Peak nasal inspiratory flow evaluation as an objective method of measuring nasal airflow

Abstract

Acoust ic rhinometry, rhinomanometry and Inspiratory Peak Nasal Flow (IPNF) are used in order to objectively assess nasal patency. These are expensive not very practical tests, except for IPNF, which is a fast, simple and low cost method.Objective: To assess IPNF in healthy individuals complaining of nose obstruction caused by allergic rhinitis.Method: IPNF use in 78 individuals with and without rhinitis symptoms. Study design: Contemporary cross-sectional cohort.Results: IPNF showed significant results for nasal obstruction, rhinorrhea, pruritus, sneezes and tearing (p < 0.001). There was no correlation between the presence of nasal septum deviation and IPNF (p = 0.561). We found a positive correlation between IPNF and the Visual Analogue Scale (VAS) for nasal obstruction (p = 0.002). In the multiple linear regression model, there was a statistical significance between the values found in IPNF with allergic rhinitis and age (p = 0.005 and p = 0.023 respectively). Conclusion:IPNF proved to be a reliable method to detect changes in nasal patency, by obstructive causes as well as inflammatory causes, with an acceptable level of statistical significance, simple, easy to handle, inexpensive and reproducible. Braz J Otorhinolaryngol. 2011;77(4):473-80. BJORL ORIGINAL ARTICLE

Nasal Peak Inspiratory Flow in Healthy and Obstructed Patients: Systematic Review and Meta‐Analysis

“…Rhinitis was defined according to the validated Meltzer scoring system, where signs and symptoms such as turbinate swelling and nasal congestion were assessed by clinicians and assigned a score using a four‐point scale from 0 to 3, where 0 represented no symptoms; 1, mild; 2, moderate and 3, severe 42 . In another study, ENT physicians diagnosed rhinitis on the basis of positive history, anterior rhinoscopy, and nasal fibroscopy 3 . Allergic rhinitis was defined according to the ARIA (Allergic Rhinitis and its Impact on Asthma) initiative, with positive skin‐prick test to airborne allergens 30,38 .…”

“…The included studies consisted of cohorts (n = 18), 3,6,17,18,21–24,28–30,32–34,37–40 case controls (n = 6), 2,4,15,31,35,36 or case series (n = 5) 11,12,25–27 . These studies involved healthy subjects (n = 1727), 2–4,6,15,17,18,21,23,29–35 and patients with rhinitis (n = 95), 4 allergic rhinitis (n = 288), 2,3,30,37–39 seasonal allergic rhinitis (n = 182), 24–27 chronic rhinosinusitis (n = 110), 22,28 asthma (n = 87), 36 adenotonsillar hypertrophy (n = 50), 40 and functionally relevant structural nasal deformities (n = 142) 11,12,15,35 . The mean age of subjects ranged from 18 to 72 years (Fig.…”

“…Most studies used the best of three NPIF attempts except for two that used two attempts, 17,29 one that used five attempts, 2 and two where it was not clearly stated 38,40 . The highest value of all attempts was taken as the NPIF in most studies except for five that took the average of all attempts, 2,17,31,36,37 and five that did not specify 3,4,38,40,41 . The residual volume method where patients perform NPIF from the end of a full expiration was used in 15 studies 6,12,15,17,18,24–29,32–35 .…”

“…The residual volume method where patients perform NPIF from the end of a full expiration was used in 15 studies 6,12,15,17,18,24–29,32–35 . This was not specified in 14 studies 2–4,11,21–23,30,31,36–40 …”

“…The studies were pooled as two separate populations: normal nasal breathing or nasal obstruction. SD was imputed for 10 studies 3,15,21–28 using formulae from the Cochrane handbook 20 . The data were analyzed using a random‐effects model and presented as a pooled summary estimate of the mean value with 95% confidence intervals (CIs).…”