Objective measurement of nasal airway dimensions and resistance using acoustic rhinometry and rhinomanometry in habitual snorers compared with non-snorers

Abstract

Snorers represent a heterogeneous group that requires adequate assessment before recommending surgical treatment. Most studies of the pathophysiology of snoring and obstructive sleep apnea have emphasized anatomical abnormalities in the oropharyngeal and hypopharyngeal airways. It is still unclear if nasal airway restriction plays an important role in sleep-disordered breathing and there is no general consensus if treatment of nasal pathology should be included in the management of patients with snoring or sleep apnea. The aim of this study was to compare nasal dimensions and airflow resistance of habitual snorers with non-snoring individuals by means of acoustic rhinometry and rhinomanometry. Sixty individuals were enrolled in this analytical cross-sectional study. They were divided in two groups: group A (case) consisted of 30 patients with a main complaint of chronic snoring referred to ear, nose, and throat (ENT) clinic of Hazrat-e-Rasoul University Hospital, Tehran, Iran. Group B (control) consisted of 30 individuals without any complaint of snoring. The subjects were assessed objectively with acoustic rhinometry and rhinomanometry. Nasal dimensions and airflow resistance were recorded for all individuals. The most common site of minimum cross-sectional area (MCA) was at the left concha-notch in both snoring and non-snoring individuals. Significant reduction of cross-sectional area of both isthmus and concha notches was seen in habitual snorers (P < 0.05). The mean total airflow resistances in both pressures of 75 and 150 Pa was higher in habitual snorers. Whereas, these differences were not statistically significant (P > 0.05). The results of our study illustrate that acoustic rhinometry, rhinomanometry may be helpful methods for quantitative assessments of nasal airway respiratory function, and configuration in snorers; especially to evaluate site of MCA, decreased nasal cross-sectional area and increased nasal airflow resistance in habitual snorers which may lead to OSA.

The Link between Rhinitis and Rapid-Eye-Movement Sleep Breathing Disturbances in Children with Obstructive Sleep Apnea

“…25 The dissociation of the diagnosis of OSA and AHI severity (determined by total events occurring in REM ϩ NREM) presented by Lofaso 25 26,27 In contrast, the evaluation of daytime nasal dimensions and airflow resistance by acoustic rhinometry and rhinomanometry can discriminate habitual snorers from nonsnoring individuals. 28 Collectively, these data suggest that although rhinitis is associated with increased daytime nasal resistance and snoring, nasal inflammation/congestion maybe linked to OSA by additional sleep-related mechanisms. A possible explanation to this phenomenon might be found in the modulatory effect of sleep stages in nocturnal nasal obstruction.…”

Clinical Application of Nasometry in Patients with Nasal Obstruction

“…These were proven to be effective tools for the measurement of the nasal cavity pressure, nasal airway respiratory function, and configuration of the nasal cavity. [25][26][27] Rhinomanometry has been used to measure total nasal resistance, whereas peak nasal inspiratory flow has often been described as an effective measure for assessing the presence and severity of changes in nasal patency. 25 Both diagnostic tests are difficult to perform and require placement of a mask or cannula, and thus are not well tolerated by patients.…”

The effect of adenoidectomy on occlusal development and nasal cavity volume in children with recurrent middle ear infection

“…Habitual snorers have been found smaller nasal cavity volumes as compared to healthy individuals [46]. The patient's position is an important factor in oral breathing and nasal obstruction.…”