Correlation between nasal resistance and different acoustic rhinometry parameters in children and adolescents with and without allergic rhinitis

Wandalsen, Gustavo Falbo; Mendes, Aline Inês; Solé, Dírceu

doi:10.5935/1808-8694.20120038

Cited by 16 publications

(19 citation statements)

References 27 publications

(33 reference statements)

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“…It is noteworthy that TNR and V5 are distinct parameters and that while V5 reflects the geometry of the nasal cavity, TNR is a physiological variable that is measured dynamically during tidal breathing. The differences between these 2 variables were seen clearly in our previous study, where we demonstrated that although significant, the correlation between them was only moderate, with correlation coefficients of around 0.5 [15]. In this preliminary analysis of our data, we compared TNR (obtained by AAR) with several AR parameters (V5, V4, V2-5, and minimal cross-sectional area) at 3 points: baseline, after induction of nasal obstruction, and after administration of a topical decongestant.…”

Section: Resultsmentioning

confidence: 95%

“…In this preliminary analysis of our data, we compared TNR (obtained by AAR) with several AR parameters (V5, V4, V2-5, and minimal cross-sectional area) at 3 points: baseline, after induction of nasal obstruction, and after administration of a topical decongestant. Since we found that V5 was the parameter with the highest correlation with TNR, we decided to use it in the present study [15].…”

Section: Resultsmentioning

confidence: 99%

“…Nasal volumes were also measured 3 times, and the mean value of each nostril was added to obtain total nasal cavity values [14]. According to previous recommendations, the volume of the first 5 cm (V5) was selected for analysis [15].…”

Section: Nasal Provocation Testsmentioning

confidence: 99%

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Acoustic Rhinometry in Nasal Provocation Tests in Children and Adolescents

Gf¹,

Ai²,

Matsumoto³

et al. 2016

J Investig Allergol Clin Immunol

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Objectives: To standardize acoustic rhinometry (AR) in nasal provocation tests (NPTs) with histamine in children and adolescents. Patients and Methods: We performed a cross-sectional validation to compare AR with anterior active rhinomanometry (AAR) during histamine NPT in 20 children and adolescents with persistent allergic rhinitis and 20 controls. Changes in total nasal resistance (AAR) were compared with changes in nasal volume in the first 5 cm (V5 ; P=.04) at baseline. The mean histamine concentration necessary to increase total nasal resistance by at least 100% was significantly lower in the rhinitis group than in the control group (0.72 mg/mL vs 2.4 mg/mL; P<.001). At the end of the NPT a mean increase of 126% in total nasal resistance and a mean decrease of 24.3% in V5 were observed in the rhinitis group. When compared with the AAR criteria, the highest sensitivity and specificity values were observed for a cutoff represented by a 19%-21% drop in V5. Conclusions: We found AR to be a feasible and sensitive tool for monitoring nasal response in children and adolescents undergoing histamine NPT. The best AR cutoff for ending the NPT was a 19%-21% drop in V5. Key words: Rhinitis. Nasal provocation tests. Histamine. Acoustic rhinometry. Rhinomanometry. Nasal cavity. Airway resistance. ResumenObjetivos: Estandarizar la rinometría acústica (RA) como medida de la respuesta a la prueba de provocación nasal con histamina (PPN) en niños y adolescentes. Pacientes y métodos: Se realizó un estudio de validación transversal comparando la RA frente a la rinomanometría anterior (RAA) activa en la evaluación de la respuesta frente a la PPN con histamina, realizado en 20 niños o adolescentes, diagnosticados de rinitis alérgica persistente y 20 controles sanos. Las variables estudiadas fueron los cambios en la resistencia nasal total, medida mediante RAA y los cambios en el volumen nasal de los primeros 5 cm (V5) evaluados mediante RA. Resultados: En relación con los sujetos control, los pacientes con rinitis alérgica presentaban niveles basales de resistencia nasal total significativamente más elevados (medias respectivas 0,34 Pa/cm 3 /s versus 0,21 Pa/cm 3 /s; p= 0,01) y valores de V5 significativamente inferiores (medias respectivas 8,20 cm 3 versus 9,24 cm 3 ; p= 0,04). La concentración media de histamina necesaria para incrementar el 100% la resistencia total nasal fue significativamente más baja en los pacientes con rinitis que en los controles (medias respectivas 0,72 mg/ml versus 2,4 mg/ml; p< 0,001). Al final de la PPN el incremento medio de la resistencia nasal total fue del 126%, en los sujetos con rinitis alérgica. En ese momento también se observó en este grupo un decremento medio del V5 del 24,3%. Utilizando como patrón oro de respuesta positiva un incremento en la resistencia nasal total del 100% mediante RAA, los puntos de corte con mayor sensibilidad y especificidad para el descenso de V5 se encontraban en un descenso de entre el 19 y 21%. Conclusiones: Nuestros resultados demuestran que la RA es ...

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Section: Resultsmentioning

confidence: 95%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Acoustic Rhinometry in Nasal Provocation Tests in Children and Adolescents

Gf¹,

Ai²,

Matsumoto³

et al. 2016

J Investig Allergol Clin Immunol

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“…This hypothesis has been tested in several in vivo studies. Except for one study that reported a strong correlation between mCSA and nasal resistance (Roithmann et al, 1994), all other studies found either a moderate correlation between these variables (typically Pearson ∣r∣ = 0.4 to 0.6) (Scadding et al, 1994; Tai et al, 1998; Wandalsen et al, 2012; Yepes-Nunez et al, 2013), or no correlation at all (Naito et al, 2001; Numminen et al, 2002; Passali et al, 2000; Zhao et al, 2014). To the best of our knowledge, a systematic investigation of the relationship between nasal resistance and mCSA has not been performed.…”

Section: Introductionmentioning

confidence: 99%

The relationship between nasal resistance to airflow and the airspace minimal cross-sectional area

Garcia

Hariri

Patel

et al. 2016

Journal of Biomechanics

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The relationship between nasal resistance (R) and airspace minimal cross-sectional area (mCSA) remains unclear. After the introduction of acoustic rhinometry, many otolaryngologists believed that mCSA measurements would correlate with subjective perception of nasal airway obstruction (NAO), and thus could provide an objective measure of nasal patency to guide therapy. However, multiple studies reported a low correlation between mCSA and subjective nasal patency, and between mCSA and R. This apparent lack of correlation between nasal form and function has been a long-standing enigma in the field of rhinology. Here we propose that nasal resistance is described by the Bernoulli Obstruction Theory. This theory predicts two flow regimes. For mCSA > Acrit, the constriction is not too severe and there is not a tight coupling between R and mCSA. In contrast, when mCSA < Acrit, nasal resistance is dominated by the severe constriction and it is predicted to be inversely proportional to the minimal cross-sectional area (R ∝ mCSA−1). To test this hypothesis, computational fluid dynamics (CFD) simulations were run in 3-dimensional models based on computed tomography scans of 15 NAO patients pre- and post-surgery (i.e., 60 unilateral nasal cavities). Airspace cross-sectional areas were quantified perpendicular to airflow streamlines. Our computational results are consistent with the theory. Given that in most people mCSA > Acrit (estimated to be 0.37 cm2), this theory suggests that airway constrictions are rarely an exclusive contributor to nasal resistance, which may explain the weak correlation between mCSA and subjective nasal patency.

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“…23,24 The sensitivity and specificity were found to be 32.3% and 70.8%, respectively, in our study. The family and physician's reluctance or hesitation is another disadvantage of this technique; in which case, the lateral cranial x-ray may need to be repeated for correct dose and position.…”

Section: Discussionmentioning

confidence: 66%

Validity of Acoustic Rhinometry in the Evaluation of Patients With Adenoid Hypertrophy

Uyar

Tekat²,

Koyuncu³

et al. 2014

Journal of Craniofacial Surgery

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Reliability of acoustic rhinometry (AR) for preoperative diagnosis and decision of surgery in children with adenoid hypertrophy were investigated in this study. Fifty-five children who cannot tolerate nasal endoscopic examination were included. The AR was performed preoperatively and postoperatively 1 month later. The volume of distance between the 6th and 10th centimeters in rhinogram curve was calculated for evaluating the adenoid notch (AN) region. The volume of AN region was compared with each patient's volume of the adenoid tissue removed with adenoidectomy. Whereas the median adenoid specimen volume was 2.0 (1.0-2.0) cm3 in 23 patients with complaint of nasal obstruction, median AN volumes in the rhinogram curve was 2.3 (0.8-5.2) cm3. All children whose preoperative nasopharyngeal volume was 4.2 cm3 or less had increased volume in the area representing the nasopharynx on rhinogram. We found a statistically significant relationship between the AN and the adenoid specimen volume (P = 0.000, r = 0.797). The sensitivity and specificity were found as 61.2% and 95.8%, respectively. We concluded that the children whose preoperative nasopharyngeal volumes were measured as 4.2 cm3 or less by AR could benefit more from adenoidectomy.

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Correlation between nasal resistance and different acoustic rhinometry parameters in children and adolescents with and without allergic rhinitis

Abstract: Our data showed that NR and acoustic rhinometry parameters have negative and significant correlations. Nasal volumes are, in general, better correlated than minimal cross-sectional areas. V5 was the parameter with the highest correlation in the rhinitis group and in the combined analysis.

Cited by 16 publications

References 27 publications

Acoustic Rhinometry in Nasal Provocation Tests in Children and Adolescents

Acoustic Rhinometry in Nasal Provocation Tests in Children and Adolescents

The relationship between nasal resistance to airflow and the airspace minimal cross-sectional area

Validity of Acoustic Rhinometry in the Evaluation of Patients With Adenoid Hypertrophy

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