Diagnosing nasal obstruction and its common causes using the nasal acoustic device: A pilot study

Li, Chia-Hung; Kaura, Anika; Tan, Calvin; Whitcroft, Katherine L.; Leung, Terence S.; Andrews, Peter

doi:10.1002/lio2.445

Cited by 6 publications

(5 citation statements)

References 36 publications

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“…We first introduced the NOBI concept in a pilot study using the nasal acoustic device to diagnose nasal obstruction (NO). 20 Here we demonstrated that the NOBI model could be applied to NIPF measurements and nasal acoustic scores. The NOBI values were used to identify the presence of a deviated nasal septum (DNS) with a sensitivity of 68% using NIPF and 77% using NAD acoustic scores.…”

Section: Key Findingsmentioning

confidence: 80%

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The Nasal Obstruction Balance Index: A Novel Approach to Improving Correlation Between Unilateral Nasal Airway Measurements and Evaluating Nasal Airway Asymmetry

et al. 2021

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Objectives/Hypothesis: Demonstrate that the Nasal Obstruction Balance Index (NOBI) model fulfils the unmet need of improving unilateral correlation between subjective and objective nasal obstruction outcome measures and identifying the more obstructed side.1. Improve correlation between unilateral objective nasal airway measurements (nasal inspiratory peak flow [NIPF] and acoustic rhinometry [AR]) and subjective Visual Analogue Scale for nasal obstruction (VAS-NO) scores. 2. Improve assessment of nasal airway asymmetry by evaluating unilateral measurements both before and after the application of nasal decongestant; which the patient could better understand. NOBI represents a ratio calculated by taking the difference between left and right nasal airway measurements and divided by the maximum unilateral measurement. It is based on Poiseuille's law and aims to reduce the confounding variables which challenge nasal airway measurement.Study Design: Prospective cohort study. Methods: Forty-three controls and 34 patients with nasal obstruction underwent both unilateral and bilateral NIPF, AR and VAS-NO measurements; these were repeated after the application of nasal decongestant. The NOBI values for unilateral NIPF, AR, and VAS-NO were calculated both before and after decongestant.Results: The correlation between unilateral NIPF and AR measurements was enhanced considerably (r = 0.57, P < .01) when NOBI was applied. The NOBI metric significantly increased the correlation between unilateral NIPF, AR, and VAS-NO scores. Postdecongestant NOBI for NIPF and AR measurements correctly identified the more obstructed side in 82.4% and 94.1% of the deviated nasal septum (DNS) cases, respectively. Conclusion:The NOBI model provides a better correlation between unilateral subjective and objective measurements and identifies the more obstructed side.

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Section: Key Findingsmentioning

confidence: 80%

“…We first introduced the NOBI concept in a pilot study using the nasal acoustic device to diagnose nasal obstruction (NO) 20 . Here we demonstrated that the NOBI model could be applied to NIPF measurements and nasal acoustic scores.…”

Section: Discussionmentioning

confidence: 99%

The Nasal Obstruction Balance Index: A Novel Approach to Improving Correlation Between Unilateral Nasal Airway Measurements and Evaluating Nasal Airway Asymmetry

et al. 2021

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“…Despite development of techniques to measure nasal obstruction, such as nasal inspiratory peak flow (NIPF), Andrews et al demonstrated that improvement in NIPF does not necessarily correlate with improved selfreported functional outcomes. 20 Although studies are underway to further evaluate novel methods of assessing nasal obstruction quantitatively, such as acoustic rhinometry, 21 there is currently no consensus as to how this should best be measured and documented. This therefore means that patient-reported outcome measures, such as SNOT-22, NOSE, and FACE-Q, remain the mainstay of postoperative evaluation of surgical success.…”

Section: Discussionmentioning

confidence: 99%

Litigation in Septorhinoplasty Surgery: A Pan-Specialty Review of National Health Service (the United Kingdom) Data

et al. 2022

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Introduction Success in septorhinoplasty surgery can be difficult to assess, due to a lack of objective and measurable outcomes. If patients’ expectations are not met, this places surgeons performing septorhinoplasty at risk of litigation, which can be stressful and costly. Methods NHS Resolution is a government funded organisation in the UK, which provides expertise to the NHS on resolving patient concerns. Data was requested from NHS Resolution for claims involving septorhinoplasty surgery over a period of five years between April 2015 and April 2020. Rhinoplasty claims performed by all specialties were included. Data included the claim status, incident details, alleged injury, damages claimed, and damages paid. Results A total of 31 claims were identified by the study, equating to a total cost of £1,347,336.10. Of the 31 claims for rhinoplasty or septorhinoplasty, nine cases were open (29%, £962,361.00) and 22 cases were closed (71%, £384,975.10). The common causes for claims were ‘intra-op problems’ (32%), ‘failure to warn – informed consent’ (19%) and ‘foreign body left in situ’ (13%). The most common injuries were ‘cosmetic disfigurement’ (39%), ‘unnecessary pain’ (29%) and ‘additional/ unnecessary operation’ (29%). Conclusion This study highlights the need for improved awareness of clinical negligence claims among surgeons who perform septorhinoplasty. Results are applicable to all specialities who perform the procedure. The study highlights the importance of assessing patients’ motives and expectations prior to surgery, and emphasises the need for a well-documented rigorous consent process.

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“…The CRS patient group exhibited a lower percentage change in unilateral nasal inspiratory peak flow (uNIPF) after applying nasal decongestant compared to the non-CRS group. Conversely, the AR patient group showed an opposite trend 5 .…”

Section: Introductionmentioning

confidence: 88%

Segmentation of endoscopy images of the anterior nasal cavity using deep learning

Phoommanee,

Andrews,

Leung

2024

Medical Imaging 2024: Computer-Aided Diagnosis

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Nasal obstruction (NO), which affects one-third of the adult population, is characterized by a blockage in the nasal cavity. Rhinologists commonly employ nasal endoscopy (NE) in the differential diagnosis of NO, along with a focused history and other examinations such as skin prick tests and CT scans. This study aims to establish NE as a reliable standalone diagnostic tool, eliminating the necessity for CT scans and skin prick tests in the diagnosis of NO. However, currently, there is a lack of objective methods to quantify the severity of NO. To address this problem, we used deep learning to identify the anatomical structures of the anterior nasal cavity, which will then be graded by an objective grading system. In this paper, we evaluated the performance of various deep learning methods (DeepLabv3+, MaskFormer, and Mask2Former) with different pre-trained backbones (ResNet-101 -CNN-based, and Swin-Tiny -transformer-based), for semantic segmentation of the anterior nasal cavity. Sixty-two participants were examined with NE before and after using a nasal decongestant. For model training and validation, 608 images from 46 participants were utilized, and 171 images from 16 participants were reserved for testing. The fine-tuned Mask2Former with low-light image enhancement achieved a mean intersection-over-union of 81.7% and 61.2% on the validation and testing sets, respectively. These findings represent the first successful semantic segmentation of key anatomical structures within the anterior nasal cavity. These segmented structures will serve as the basis for classifying the severity of NO and diagnosing NO conditions, enabling AIbased consultations in primary care settings such as general practices and remote locations, where access to ENT expertise may be limited.

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Diagnosing nasal obstruction and its common causes using the nasal acoustic device: A pilot study

Cited by 6 publications

References 36 publications

The Nasal Obstruction Balance Index: A Novel Approach to Improving Correlation Between Unilateral Nasal Airway Measurements and Evaluating Nasal Airway Asymmetry

The Nasal Obstruction Balance Index: A Novel Approach to Improving Correlation Between Unilateral Nasal Airway Measurements and Evaluating Nasal Airway Asymmetry

Litigation in Septorhinoplasty Surgery: A Pan-Specialty Review of National Health Service (the United Kingdom) Data

Segmentation of endoscopy images of the anterior nasal cavity using deep learning

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