Assessment of nasal obstruction symptoms using the NOSE scale after surgically assisted rapid maxillary expansion

Abstract

The Nasal Obstruction Symptom Evaluation (NOSE) scale is a reliable and valid instrument used widely in otorhinolaryngology to evaluate nasal obstruction symptoms in patients with nasal disorders. The purpose of this study was to assess nasal obstruction symptoms prospectively in patients undergoing surgically assisted rapid maxillary expansion (SARME) using the NOSE scale. Sixteen patients were studied (mean age 31±7.7 years), 10 women and six men, all with a transverse maxillary deficiency and an indication for SARME. Hyrax type devices were placed preoperatively and SARME was performed using Kraut's technique. The NOSE scale was applied prospectively to assess nasal obstruction symptoms. The results were recorded for each score on a scale ranging from 0 to 4, and these scores were multiplied by 5, generating a balanced scale from 0 to 100. Data were stratified according to NOSE scores, and nasal obstruction was categorized as mild (0-25), moderate (26-50), or severe (>50). The questionnaire was administered twice, first preoperatively and then at 6 months after surgery, and the results compared. Data were analyzed statistically using SAS statistical package software and showed that patients experienced a subjective improvement or did not have a worsening of nasal obstruction symptoms after SARME.

Management of midnasal stenosis with infant surgically assisted rapid palatal expansion (iSARPE)

“…Subjective improvement in nasal symptoms has been incidentally noted with this procedure. A 2015 study of patients undergoing SARPE showed at 6 months that their Nasal Obstruction Symptom Evaluation scores were either stable or improved . When rapid maxillary expansion without surgery is used in pediatric patients, an increase in nasal dimensions is also noted by acoustic rhinometry .…”

“…A 2015 study of patients undergoing SARPE showed at 6 months that their Nasal Obstruction Symptom Evaluation scores were either stable or improved. 9 When rapid maxillary expansion without surgery is used in pediatric patients, an increase in nasal dimensions is also noted by acoustic rhinometry. 10 This procedure has never been described with nasal stenosis as the primary indication for surgery.…”

Volumetric upper airway changes following a new technique for Surgically-Assisted Maxillary Expansion (SAME)

“…1 Clinical features of SMC include a narrow palate, unilateral or bilateral posterior cross bite, dental crowding, and difficulty in nasal breathing. [2][3][4] Several approaches are available to treat SMC, including rapid maxillary expansion (RME) and slow maxillary expansion (SME), which are successful in correcting this discrepancy in children aged up to 13-15 years, but they are inefficient after the ossification of the mid-palatal suture occurs. Surgically-assisted maxillary expansion (SAME) is indicated in patients who have already achieved maturity of the mid-palatal suture.…”

“…6 The relationship between SMC and respiratory problems, such as obstructive sleep apnea, has received increasing attention in the recent literature. 4,7,8 The volume of air passing through the nose and the nasopharynx is limited by the shape and diameter of the latter. 9 Some authors observed SMC in patients who presented with constricted nasopharyngeal dimensions and altered the respiratory function.…”

The Upper Airway Nasal Complex: Structural Contribution to Persistent Nasal Obstruction

“…6 Rapid maxillary expansion (RME) that is primarily used to treat transverse maxillary discrepancy is well documented in the dental literature for improvement in nasal airway patency and nasal obstruction. [7][8][9][10] In the pediatric population, RME has been used to improve nasal breathing in patients with obstructive sleep apnea. 11 Given these findings, the primary objective of our study was to characterize maxillary bone skeletal parameters in adult patients with persistent nasal obstruction after initial soft tissue treatment.…”