Does Nasal Obstruction Mean That the Nose Is Obstructed?

Kjærgaard, Thomas; Cvancarova, Milada; Steinsvåg, Sverre K.

doi:10.1097/mlg.0b013e318173a025

Cited by 76 publications

(112 citation statements)

References 11 publications

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“…NO-VAS was categorized as mild (0-30 mm), moderate (31-70 mm) and severe (71-100 mm) (29) . PNIF was used as a continuous Further, we fitted ordinal logistic regression to assess possible association between VAS (in three categories) and having asthma.…”

Section: Discussionmentioning

confidence: 99%

The determining factors of peak nasal inspiratory flow and perception of nasal airflow in asthmatics

Thorstensen

Sue‐Chu

Bugten

et al. 2014

Rhin

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Background: The effect of pulmonary pathology on peak nasal inspiratory flow (PNIF) remains largely unknown. We investigated an association between a diagnosis of asthma and of lung function on PNIF when adjusted for possible confounders. Further, we investigated the perception of nasal obstruction in asthmatics compared to healthy controls when adjusted for PNIF.Methodology: Eighty-seven asthmatics and 92 non-asthmatic controls underwent PNIF (categorized into groups of high, medium and low), acoustic rhinometry (AR) and spirometry, and we assessed symptoms of nasal obstruction on visual analogue scales (VAS) in three categories.Results: PNIF was significantly associated with asthma and forced expiratory volume in the first second (FEV1) (% predicted).Other factors associated with PNIF were the degree of nasal obstruction measured both subjectively on a VAS and objectively with AR, age and disease status. Asthma patients were 19 times more likely to be in a higher VAS category compared to non-asthmatic controls independent of PNIF group. Conclusion:Special care has to be taken when interpreting PNIF values in patients with asthma or reduced FEV1 (% predicted).The sensation of nasal obstruction in asthmatics is different from controls despite being in the same PNIF group.

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Section: Discussionmentioning

confidence: 99%

The determining factors of peak nasal inspiratory flow and perception of nasal airflow in asthmatics

Thorstensen

Sue‐Chu

Bugten

et al. 2014

Rhin

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“…Este hallazgo es compatible con lo descrito por Zhang y cols 15 quienes diseña-ron un trabajo prospectivo que incluyó 316 pacientes con obstrucción nasal, en el cual encontraron una correlación significativa entre las resistencias nasales rinomanométricas y los volúmenes medidos por rinometría acústica. Esto es compatible con hallazgos de otros estudios que miden flujo nasal 14,16,17 , los cuales también se correlacionarían con las mediciones rinométricas.…”

Section: Discussionunclassified

“…En el caso de la ATM3, a pesar de no alcanzar valores significativos de asociación estadística, la probabilidad de asociación obtenida fue bastante cercana al punto de corte, pudiendo mostrar una tendencia que alcanzara significancia con un tamaño muestral más grande. Estos resultados fueron similares a lo reportado en un estudio que incluyó 2.523 pacientes 17 , en el cual se encontró correlación significativa entre los síntomas referidos por los pacientes, y las áreas mínimas transversales mínimas (totales y posteriores) de la fosa nasal, así como los volúme-nes, no encontrando asociación con el área transversal mínima anterior. De este modo, existen otros trabajos que muestran, tanto una correlación significativa entre los síntomas subjetivos y los valores entregados por la rinometría acústica 2,14 , como otros en los que no se obtuvo dicha correlación 14,18 .…”

Section: Discussionunclassified

Rol de la rinometría acústica en la evaluación de los pacientes candidatos a rinoseptoplastía

et al. 2009

Rev. Otorrinolaringol. Cir. Cabeza Cuello

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RESUMENIntroducción: La obstrucción nasal es un síntoma de difícil evaluación particularmente en pacientes candidatos a rinoseptoplastía. Existen diferentes métodos para valorarla, dentro de los cuales se encuentra la rinometría acústica, la cual entrega las áreas transversales y volúmenes nasales en función de la distancia desde las narinas.Objetivos: El objetivo del presente trabajo fue comparar los resultados de la rinometría acústica con los obtenidos por otros métodos de evaluación de la obstrucción nasal.Material y método: Se diseñó un estudio prospectivo, descriptivo. Se evaluaron 26 fosas nasales correspondientes a 13 pacientes candidatos a rinoseptoplastía, mediante rinoscopía anterior, endoscopía nasal, rinomanometría y sensación subjetiva de obstrucción nasal referida por el paciente. Luego se comparó dicha evaluación con los datos obtenidos mediante la rinometría acústica.Resultados: Se obtuvo una buena asociación entre los valores entregados por la rinometría acústica y tanto la sensación subjetiva de obstrucción nasal referida por el paciente como la rinomanometría. Por otra parte, no hubo buena asociación entre la rinometría acústica y, tanto la rinoscopía anterior como la endoscopía.Conclusiones: La rinometría acústica es una herramienta útil para la evaluación de la obstrucción nasal de pacientes candidatos a rinoseptoplatía, sin embargo no reemplaza la correcta valoración clínica.Palabras clave: Obstrucción nasal, rinometría acústica, rinomanometría, rinoseptoplastía. ABSTRACTIntroduction: Nasal obstruction is difficult to evaluate, particularly in candidates to rhinoseptoplasty. One of the methods available to assess nasal obstruction is acoustic rhinometry, which yields an estimate of nasal cross-sectional area and nasal volume as a function of distance from the nostrils.Aim: The aim of this study was to compare results from acoustic rhinometry to those obtained using other nasal obstruction evaluation methods. Alternative methods used were: Anterior rhinoscopy, nasal endoscopy, rhinomanometry, and subjective sensation of nasal obstruction as reported by the patient.Material and method: A prospective, descriptive study design was used, evaluating a total of 26 patients.Results: A good association was found between the values produced by acoustic rhinometry and those obtained by rhinomanometry and the subjective sensation of nasal obstruction reported by patients. On the other hand, the association between acoustic rhinometry and both anterior rhinoscopy and nasal endoscopy was weak.

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“…Peak nasal inspiratory flow and rhinomanometry are useful for evaluating the severity of nasal congestion (score, 1B), whereas acoustic rhinometry was given a score of 2B (weak recommendation, moderate-quality evidence). PNIF and AcRh outcomes have relatively low correlations (R 2 5 0.13 to 0.35; P , 0.001; n 5 2,523) (28), but other factors such as pressure (wall strain), stress (wall deformation by airflow), temperature, secretions, the presence of irritants or fine particulate matter in inhaled air, and other confounding factors may reduce the statistical relationship between fullness and geometric and flow outcomes. This has been demonstrated by applying aromatics such as L-menthol, vanilla, and camphor into the nostrils.…”

Section: Subjective Perceptions Of Fullness Versus Objective Measuresmentioning

confidence: 99%

“…The relationship between this statement and objective measurements of airflow restriction has been tested by several methods. Acoustic rhinometry (AcRh), rhinomanometry, nasal peak inspiratory flow, and vasoconstrictor responses to sympathomimetics (congestion index) (24,26,27) rely on changes in airway dimensions and geometry to determine whether the nose is obstructed (28). Microstereometry and laser Doppler studies examine smaller scale changes in the superficial lamina propria vessels (2).…”

Section: Subjective Perceptions Of Fullness Versus Objective Measuresmentioning

confidence: 99%

Subjective Nasal Fullness and Objective Congestion

Baraniuk¹

2011

Proceedings of the American Thoracic Society

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How well do subjective descriptions of the sensation of nasal closure or absence of nasal patency agree with objective measures of nasal geometry and airflow? Problems with this concept begin with terminology. ''Congestion'' has been applied to both the subjective and objective measures. Therefore, the term ''fullness'' will be used to describe perceptions of nasal mucosal heaviness or blockage that subjects with allergic rhinitis articulate. ''Congestion'' will refer to the objective measures used to assess patency. Sensations attributed to the nasal mucosa are highly integrated interpretations summed from multiple subsets of nociceptive and other neurons. Activation of sensor systems is required to depolarize afferent neurons. These sensors and other receptor proteins can be modulated by inflammation as part of the neural plasticity that leads to increased sensitivity to nasal stimuli. This plasticity and hyperalgesia may extend from the afferent neuron to spinal cord dorsal horn synapses, and regulatory and analytical regions of the brainstem and cerebrum. Although glandular hypersecretion can deliver obstructing material into the nasal cavities, the dilation of deep venous sinusoids is the strongest factor regulating nasal airspace volumes. There is a long history of attempts to correlate subjective sensations to objective measurements such as airflow resistance (rhinomanometry), nasal wall geometry (acoustic rhinometry), and peak nasal inspiratory flow. The medical evidence supporting each method has been analyzed on the basis of the GRADE (Grading of Recommendations Assessment, Development, and Evaluation) system. These results provide a starting point for linking the outcomes of pathophysiological processes with a patient's psychometrically calibrated sensation of airflow.

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Does Nasal Obstruction Mean That the Nose Is Obstructed?

Cited by 76 publications

References 11 publications

The determining factors of peak nasal inspiratory flow and perception of nasal airflow in asthmatics

The determining factors of peak nasal inspiratory flow and perception of nasal airflow in asthmatics

Rol de la rinometría acústica en la evaluación de los pacientes candidatos a rinoseptoplastía

Subjective Nasal Fullness and Objective Congestion

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