P185: Positive Cottle Test in Randomly Selected Volunteers

Abstract

CONCLUSIONS: Patient information on the internet is dominated by U.S. sites. Information from the ENT-UK web site is not on the listing by all search engines. There are few good quality web sites that explain the nature and risks of ESS, which may help patients in making decisions regarding treatment. Most of the information on the sites relates to postoperative care. A higher ranked web site is no indication of reliability.

Evaluation of the Patient with Nasal Obstruction

“…Because it can suffer from concurrent static and dynamic obstruction, evaluation of the external nasal valve can be particularly complex. [5][6][7] Even when faced with an obviously narrowed or floppy nostril, it can sometimes be difficult to determine the appropriate management. According to Bernoulli's principle, as a fluid-such as air-moves faster, its pressure will decrease.…”

“…The importance of a thorough history and physical examination should not be underestimated, as objective measurements of nasal patency and specific diagnostic tests often do not correlate with subjective airflow, 3,4 specifically as it relates to the nasal valve. [5][6][7] The approach to nasal obstruction varies among specialists. According to Shemirani et al, 8 otolaryngologists were more likely to perform nasal endoscopy to diagnose nasal obstruction, whereas allergy testing was the most common diagnostic test used by allergists.…”

An evidence‐based approach to the management of the adult with nasal obstruction

“…By providing maximal resistance to airflow even minor narrowing of this area can, according to Poiseuille’s law, lead to symptomatic obstruction for the patient. Manually elevating the cheek to restore nasal patency by indirectly widening the nasal valve has been traditionally used to diagnose this condition (Cottle’s manoeuvre) but there remains doubt over its specificity 4 Anterior rhinoscopy.…”