formant frequencies of the consonants /m/ and /n/ in the word /mini/, and 4 formant frequencies (F1, F2, F3, and F4) for nasalized /i/ vowel following a nasal consonant /n/ in the word /mini/ were compared. The differences in nasal resonance were evaluated. All patients were asked whether change in their voices after the surgery. Preoperative and postoperative voice parameters and anterior rhinomanometry results were compared separately with the control group as well as in the patient group itself.Results.Preoperative total nasal resistance (TNR) values of patients were higher than the control group (P=0.001). TNR values of patients measured one day before surgery and after surgery in the 1st and 3rd months were different and these differences were significant statistically (P=0.001). There was no significant difference between the voice analysis parameters in preoperative, postoperative 1st, and 3rd months. As a result of their subjective reviews, 12 patients (36%) noted their voices were better than before surgery and 20 patients (61%) noted no change before and after surgery.Conclusion.Providing widened nasal cavity has no effect on voice quality.

The effects of inferior turbinoplasty on nasal airflow during cosmetic rhinoplasty.

SUMMARYRhinoplasty is one of the most common and challenging cosmetic procedures. One of the complications of rhinoplasty associated with dissatisfaction is nasal obstruction, which is often due to narrowing of the nasal valve area. Application of certain procedures such as turbinoplasty can prevent and correct this problem. This study aim was to investigate the effect of inferior turbinoplasty in reduction of airflow resistance and nasal obstruction. Using active anterior rhinomanometry, nasal airflow was measured in 50 patients who underwent cosmetic rhinoplasty and bilateral turbinoplasty before and 6 months after surgery. None of the patients subjectively complained of nasal obstruction before or after surgery. According to rhinomanometry results, improvement in nasal airflow was seen both in inspiration and expiration, although only expiration was significant (p = 0.034). Airflow changes in males and females and in different age groups was not significant (p > 0.05). It appears that rhinoplasty does not adversely affect nasal airflow when it is accompanied by simple adjuvant procedure inferior turbinoplasty.

The value of posterior rhinomanometry in evaluating patients with snoring and obstructive sleep apnea syndrome

Abstract BACKGROUND. Nowadays, snoring and obstructive sleep apnea are the most common sleep-related breathing disorders (SRBD) found in the medical practice and they are estimated to affect approximately 4% of men and 2% of women in the middle-aged workforce. There are some ENT pathologies that are involved in snoring, and also in obstructive sleep apnea syndrome. The nose plays an important part in both breathing and SRBD. The aim of this study was to determine the role of posterior rhinomanometry in the diagnoses of snoring and obstructive sleep apnea syndrome. MATERIAL AND METHODS. We present a retrospective observational study that took place during a three-year period, between 2009 and 2012. In this study were included 110 subjects, who have undergone polysomnographic investigations, as well as an ENT clinical examination focused on endoscopy and posterior rhinomanometry evaluation. RESULTS. The mean age was 46.09 ± 10.91 years, the mean height was 177.58 ± 10.02 cm and the mean weight was 98.45 ± 17.74 kg. Analysing these results, we found a significant correlation between them and the severity of the sleep pathology. The posterior rhinomanometry results were correlated with nasal allergic rhinitis (p = 0.06) and not correlated with other nasal pathology, such as nasal septum deviation. The changes in the size and shape of the tongue base or epiglottis proved to have an important impact upon rhinomanometric values, with a statistically significant value (p = 0.03, respectively p = 0.08). CONCLUSION. All diagnostic methods must be interpreted in connection with each other.

Decrease of nasal airway resistance and alleviations of symptoms after balloon sinuplasty in patients with isolated chronic rhinosinusitis: a prospective, randomised clinical study.

The aim of this study was to evaluate and compare the clinical outcome of balloon sinuplasty and uncinectomy for patients suffering from isolated chronic rhinosinusitis of the maxillary sinus. A prospective, randomised, non-blinded, controlled trial was conducted. The study was carried out at the Department of Otolaryngology, Tampere University Hospital, Finland. Adult patients with symptomatic isolated chronic or recurrent rhinosinusitis without severe findings in the sinuses, as documented in the sinus' Computer Tomography scan and clinical examination, were randomised into two groups: uncinectomy and balloon sinuplasty. The variables in our study are the Sinonasal Outcome Test-22 (SNOT 22), acoustic rhinometry and rhinomanometry. These parameters were analysed preoperatively and postoperatively (after 3 and 6 months). The preliminary results of our study have been previously published. Both balloon sinuplasty and uncinectomy significantly improved almost all the parameters of SNOT22 (P < 0.05), with no significant difference being found between these two groups (P > 0.05). Based on rhinomanometry results, airway resistance decreased after treatment. Regarding adverse effects, balloon sinuplasty was significantly associated with a lesser risk of synechia. Both balloon sinuplasty and uncinectomy improved the quality of life and decreased upper airway resistance of patients with mild, isolated chronic or recurrent rhinosinusitis. The smaller risk of postoperative synechiae with balloon sinuplasty combined with its promising efficiency could partially compensate for its high material cost.

Therapeutic Effects of Radiofrequency and Intranasal Corticosteroid on Rhinomanometry in Patients With Inferior Turbinate Hypertrophy

Background: Inferior turbinate hypertrophy (ITH) is one of the common causes of nasal obstruction. In some case with ITH due to allergic rhinitis medical therapy can be useful and in cases with refractory ITH surgical techniques may be helpful. Although there is no excellence [or superiority] among these surgical methods, radiofrequency (RF) has recently become popular. Objectives: This study compared the therapeutic effects of intranasal corticosteroid and RF in patients with ITH due to allergic rhinitis. Patients and Methods: In this randomized clinical trial, patients with ITH due to allergic rhinitis, referred to Baqiyatallah University of Medical Sciences Allergy Clinic, were randomly assigned to RF and intranasal corticosteroid spray groups (fluticasone 125 µg). Patients were evaluated by the symptoms severity, which were measured by visual analogue scale (0-10 score) and rhinomanometry, four times (before the intervention and the 1st, 3rd and 6th month after the intervention). Data were analyzed by SPSS version 21. Results: Sixty patients with ITH due to allergic rhinitis were evaluated, among which 26 were male and 34 were female. The mean age was 35.5 ± 8.86 years old and the mean body mass index (BMI) was 22.97 ± 3.12 kg/m2. There was no significant difference in demographic data among the groups. All the patients showed significant improvements in symptoms severities and rhinomanometry at all the after intervention visits. The best results were obtained in the 6th month of follow-up. The mean nasal obstruction severity and rhinomanometry results were significantly higher in the RF group at all the after intervention visits (P < 0.05). Conclusions: According to the results, we suggest using RF technique for patients with ITH due to allergic rhinitis, which is an outpatient procedure with local anesthesia; long-term effects of these two therapeutic methods (corticosteroid an RF) could be evaluated in future studies.

Comparison of conjunctival and nasal provocation tests in allergic rhinitis children with Dermatophagoides pteronyssinus sensitization

Nasal provocation tests (NPTs) are indicated in confirming the diagnosis of allergic rhinitis if the clinical history, skin tests or sIgE are inconclusive. NPTs are time- consuming, technically difficult and expensive to perform. Consequently, conjunctival provocation tests (CPTs), which are easier, cheaper and safer should be considered as an alternative method. No recent study has compared CPTs with NPTs in allergic rhinitis children. To compare CPTs with NPTs in allergic rhinitis children with house dust mite sensitization Fifty-five children with allergic rhinitis were included. Thirty-six children had positive skin prick tests (SPTs) to Dermatophagoides pteronyssinus (Dp). NPTs were performed by spraying 0.1 ml of Dp extract with concentrations of 50, 200 and 500 AU/ml to each nostril at 15 minute interval. The clinical symptom scores, anterior rhinomanometry results and nasal peak flow testing were performed to assess the responses. For CPTs, 0.1 ml of the same concentration of allergen extract was droppedinto one eye and the control solution was dropped into the other. The responses were assessed by clinical symptom scores. The tests were stopped when the subject reported a positive response, or continued to the maximum concentration. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of CPT compared with NPT are 97.1% (84.7-99.9), 90.5% (69.6-98.8), 94.3% (80.8-99.3), 95% (75.1-99.9) and 94.5 (84.9-98.9), respectively in all patients. Among individual allergic rhinitis subjects the sensitivity, specificity, PPV and NPV are 100%. CPT can be an alternative test for NPT in allergic rhinitis children with house dust mite sensitization, even if they do not have conjunctival symptoms.

The effects of disclosure of sequential rhinomanometry scores on post‐septoplasty subjective scores of nasal obstruction: a randomised controlled trial

We sought to evaluate the effects of awareness of rhinomanometric results on subjective sensation of nasal breathing in patients after septoplasty. Prospective randomised study. Clinical Hospital Rijeka. A study of 60 patients (45 M, 15 F) who underwent septoplasty was performed at the ENT Clinic, Clinical Hospital Rijeka. The patients were randomised into two groups; group A was shown their rhinomanometry scores at 3 months postoperatively, while group B remained unaware of their rhinomanometry results. The assumption is that in the same settings patients aware of their rhinomanometric results have better performances of their Nasal Obstruction Symptom Evaluation (NOSE) scale and thereby a better quality of life (QOL) after septoplasty. The differences in rhinomanometric results and NOSE scale prior and after septoplasty were statistically significant (P < 0.001), all patients achieving better results after the operation. There was no statistically significant difference in resistance (F = 0.004; P = 0.948) and improvement of rhinomanometry results in postoperative measurements (F = 0.110; P = 0.896) between groups A and B. The symptoms measured by the NOSE scale were the same in both groups preoperatively and 1 month after septoplasty (F = 2.906; P = 0.094). Three months postoperatively in group A, the NOSE scale score was lower (M = 11.67; sd = 12.34) than in group B (M = 27.50; sd = 18.04). The results suggest that disclosing information to patients about their post-septoplasty rhinomanometry results may improve subjective nasal breathing, and thus improve their QOL.

A randomized clinical study: outcome of submucous resection of compensatory inferior turbinate during septoplasty

Septoplasty and/or turbinate surgery are commonly used surgical techniques for the treatment of mechanical nasal obstruction. The aim of this study was to define the effectiveness of submucous resection of a hypertrophied turbinate together with simultaneous septoplasty for the treatment of nasal obstruction. Forty-two patients with septum deviation and compensatory contralateral inferior turbinate hypertrophy were recruited in this study. The inferior turbinate hypertrophy was diagnosed based on examination. The patients were randomly divided into two groups. In group A, a submucous resection was performed to treat a hypertrophied inferior turbinate, together with a septoplasty. In group B, only a septoplasty was performed. Acoustic rhinometry and rhinomanometry tests were conducted for an objective evaluation of nasal patency. A visual analog scale (VAS) was applied to the patients for the subjective evaluation of nasal obstruction complaints. The application of submucous resection intended to reduce a hypertrophied inferior turbinate led to a distinctive increase in cross-sectional area of nasal patency; however, when the two groups were compared, it was statistically significant only at the post-operative sixth month. There was no difference between the results of rhinomanometry. The subjective symptom scores were better in group A than in group B between the post-operative first to sixth month. Submucous resection of a hypertrophied inferior turbinate is necessary for the treatment of nasal obstruction.

Influence of Sinus Surgery in Rhinometric Measurements

The objectives of this prospective study were to clarify how well acoustic rhinometry (AR), computed tomography volumetry (CTV), rhinomanometry (RMM), and the visual analogue scale (VAS) identify changes in intranasal pathology after endoscopic sinus surgery in patients with chronic sinusitis. The measurements were performed in 44 nasal cavities of 11 patients pre- and postoperatively, 6 of whom underwent middle meatal antrostomy and 5 of whom underwent ethmoidectomy. The AR and RMM results were compared with those obtained with CTV and VAS. Furthermore, a favourable outcome in sinus surgery was obtained with all of the methods. The results showed clearly that endoscopic sinus surgery significantly changes the intranasal geometry and can be obtained reliably using rhinometric measurements. Both AR and CTV identified statistically significant (p < .05) volume changes in the nasal cavities. The AR and CTV results correlated generally well (r = .72) with each other, but wide differences were seen between the operative groups. Correlation in the ethmoidectomy group was very strong (r = .93) but weak in the middle meatal antrostomy group (r = .37). In the nasal function measurements, nasal obstruction decreased significantly (p < .05) after the surgery. The changes were clearly obtained using RMM and VAS (p < .05). Correlation between these methods was generally poor (r < .30), but a difference was again seen in the operative groups. In the ethmoidectomy group, correlation was moderately good (r = .55) but weak in the middle meatal antrostomy group (r = .29). We concluded that rhinometric methods are reliable tools for evaluation of operative outcome in endoscopic sinus surgery patients. Inspiratory resistance measured with RMM and nasal obstruction assessed with VAS appeared to measure separate parameters in nasal function.