Guideline Values for Minimum Nasal Cross-Sectional Area in Children

Laine-Alava, Maija T.; Murtolahti, Siiri; Crouse, Ulla; Warren, Donald W.

doi:10.1177/1055665618767107

Cited by 6 publications

(6 citation statements)

References 56 publications

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“…Key details included studies for normative measurement values and treatment indications listed in Appendix A. Three studies [24][25][26] discussed the analysis of peak flow inspiratory flow limitations and parameters, 3 evaluated pediatric and adult acoustic sound measurements with rhinometry [14][15][16], and 14 evaluated rhinomanometry and mean resistance parameters as a diagnostic tool for various treatment options to improve nasal breathing, nasal function, sleep, and overall quality of life [9- 14,[17][18][19][20][21][22][23]27,28 ]. Figure 1 shows a majority of the articles reviewed were published between 2016 and 2022 after the validation of 4-phase rhinomanometry and its increased recognition as a standard of care for measuring nasal function in 2015 [29][30] .…”

Section: Discussionmentioning

confidence: 99%

“…This was conducted by establishing current researched normal measurement values and parameters for each technology as part of the algorithm [9-28]. We found consistency among the measurement variables discussing the conclusive amount of decrease in nasal pressures, increase in cross-sectional measurements, increase in nasal volume, and increases in inspiration measured in liters per minute among gender differences, age, and height used in the context of the scoring platform [10,11,[14][15][16][24][25][26]34]. The validated measurements and biomarkers guided the formulation of an algorithm for DAFNE Scoring System from the login page, to entering the measurement value, to understanding the data to suggestions for interprofessional collaborative care.…”

Section: Measurement Values Of Rhinomanometry Acoustic Rhinometry And...mentioning

confidence: 99%

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Validation of a Novel User Interface and Calculation Method For Determining Nasal Resistance And Patency

Davidson¹,

Harrell²

2022

Preprint

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Background: The Davidson Airway Function &amp; Nasal Evaluation (DAFNE) Scoring System was developed as an intuitive and research-based scoring system that could be validated through beta testing and easily introduced to healthcare providers of several subspecialties who treat nasal obstruction and breathing disorders (MDs, PAs, PTs, APRNs, DDSs, and DCs). This scoring system was shown to increase the knowledge of airway function, nasal measurement parameters, and identification of proper treatment options for sleep and breathing disorders. The basis for the DAFNE score was developed from a systematic review of nasal measurement data. Methods: Electronic searches of PubMed, MEDLINE, EMBASE Cochrane Library, and Scopus of publications between 1988-2022 were used to identify studies validating nasal function measurement parameters to create the algorithm for the DAFNE Score™. The systematic review was accomplished using the 2020 ‘Preferred Reporting Items for Systematic Reviews’ (PRISMA) guidelines. Results: Twenty studies met the inclusion criteria for systematic review. Primary outcomes measurements demonstrated reliability, repeatability and validity of the DAFNE measurement technologies, data and output. Conclusions: The data analysis and systematic review uncovered a need and framework to develop and validate a web-based software algorithm for global access to improve the understanding of data interpretation of nasal measurements from three nasal measurement technologies. DAFNE Scoring should be used as an adjunct tool in routine clinical practice and research to further understand the technology data output and how to collaborate with other healthcare providers to improve patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Measurement Values Of Rhinomanometry Acoustic Rhinometry And...mentioning

confidence: 99%

Validation of a Novel User Interface and Calculation Method For Determining Nasal Resistance And Patency

Davidson¹,

Harrell²

2022

Preprint

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“…In the most basic form, DAFNE Scoring System evaluates the maximum mean testing score for each instrument and describes how to process the data into the treatment care plan. We found consistency among the measurement variables discussing the conclusive amount of decrease in nasal pressures, increase in cross-sectional measurements, increase in nasal volume, and increases in inspiration measured in liters per minute among gender differences, age, and height used in the context of the scoring platform [10,11,[14][15][16][24][25][26]28,34]. The validated measurements and biomarkers guided the formulation of an algorithm for DAFNE Scoring System from the login page, to entering the measurement value, to understanding the data to suggestions for interprofessional collaborative care.…”

Section: Measurement Values Of Rhinomanometry Acoustic Rhinometry And...mentioning

confidence: 99%

Development and Validation of DAFNE: A Web Based Tool for Determining Airway Treatment Options for OSA and Nasal Breathing Disorders

Davidson¹,

Harrell²

2023

Preprint

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Background: The diagnosis of nasal airway disorders relies on questionnaires, subjective data, and objective data. Interpretation of objective data obtained from measurement technology is not well understood by providers and researchers who use the equipment to test nasal airway function, justifying the need to cre-ate a new clinical tool. The Davidson Airway Function & Nasal Evaluation (DAFNE) Scoring System is a web-based scoring system that allows healthcare providers (MDs, PAs, PTs, APRNs, DMDs, DDSs, SLPs, and DCs) and researchers who treat nasal obstruction and breathing disorders to make more accurate diagnostic decisions, select the appropriate treatment for individualized patient care, monitor treatment progression and outcomes, and show how to approach a collaborative care model with other healthcare professionals. The current technologies, such as 4-phase rhinomanometry, use a simple approach that relies on a measurement tracing intersecting a color-coded y-axis on a four-quadrant graph with diagnostic numeric data output de-scribing nasal airflow and resistance. This is a good source of biofeedback demonstrating abnormal nasal breathing patterns but lacks interpretation guidelines to describe the severity of disease. The more sophisti-cated proprietary DAFNE approach uses multiple parameters which include airflow restriction, speed, vol-ume, and patient characteristics to identify patients’ disease progression much more accurately. Additionally, it explains how to segregate patients into appropriate treatment options which minimizes risks and compli-cations associated with sleep and breathing disorders while improving patient outcomes. Methods: Electronic searches of PubMed, MEDLINE, EMBASE Cochrane Library, and Scopus of publications between 1988-2022 were necessary to identify studies which determined the ranges of nasal function measurement parameters among three airway measurement technologies used in writing the DAFNE Score algorithm. The performance of DAFNE was evaluated compared to the research data and patient demographics used in previous studies. Results: By using primary outcome measurements from the literature, we were able to create a reliable, re-peatable, and validated tool to facilitate patient identification, treatment stratification, and collaboration for sleep and nasal breathing dysfunction. Subsequently, we found DAFNE could be used to identify the appro-priateness of a sleep study. Conclusions: DAFNE Scoring System has demonstrated the ability to detect high risk patients in the pediatric and adult populations susceptible of sleep apnea and breathing dysfunction needing a sleep study and treatment to improve nasal airway function and sleep. DAFNE Scoring System should be used as an adjunct tool in routine clinical practice and research to further understand the technol-ogy data output, identify patients at risk, stratify treatment options, progress, and stabilization after treatment, and how to collaborate with other healthcare providers to improve patient outcomes.

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“…25 Laine-Alava et al hypothesized that the increase in nasal airway size is not uniform during growth in schoolage children and is typically completed at approximately 17 years of age. 26 Moreover, rhinomanometry can be timeconsuming and cumbersome in children. 27 The panel for this CCS supported allergological evaluation but not nasal cytology.…”

Section: Diagnostic Workupmentioning

confidence: 99%

Pediatric Inferior Turbinate Hypertrophy: Diagnosis and Management. A YO‐IFOS Consensus Statement

et al. 2023

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ObjectivePediatric inferior turbinate hypertrophy (PedTH) is a frequent and often overlooked cause or associated cause of nasal breathing difficulties. This clinical consensus statement (CCS) aims to provide a diagnosis and management framework covering the lack of specific guidelines for this condition and addressing the existing controversies.MethodsA clinical consensus statement (CCS) was developed by a panel of 20 contributors from 7 different European and North American countries using the modified Delphi method. The aim of the CCS was to offer a multidisciplinary reference framework for the management of PedTH on the basis of shared clinical experience and analysis of the strongest evidence currently available.ResultsA systematic literature review following the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) criteria was performed. From the initial 96 items identified, 7 articles were selected based on higher‐evidence items such as randomized‐controlled trials, guidelines, and systematic reviews. A 34‐statement survey was developed, and after three rounds of voting, 2 items reached strong consensus, 17 reached consensus or near consensus, and 15 had no consensus.ConclusionsUntil further prospective data are available, our CCS should provide a useful reference for PedTH management. PedTH should be considered a nasal obstructive disease not necessarily related to an adult condition but frequently associated with other nasal or craniofacial disorders. Diagnosis requires clinical examination and endoscopy, whereas rhinomanometry, nasal cytology, and questionnaires have little clinical role. Treatment choice should consider the specific indications and features of the available options, with a preference for less invasive procedures.Level of Evidence5 Laryngoscope, 2023

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Guideline Values for Minimum Nasal Cross-Sectional Area in Children

Cited by 6 publications

References 56 publications

Validation of a Novel User Interface and Calculation Method For Determining Nasal Resistance And Patency

Validation of a Novel User Interface and Calculation Method For Determining Nasal Resistance And Patency

Development and Validation of DAFNE: A Web Based Tool for Determining Airway Treatment Options for OSA and Nasal Breathing Disorders

Pediatric Inferior Turbinate Hypertrophy: Diagnosis and Management. A YO‐IFOS Consensus Statement

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