Investigation of Repeatability of Peak Nasal Inspiratory Flow Rate Measurements Under Baseline Conditions and After Administration of 0.05% Oxymetazoline

Abstract

Objectives Peak nasal inspiratory flow (PNIF) measurement is an inexpensive and user-friendly method to assess nasal patency. However, the repeatability of PNIF measurements, as well as the threshold value of a change in PNIF, which can be considered significant remain unclear. This study aims to investigate the repeatability of PNIF measurements and the change in PNIF after the administration of 0.05% oxymetazoline. Methods Repeated measurements of PNIF (Clement Clarke In-Check nasal inspiratory flow meter; Clement Clarke International, Ltd, Harlow, Essex, UK) were obtained in 333 healthy volunteers (174 women). Based on age, participants were categorized into three groups (6–7 years, 13–14 years, and 20–45 years). We obtained five measurements in each participant. PNIF was remeasured in 294 subjects 30 min after administration of 0.05% oxymetazoline. The variability in PNIF measurements was assessed using the coefficient of variation (CV = standard deviation × 100%/mean). Results The first four PNIF measurements significantly differed from each other. The difference in PNIF measurements ceased to be statistically significant only between the fourth and fifth measurements (p = 0.19). PNIF repeatability was acceptable; the median CV was 15.5% (0–66), which did not significantly differ between age groups. The administration of 0.05% oxymetazoline led to a statistically significant increase in the PNIF value by 14.3% (−45, 157%) (p = 0.000000). Conclusions 1. No statistically significant difference was observed in PNIF values only between the fourth and fifth measurements; therefore, at least three measurements are essential to draw meaningful conclusions. 2. PNIF measurements were satisfactorily characterized by a relatively low CV (15%). 3. The administration of 0.05% oxymetazoline led to an increase in PNIF by approximately 14% over the baseline value.

Role of trigeminal sensation in patients without nasal obstruction: A pilot study

“…Oxymetazoline has potent decongestant effects, and in some studies has affected NOSE values in septoplasty patients and PNIF values in healthy patients. 6,7 The trigeminal nerve receptors and their function play an important role in nasal sensation. When stimulated by eucalyptol, the TRPM8 receptor creates the feeling of a clear nasal passage.…”

“…We found a significant difference between the change in assessments with control intranasal spray compared with the change assessments with oxymetazoline intranasal spray in TNSS, and did not find a difference in NOSE or PNIF. Oxymetazoline has potent decongestant effects, and in some studies has affected NOSE values in septoplasty patients and PNIF values in healthy patients 6,7 …”

Comparison of Allergen Immunotherapy Alone and in Conjunction With Turbinate Surgery for Nasal Obstruction in Perennial Allergic Rhinitis Patients

“…NPIF was measured as L/minute with an anesthetic face mask which was attached to an In-Check flow meter (Clement Clarke International, Harlow, Essex, UK). 18 The mask provided an airtight seal while allowing full movements of the anterior nares. After a full expiration, patients were instructed to take a maximal inspiration through their nostrils with their mouth closed.…”

Reflecting on the Work of the Giants That Come Before You

“…2 Kim et al, examine the effect of low strength hypochlorous acid in the treatment of allergic rhinitis 3 , and Dor-Wojnarowska et al, examine the repeatability of peak nasal flow and its modulation by oxymetazoline. 4 Fiorenza et al, continue the long honored, but often forgotten, art of anatomical analysis through the interpretation of radiographic images 5 , and McKeon et al, return to the regularly lost art of simply speaking to their patients, as they analyze whether or not preoperative phone calls can actually improve outcomes and decrease questions after endoscopic sinus surgery. 6 It is incredible to think that over the past 30 years, the safety of general anesthesia has increased almost 60-fold, and Levi et al, examine whether pushing the age boundaries of elective anesthesia for endoscopic sinus surgery aligns with that trend-a point of importance for the large segment of our aging population.…”