The clinical value of peak nasal inspiratory flow, peak oral inspiratory flow, and the nasal patency index

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.

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Nasal functional modifications after physical exercise: olfactory threshold and peak nasal inspiratory flow

Rhinology Journal ◽

10.4193/rhino09.141 ◽

2010 ◽

Vol 48 (3) ◽

pp. 277-280

Author(s):

G. Marioni ◽

G. Ottaviano ◽

A. Staffieri ◽

M. Zaccaria ◽

V.J. Lund ◽

...

Keyword(s):

Physical Exercise ◽

Inspiratory Flow ◽

Nasal Patency ◽

Olfactory Threshold ◽

Threshold Test ◽

Significant Difference ◽

The Mean ◽

The Stability ◽

Peak Nasal Inspiratory Flow ◽

Olfactory Thresholds

Statement of problem: The respiratory nasal effects of physical exercise have been extensively investigated; on the other hand there are no data regarding olfactory threshold modification after aerobic physical exercise. Methods: The present prospective study investigated the modifications in nasal respiratory flows and olfactory thresholds after controlled aerobic physical exercise in a cohort of 15 adult, healthy volunteers. The Peak Nasal Inspiratory Flow (PNIF), and the Sniffin’ Sticks olfactory threshold test were used for our determinations. Main results: The mean PNIF after physical exercise was significantly higher than the mean PNIF value found before physical exercise. Statistical analysis ruled out any significant difference between mean olfactory thresholds pre vs post physical exercise. Principal conclusions: These outcomes confirmed PNIF sensitivity and reliability also in determining the changes in nasal patency occurring after physical exercise. The active vasoconstriction of nasal mucosa associated with the reduction of blood flow to the olfactory epithelium due to physical exercise may be compensated for by the increase of olfactory molecules that reach the olfactory mucosa because of nasal mucosal shrinkage: this mechanism could explain the stability of mean olfactory threshold after physical exercise.

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Peak nasal inspiratory flow – the plateau effect

The Journal of Laryngology & Otology ◽

10.1017/s0022215100130282 ◽

1995 ◽

Vol 109 (5) ◽

pp. 399-402 ◽

Cited By ~ 19

Author(s):

R. W. Clarke ◽

A. S. Jones ◽

H. Richardson

Keyword(s):

Inspiratory Flow ◽

Nasal Resistance ◽

Nasal Patency ◽

Progressive Decrease ◽

Respiratory Flow ◽

Recording Change ◽

Peak Nasal Inspiratory Flow

AbstractTo study the efficacy of peak nasal inspiration flow (PNIF) as a means of recording change in nasal patency 20 subjects were given increasing doses of intranasal 5tometazo1ine. Nasal resistance (NR) and peak nasal inspiratory flow (PNIF) were measured in the resting stateand after each xylometazoline administration. Successive increases in dose caused a progressive decrease in nasal resistance and an increase in PNIF but the change in peak nasal inspiratory flow (PNIF) was much less. Peak nasal inspiratory flow shows a plateau effect as nasal resistance decreases. The reasons for this plateau are discussed in terms of respiratory flow mechanics

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Validitas metode rinohigrometri sebagai indikator sumbatan hidung

Oto Rhino Laryngologica Indonesiana ◽

10.32637/orli.v41i2.49 ◽

2011 ◽

Vol 41 (2) ◽

pp. 128

Author(s):

Rachmawati Djalal ◽

Abdul Qadar Punagi ◽

Andi Baso Sulaiman ◽

Fadjar Perkasa

Keyword(s):

Physical Examination ◽

Nasal Cavity ◽

Diagnostic Test ◽

Sensitivity And Specificity ◽

Nasal Obstruction ◽

Nasal Mucosa ◽

Inspiratory Flow ◽

Nasal Patency ◽

Basic Standard ◽

Peak Nasal Inspiratory Flow

Background: The narrowing of nasal cavity due to nasal mucosa changes or other factors may leadsto nasal obstruction. Symptoms of nasal obstruction can be classified from mild to severe and in somecases total obstruction may occur. Purpose: The objective of the research was to determine the validity of rhinohygrometric method as nasal obstruction indicator. The complaint of nasal obstruction depicted theexistence of abnormalities either anatomically, physiologically or pathologically. The evaluation of thenasal obstruction was based on anamnesis, physical examination and also supporting examination forthe measurement of the nasal patency. Method: An analytic study had been carried out on the diagnostic test for determining sensitivity and specificity values of rhinohygrometeric method as nasal obstruction indicator compared with peak nasal inspiratory flow (PNIF) as the basic standard on subjects who hadnasal obstruction and subjects who did not have nasal obstruction. Results: In the research, the valuesof cutting off point rhinohygrometeric method are 3 cm and 4 cm on the length and width, while thevalue of basic standard of PNIF cutting off point is 80 liter/minute. Sensitivity and specificity methodof rhinohygrometeric on the length were 87.8% and 100% while on the width were 95.1% and 89.8%.Conclusion: Rhinohigrometeric method has validity as indicator of nasal obstruction. Keywords: rhinohygrometeric method, nasal obstruction, cutting off point, sensitivity and specificity Abstrak : Latar belakang: Setiap penyempitan rongga hidung baik akibat proses perubahan pada mukosahidung ataupun penyebab yang lain akan mengakibatkan timbulnya gejala sumbatan hidung. Gejalasumbatan hidung dapat bersifat ringan sampai berat bahkan dapat terjadi sumbatan total. Tujuan: Untukmenentukan validitas metode rinohigrometri sebagai indikator sumbatan hidung. Metode: Penelitian inimenggunakan studi analitik terhadap uji diagnostik untuk menentukan nilai sensitivitas dan spesifisitasmetode rinohigrometri sebagai indikator sumbatan hidung dibandingkan dengan peak nasal inspiratoryflow (PNIF) sebagai standar baku pada subjek yang mengalami sumbatan hidung dan subjek yang tidakmengalami sumbatan hidung. Hasil: Penelitian menunjukkan bahwa telah ditetapkan nilai titik potongmetode rinohigrometri adalah 3 cm dan 4 cm pada sisi panjang dan lebar, sedangkan nilai titik potongstandar baku PNIF adalah 80 liter/menit. Sensitivitas dan spesifisitas metode rinohigrometri padasisi panjang adalah 87,8% dan 100%, sedangkan pada sisi lebar adalah 95,1% dan 89,8%. Kesimpulan:Metode rinohigrometri memiliki validitas sebagai indikator sumbatan hidung. Kata kunci: metode rinohigrometri, sumbatan hidung, titik potong, sensitivitas, spesifisitas

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Peak nasal inspiratory flow and peak expiratory flow. Upright and sitting values in an adult population

Rhinology Journal ◽

10.4193/rhino15.180 ◽

2016 ◽

Vol 54 (2) ◽

pp. 160-163

Author(s):

Giancarlo Ottaviano ◽

Glenis K. Scadding ◽

Valentina Iacono ◽

Bruno Scarpa ◽

Alessandro Martini ◽

...

Keyword(s):

Body Position ◽

Adult Population ◽

Standing Position ◽

Inspiratory Flow ◽

Nasal Patency ◽

Significant Difference ◽

Positive Effect ◽

Present Pilot Study ◽

Peak Nasal Inspiratory Flow

Background: Nasal obstruction is correlated with a decreased quality of life . An easy way to evaluate nasal patency is the peak nasal inspiratory flow (PNIF) measurement. Normal PNIF values have been published by many authors. However, some authors evaluated volunteers in a sitting position, while others have measured PNIF values in standing volunteers. Body position has been shown to influence pulmonary function, with differences between sitting and upright positions. As nasal and pulmonary flows are strictly related, the present pilot study tried to establish whether PNIF/PEF changed with body position in adults. Methodology: PNIF and PEF were measured in sitting and standing positions with the order of testing randomized in 76 healthy volunteers, 30 male (40 ± 16 years). Results: In the group as a whole between sitting and upright position, PEF was significantly different (p=0.009), while PNIF showed a trend towards a significant difference (p=0.10). Conclusions: The present study, although showing a generally positive effect of the standing position on PEF values, does not show a clear effect on PNIF.

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Respiratory mode, nasal patency and palatine dimensions

CoDAS ◽

10.1590/2317-1782/20152014177 ◽

2015 ◽

Vol 27 (2) ◽

pp. 201-206 ◽

Cited By ~ 7

Author(s):

Maria Elaine Trevisan ◽

José Humberto Bellinaso ◽

Andrielle de Bitencourt Pacheco ◽

Luciana Barros Augé ◽

Ana Maria Toniolo da Silva ◽

...

Keyword(s):

Nasal Obstruction ◽

Negative Correlation ◽

Hard Palate ◽

Nasal Patency ◽

Nasal Breathing ◽

Nose Scale ◽

Symptom Evaluation ◽

Plaster Models ◽

Digital Caliper ◽

Peak Nasal Inspiratory Flow

Purpose: To investigate the influence of breathing mode and nasal patency in the dimensions of the hard palate by comparing mouth breathing (MB) and nasal breathing (NB) adults. Methods: Seventy-seven individuals, distributed into the MB group (n=38) and the NB group (n=39), of both genders and aged between 18 and 30 years old, took part in the study. The respiratory mode diagnosis was based on anamnesis, physical characteristics, and otorhinolaryngological examination. The volunteers were evaluated in terms of nasal patency, with a peak nasal inspiratory flow (PNIF) meter, and obstruction symptoms, by a Nasal Obstruction Symptom Evaluation (NOSE) scale, and had their transversal and vertical hard palate dimensions measured with a digital caliper in plaster models. Results: Comparing both groups, the MB group presented significantly higher values in the NOSE scale, lower values in the PNIF, lower values in the transversal distance of the palate in the intercanine region, and significantly higher values in the vertical distance in the regions of the first and second premolars and molars. There was a negative correlation between PNIF and NOSE, and a positive correlation between PNIF and transversal distance of the palate in the region of the first premolars. Conclusion: MB adults presented reduced nasal patency and a higher degree of nasal obstruction symptoms. The hard palate was morphologically narrower and deeper in adults with the MB mode compared to the NB mode. Moreover, it was concluded that the smaller the nasal patency, the greater the obstruction symptoms and the narrower the hard palate.

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Evaluating the Incidence and Serverity of Rhinitis Using a Peak Nasal Inspiratory Flow Meter and the SNOT-22 Questionnaire

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.05.10472 ◽

2021 ◽

Vol 104 (5) ◽

pp. 701-708

Keyword(s):

Nasal Obstruction ◽

Diagnostic Tool ◽

Normal Population ◽

Visual Analogue Score ◽

Epidemiological Studies ◽

Inspiratory Flow ◽

Diagnostic Potential ◽

Questionnaire Surveys ◽

Peak Nasal Inspiratory Flow ◽

Snot 22

ackground: Rhinitis is a common worldwide problem that is still under-diagnosed and under-treated in many countries. Most epidemiological studies use only questionnaire surveys to gauge the severity of symptoms and lack objective diagnostic criteria to quantify the severity of symptoms such as nasal obstruction. The incidence of rhinitis was examined with the use of the Peak Nasal Inspiratory Flow (PNIF), the Sino-Nasal Outcome Test 22 (SNOT-22), and the visual analogue score (VAS) with the intention to determine the efficacy of PNIF as an objective diagnostic tool for rhinitis and to establish normal reference values for PNIF and SNOT-22 in a normal population. Materials and Methods: PNIF, SNOT-22, and VAS of 256 subjects with and without rhinitis from the general population were evaluated. Results: The incidence of rhinitis was 51% with PNIF, SNOT-22, and VAS scores being significantly better (p<0.01) in subjects without rhinitis compared to subjects with rhinitis. Median PNIF for the population with rhinitis and without was 90 L/minute and 110 L/minute, respectively. Median SNOT-22 for the population with rhinitis and without was 41 over 110 and 4 over 110, respectively. Fifty-three percent of subjects with rhinitis were unaware of the severity of their symptoms until they completed the assessments. At a PNIF cut-off point of 95 L or less per minute, there was a moderate to good diagnostic potential for rhinitis. At a SNOT-22 cut-off point of 21 or less over 110, there was an excellent diagnostic potential for rhinitis. When PNIF and SNOT-22 are used together, the diagnostic accuracy for rhinitis is 97.6%. Conclusion: The incidence of rhinitis is high and it is an unrecognized problem. PNIF is a cheap, simple, and useful objective diagnostic tool to assess changes in nasal patency and to discriminate between patients with moderate to severe rhinitis. Keywords: Rhinitis, Peak Nasal Inspiratory Flow, SNOT-22, Nasal obstruction, Epidemiology

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