To study the geometry of the nasal cavity we applied an acoustic method (J. Appl. Physiol. 43: 523-536, 1977) providing an estimate of cross-sectional area as a function of distance. Acoustic areas in a model constructed from a human nasal cast, in the nasal cavity of a cadaver and in 10 normal subjects and two patients with well-defined afflictions of the nasal cavity, were compared with similar areas obtained by computerized tomography (CT) scans, a specially developed water displacement method, and anterior rhinomanometry. We found a coefficient of variation of the areas of less than 2% by the acoustic method compared with 15% for the rhinomanometric measurements. Acoustic areas correlated highly to similar areas obtained by CT scanning (r = 0.94) and by water displacement (r = 0.96). In two patients the acoustic method accurately outlined, respectively, a tumor in the nose and a septum deviation. It is concluded that this method provides an accurate method for measuring the geometry of the nasal cavity. It is easy to perform and is potentially useful for investigation of physiological and pathological changes in the nose.
Aim: The prevalence of airway obstruction varies widely with the definition used. Objectives: To study differences in the prevalence of airway obstruction when applying four international guidelines to three population samples using four regression equations. Methods: We collected predicted values for forced expiratory volume in 1 s/forced vital capacity (FEV 1 /FVC) and its lower limit of normal (LLN) from the literature. FEV 1 /FVC from 40 646 adults (including 13 136 asymptomatic never smokers) aged 17-90+years were available from American, English and Dutch population based surveys. The prevalence of airway obstruction was determined by the LLN for FEV 1 /FVC, and by using the Global Initiative for Chronic Obstructive Lung Disease (GOLD), American Thoracic Society/European Respiratory Society (ATS/ERS) or British Thoracic Society (BTS) guidelines, initially in the healthy subgroup and then in the entire population. Results: The LLN for FEV 1 /FVC varied between prediction equations (57 available for men and 55 for women), and demonstrated marked negative age dependency. Median age at which the LLN fell below 0.70 in healthy subjects was 42 and 48 years in men and women, respectively. When applying the reference equations (Health Survey for England 1995-1996, National Health and Nutrition Examination Survey (NHANES) III, European Community for Coal and Steel (ECCS)/ERS and a Dutch population study) to the selected population samples, the prevalence of airway obstruction in healthy never smokers aged over 60 years varied for each guideline: 17-45% of men and 7-26% of women for GOLD; 0-18% of men and 0-16% of women for ATS/ERS; and 0-9% of men and 0-11% of women for BTS. GOLD guidelines caused false positive rates of up to 60% when applied to entire populations. Conclusions: Airway obstruction should be defined by FEV 1 /FVC and FEV 1 being below the LLN using appropriate reference equations.Chronic obstructive pulmonary disease (COPD) is a major public health concern as a cause of chronic morbidity and mortality.
To evaluate the accuracy of the acoustic reflection (AR) technique for determination of nasal cavity cross-sectional areas, the area-distance function of both sides of the nose was determined in 10 subjects and compared with magnetic resonance imaging (MRI). Interindividual variation for the correlation between MRI and AR was seen, but in general the areas from 1 to 6 cm into the nasal cavity measured by AR were larger than areas measured by MRI, especially where the surface was most convoluted. The total volume for this region was 6.47 +/- 1.83 (SD) cm3 for AR and 5.65 +/- 1.34 cm3 for MRI. It was demonstrated that this could be due to errors in calculation of the areas on the basis of MRI and AR. In the posterior part of the nasal cavity and the epipharynx, there was a convincingly higher correlation between acoustic measurements and a scan perpendicular to the assumed geometrical axis of the epipharynx than between acoustic measurements and coronal scanning. This indicates that the sound axis roughly follows the geometrical axis. In a model of two tubes (nasal cavities) joined in a larger tube (the epipharynx), closure of the posterior part of the latter revealed that the contralateral nasal cavity is likely to cause overestimation of the posterior part of the epipharynx during AR compared with MRI.
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