The role of unilateral nasal inspiratory peak flow in nasal obstruction—A study of 70 patients undergoing septorhinoplasty surgery

Kaura, Anika; Virk, Jagdeep Singh; Joseph, J.; Rennie, Catherine; Randhawa, Premjit S; Andrews, Peter

doi:10.1111/coa.13295

Cited by 4 publications

(10 citation statements)

References 17 publications

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“…We chose NIPF as it is widely used in our practice and is easy to use. NIPF is a validated tool used in the assessment of nasal airflow which in our practice has been used as a surgical outcome measurement tool for CRS and DNS treatment 36,38 . Although AAR is considered the gold standard for the measurement of nasal resistance, Ottaviano et al 39 demonstrated NIPF to be as accurate as AAR in identifying nasal obstruction.…”

Section: Discussionmentioning

confidence: 99%

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Diagnosing nasal obstruction and its common causes using the nasal acoustic device: A pilot study

Kaura

Tan

et al. 2020

Laryngoscope Investig Oto

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Objectives: There is a need to develop a medical device which can accurately measure normal and abnormal nasal breathing which the patient can better understand in addition to being able to diagnose the cause for their nasal obstruction. The aim is to evaluate the accuracy of the nasal acoustic device (NAD) in diagnosing the common causes for nasal obstruction and diagnosing normal and abnormal (nasal obstruction) nasal breathing. Methods: This pilot study recruited 27 patients with allergic rhinitis (AR), chronic rhinosinusitis (CRS), and a deviated nasal septum (DNS) which represents the common causes for NO and 26 controls (with normal nasal breathing). Nasal breathing sounds were recorded by the NAD akin to two small stethoscopes placed over the left and right nasal ala. The novel outcome metrics for the NAD include inspiratory nasal acoustic score (INA) score, expiratory nasal acoustic (ENA) score and the inspiratory nasal obstruction balance index (NOBI). The change in acoustic score following decongestant is key in this diagnostic process. Results: Pre-decongestant ENA score was used to detect the presence of nasal obstruction in patients compared to controls, with a sensitivity of 0.81 (95% CI: 0.66-0.96) and a specificity of 0.77 (0.54-1.00). Post-decongestant percentage change in INA score was used to identify the presence of AR or CRS, with a sensitivity of 0.87 (0.69-1.00) and specificity of 0.72 (0.55-0.89) for AR; and a sensitivity of 0.92 (0.75-1.00) and specificity of 0.69 (0.52-0.86) for CRS. Post-decongestant inspiratory NOBI was used to identify DNS, with a sensitivity of 0.77 (0.59-0.95) and specificity of 0.94 (0.82-1.00).

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Section: Discussionmentioning

confidence: 99%

“…NIPF is a validated tool used in the assessment of nasal airflow which in our practice has been used as a surgical outcome measurement tool for CRS and DNS treatment. 36,38 Although AAR is considered the gold standard for the measurement of nasal resistance, Ottaviano et al 39…”

Section: Repeatabilitymentioning

confidence: 99%

Diagnosing nasal obstruction and its common causes using the nasal acoustic device: A pilot study

Kaura

Tan

et al. 2020

Laryngoscope Investig Oto

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“…Unliteral measurements were recorded by placing tape over one nostril. 6 The A1 Acoustic Rhinometer (GM Instruments, Kilwinning, UK) was used to measure the Mean Cross-sectional Area (MCA). To simplify analysis, we considered only the MCA1 value which is the narrowest point in the nasal cavity and contributes significantly to nasal airway resistance.…”

Section: Study Design and Protocolmentioning

confidence: 99%

“…However, a significant correlation between these subjective and objective measurements has not been demonstrated. [1][2][3][4][5][6][7] The presence of the nasal cycle, the spontaneous, reciprocal congestion, and decongestion of the nasal mucosa, has been considered a contributing factor to this lack of correlation between objective and subjective measures. 8 Local application of nasal decongestant spray is often used to eliminate this confounding effect.…”

Section: Introductionmentioning

confidence: 99%

“…However, the correlation between unilateral AR (minimal crosssectional area), unilateral NIPF, unilateral VAS-NO, and unilateral nasal airway resistance (from RMM), is poor. [1][2][3][4][5][6] By using ratios of left and right measurements, several studies have reported improved correlation with PROMs. In the context of nasal spirometry, the nasal partitioning of airflow ratio (NPR), which is the subtraction between the two ratios of unilateral total expired nasal volumes, has been shown to correlate well with visual analogue scores (r = 0.94, P < .01).…”

Section: Introductionmentioning

confidence: 99%

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The Nasal Obstruction Balance Index: A Novel Approach to Improving Correlation Between Unilateral Nasal Airway Measurements and Evaluating Nasal Airway Asymmetry

et al. 2021

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Objectives/Hypothesis: Demonstrate that the Nasal Obstruction Balance Index (NOBI) model fulfils the unmet need of improving unilateral correlation between subjective and objective nasal obstruction outcome measures and identifying the more obstructed side.1. Improve correlation between unilateral objective nasal airway measurements (nasal inspiratory peak flow [NIPF] and acoustic rhinometry [AR]) and subjective Visual Analogue Scale for nasal obstruction (VAS-NO) scores. 2. Improve assessment of nasal airway asymmetry by evaluating unilateral measurements both before and after the application of nasal decongestant; which the patient could better understand. NOBI represents a ratio calculated by taking the difference between left and right nasal airway measurements and divided by the maximum unilateral measurement. It is based on Poiseuille's law and aims to reduce the confounding variables which challenge nasal airway measurement.Study Design: Prospective cohort study. Methods: Forty-three controls and 34 patients with nasal obstruction underwent both unilateral and bilateral NIPF, AR and VAS-NO measurements; these were repeated after the application of nasal decongestant. The NOBI values for unilateral NIPF, AR, and VAS-NO were calculated both before and after decongestant.Results: The correlation between unilateral NIPF and AR measurements was enhanced considerably (r = 0.57, P < .01) when NOBI was applied. The NOBI metric significantly increased the correlation between unilateral NIPF, AR, and VAS-NO scores. Postdecongestant NOBI for NIPF and AR measurements correctly identified the more obstructed side in 82.4% and 94.1% of the deviated nasal septum (DNS) cases, respectively. Conclusion:The NOBI model provides a better correlation between unilateral subjective and objective measurements and identifies the more obstructed side.

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Effects of Functional Rhinoplasty on Nasal Obstruction: A Meta-Analysis

2022

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The role of unilateral nasal inspiratory peak flow in nasal obstruction—A study of 70 patients undergoing septorhinoplasty surgery

Cited by 4 publications

References 17 publications

Diagnosing nasal obstruction and its common causes using the nasal acoustic device: A pilot study

Diagnosing nasal obstruction and its common causes using the nasal acoustic device: A pilot study

The Nasal Obstruction Balance Index: A Novel Approach to Improving Correlation Between Unilateral Nasal Airway Measurements and Evaluating Nasal Airway Asymmetry

Effects of Functional Rhinoplasty on Nasal Obstruction: A Meta-Analysis

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