Total nasal airway resistance while sitting predicts airway collapse when lying down

2020 ◽  
Vol 134 (10) ◽  
pp. 917-924
Author(s):  
A Karlsson ◽  
M Persson ◽  
A-C Mjörnheim ◽  
G Gudnadottir ◽  
J Hellgren
Keyword(s):  
Nasal Obstruction ◽  
Supine Position ◽  
Airway Resistance ◽  
Upper Airway ◽  
Nasal Airway ◽  
Nasal Breathing ◽  
Nasal Airway Resistance ◽  
Airway Collapse ◽  
Before And After ◽  
Lying Down

AbstractBackgroundNasal obstruction when lying down is a common complaint in patients with chronic nasal obstruction, but rhinomanometry is typically performed in the sitting position. This study aimed to analyse whether adding rhinomanometry in a supine position is a useful examination.MethodA total of 41 patients with chronic nasal obstruction underwent rhinomanometry and acoustic rhinometry, sitting and supine, before and after decongestion, as well as an over-night polygraphy.ResultsTotal airway resistance was measurable in a supine position in 48 per cent (14 of 29) of the patients with total airway resistance of equal to or less than 0.3 Pa/cm3/second when sitting and in none (0 of 12) of the patients with total nasal airway resistance of more than 0.3 Pa/cm3/second when sitting. After decongestion, this increased to 83 per cent and 58 per cent, respectively.ConclusionIncreased nasal resistance when sitting predicts nasal breathing problems when supine. Rhinomanometry in a supine position should be performed to diagnose upper airway collapse when supine.

scholarly journals Nasal obstruction causes a decrease in lip-closing force

2011 ◽  
Vol 81 (5) ◽  
pp. 750-753 ◽  
Author(s):  
Kishio Sabashi ◽  
Kaei Washino ◽  
Issei Saitoh ◽  
Youichi Yamasaki ◽  
Atsushi Kawabata ◽  
...  
Keyword(s):  
Nasal Obstruction ◽  
Airway Resistance ◽  
Correlation Coefficients ◽  
Significant Negative Correlation ◽  
Normal Group ◽  
Nasal Airway ◽  
Nasal Airway Resistance ◽  
Obstruction Group ◽  
Closing Force ◽  
Group A

Abstract Objective: To investigate the relationship between nasal obstruction and lip-closing force. Materials and Methods: Nasal airway resistance and lip-closing force measures were recorded for 54 Japanese females. The subjects were classified into normal and nasal obstruction groups according to nasal airway resistance values. Differences between the normal and nasal obstruction groups in lip-closing force were tested statistically. Correlation coefficients were calculated between the measures for the normal and nasal obstruction groups. Results: Lip-closing force for the nasal obstruction group was significantly less than for the normal group (P < .05). In the normal group, nasal airway resistance did not correlate with lip-closing force, while in the nasal obstruction group a significant negative correlation was found between nasal airway resistance and lip-closing force (P < .05). Conclusions: Nasal obstruction is associated with a decrease in lip-closing force. When the severity of nasal obstruction reaches a certain level, the lip-closing force is weakened.

Performance and work of nasal breathing

2021 ◽  
Vol 11 (41) ◽  
pp. 11-17
Author(s):  
Anita Bergmane ◽  
Klaus Vogt ◽  
Biruta Sloka
Keyword(s):  
Airway Resistance ◽  
Interquartile Range ◽  
Nasal Airway ◽  
Nasal Resistance ◽  
Nasal Breathing ◽  
First Line ◽  
Significant Difference ◽  
Before And After ◽  
Potential Parameters ◽  
Inspiratory Work

Abstract OBJECTIVE. To evaluate performance (Q) and work (W) of nasal breathing as potential parameters in functional diagnostic of nasal obstruction. MATERIAL AND METHODS. We included in our study 250 patients and we measured by 4-phase-rhinomanometry with decongestion test. We calculated performance Q of the “representative breath” in inspiration and expiration and in total breath, maximal performance Q (Qmax), Work W of nasal breathing in mJ and in mJ/litre and Q in J/min. RESULTS. The interquartile range of Win for representative breath before decongestion is 356 mJ/l, Wex 308 mJ/l, while after decongestion Win is 264 mJ/l and Wex 220 mJ/l. There is no significant difference between work before and after decongestion (p<0.001). Interquartile range for nasal breathing Q before decongestion is 19.2 J/min and after – 14.3 J/min. A significant correlation exists between logarithmic vertex resistance for inspiration and expiration and Qmax for inspiration and expiration (p<0.001). That means that the performance required by breathing depends in the first line on nasal resistance. CONCLUSION. Inspiratory work is 1.2 times higher than expiration work. Increase in nasal airway resistance is followed by increase in maximal nasal performance.

Sources of Variability in Posterior Rhinomanometry

1993 ◽  
Vol 102 (8) ◽  
pp. 631-638 ◽  
Author(s):  
David S. James ◽  
William E. Lambert ◽  
Christine A. Stidley ◽  
Thomas W. Chick ◽  
Christine M. Mermier ◽  
...  
Keyword(s):  
Airway Resistance ◽  
Upper Airway ◽  
Nasal Airway ◽  
Upper Respiratory Tract ◽  
Nasal Airway Resistance ◽  
Airway Symptoms ◽  
Subject Variability ◽  
Total Variability ◽  
Sources Of Variation ◽  
The Difference

Sources of variability in nasal airway resistance measured by posterior rhinomanometry were studied in 5 subjects tested on 5 different days and 56 subjects tested on 2 different days. On each day, a questionnaire on upper airway health and nasal symptoms was completed. The mean individual difference in nasal airway resistance between the 2 test days in the group of 56 subjects was 5.3% (SD 52.7%). Between-subject variability accounted for 74.9% and 72.5% of the total variability in the group of 5 and the group of 56 subjects, respectively. For the 5 subjects, by accounting for a change in upper airway symptoms or upper respiratory tract infection that occurred over the 5 test days, there was a significant decrease in the between-subject variability. The difference in sources of variation due to a change in upper airway symptoms was not seen in the group of 56 subjects. We conclude that the largest source of variability in nasal airway resistance is due to between-subject differences.

Dyspnea following Experimentally Induced Increased Nasal Airway Resistance

1996 ◽  
Vol 33 (3) ◽  
pp. 231-235 ◽  
Author(s):  
Donald W. Warren ◽  
Robert Mayo ◽  
David J. Zajac ◽  
A. H. Rochet
Keyword(s):  
Airway Resistance ◽  
Upper Airway ◽  
Breathing Rate ◽  
Nasal Airway ◽  
Nasal Resistance ◽  
Nasal Breathing ◽  
Oral Breathing ◽  
A Value ◽  
Normal Breathing ◽  
Study Support

Nasal resistance (NRZ) values for healthy adults range from 1.0 to 3.5 cm H2O/L/sec. Some oral breathing tends to occur at values above 3.5. The purpose of the present study was to determine at what level of NRZ individuals sense that nasal breathing is difficult. A diaphragm was used to add four different resistance loads in random to 15 adult subjects. These loads were 5, 8, and 15 cm H2O/L/sec and a value 40% above the individual's normal NRZ. Loads were added under four conditions: normal breathing, fixed flow rate, fixed breathing rate, and fixed flow and breathing rate. The pressure-flow technique was used to measure NRZ under all conditions. The study revealed that the sensation of breathing difficulty occurred at a median resistance of 5 cm H2O/L/sec and, as subjects were constrained to maintain fixed flow and breathing rates, the magnitude of RZ, at which the sensation of dyspnea was noted, decreased. The values observed in this study support previous findings suggesting that individuals switch to some oral breathing to maintain an adequate level of upper airway resistance at values between 3.5 and 4.5 cm H2/L/sec. The findings also show that individuals attempt to minimize increases in airway resistance by modifying breathing behaviors.

Component Approach for Partitioning Nasal Airway Resistance: Pharyngeal Flap Case Studies

1993 ◽  
Vol 30 (1) ◽  
pp. 78-81 ◽  
Author(s):  
Bonnie E. Smith ◽  
Thomas W. Guyette
Keyword(s):  
Nasal Cavity ◽  
Case Studies ◽  
Airway Resistance ◽  
Clinical Report ◽  
Nasal Airway ◽  
Airway Patency ◽  
Nasal Airway Resistance ◽  
Before And After ◽  
Component Approach ◽  
Pharyngeal Flap

Individuals with craniofacial anomalies often have nasal cavity and/or velopharyngeal constriction. The purpose of this clinical report was to illustrate a technique for partitioning nasal airway resistance into its nasal cavity and velo pharyngeal components. This information would be helpful in determining intervention to reduce high nasal airway resistance as well as in providing information about the outcome of corrective procedures to establish velopharyngeal competence for speech. Data from two pharyngeal flap patients seen before and after surgery were utilized in this illustration. These case studies illustrate the usefulness of component resistance measures in quantifying nasal airway patency before and after corrective surgery for velopharyngeal function.

scholarly journals Paradoxical increase in nasal airway resistance following a topical nasal decongestant spray

2011 ◽  
Vol 49 (1) ◽  
pp. 127-127
Author(s):  
N.M. Doddi ◽  
R. Eccles
Keyword(s):  
Nasal Obstruction ◽  
Common Cold ◽  
Airway Resistance ◽  
Nasal Airway ◽  
Nasal Decongestant ◽  
Nasal Airway Resistance

Nasal obstruction is a very common problem associated with common cold and topical nasal decongestant sprays are effective symptomatic treatments causing a decrease in nasal airway resistance (NAR).

The Effect of Rapid Maxillary Expansion on Nasal Airway Resistance

1986 ◽  
Vol 13 (4) ◽  
pp. 221-228 ◽  
Author(s):  
Donald J. Timms
Keyword(s):  
Pressure Difference ◽  
Airway Resistance ◽  
Rapid Maxillary Expansion ◽  
Nasal Airway ◽  
Maxillary Expansion ◽  
Nasal Airway Resistance ◽  
Before And After ◽  
Probable Significance ◽  
Airway Physiology ◽  
Age Range

There has been a long-standing controversy over the efficacy of rapid maxillary expansion to relieve nasal obstruction and improve respiration. Recently rhinomanometry has provided a discipline for the investigation into nasal airway physiology with quantifiable parameters for evaluation and comparable studies. In this trial, a sample of 26 patients (13 male and 13 female, age range 10·10 to 19·6 years), receiving rapid maxillary expansion as part of their orthodontic mechano-therapy, were appraised for nasal airway resistance before and after expansion. The posterior rhinomanometric technique was used, measuring the respiratory flow between pharynx and the nostrils at a preset pressure difference between these two points. The formula for calculating the resistance is derived from the electrical Ohm's Law and requires that the pressure difference be divided by the flow. Reductions were recorded in all cases with an average of 36·2 per cent (range 11·6–58·6). The correlation between the resistance reductions and the delivered expansions (increases in trans-palatal widths) was weak (r = 0·32). In view of the probable significance of the liminal valve in nasal resistance, expansions in this area were assessed by changes in the transalar widths. The correlation between transalar increases and the trans-palatal expansions was weak (r = 0·115), as it was between the transalar increases and the reductions in nasal airway resistance (r = 0·30).

scholarly journals Treatment with a topical glucocorticoid, budesonide, reduced the variability of rhinomanometric nasal airway resistance

2014 ◽  
Vol 52 (1) ◽  
pp. 19-24
Author(s):  
H.L. Thulesius ◽  
A. Cervin ◽  
M. Jessen
Keyword(s):  
Visual Analogue Scale ◽  
Healthy Volunteers ◽  
Nasal Obstruction ◽  
Analogue Scale ◽  
Airway Resistance ◽  
Nasal Airway ◽  
Nasal Airway Resistance ◽  
The Mean ◽  
Active Anterior Rhinomanometry

Background: Previous rhinomanometry studies have shown significant long-term variability of the nasal airway resistance and questioned the clinical validity of rhinomanometry. Research question: Could treatment with a topical glucocorticoid, budesonide, influence the long-term variability of active anterior rhinomanometry? Methods: Eight healthy volunteers participated in an unblinded controlled trial without, and later with, nasal budesonide once a day for 5 months. Their nasal airway resistance was measured every two weeks with active anterior rhinomanometry before and after decongestion with xylometazoline hydrochloride. In addition, subjective nasal obstruction was evaluated on a Visual Analogue Scale before each measurement. The participants had a year earlier been investigated with rhinomanometry every two weeks during 5 months but without budesonide treatment. We compared the variability of nasal airway resistance during the two periods with and without treatment with topical budesonide. Results: Budesonide significantly reduced mean nasal airway resistance and the standard deviation of the mean after decongestion for 6 of 8 participants. The mean reduction of the nasal airway resistance was 40% for the decongested nasal cavity compared to the period without treatment with nasal budesonide. Subjective nasal obstruction assessed by Visual Analogue Scale was reduced in 3 of the 8 participants. Conclusion: The variability of nasal airway resistance was significantly reduced by treatment with topical budesonide for 6 out of 8 healthy volunteers participating in an unblinded repeated 5 month trial where the participants served as their own controls.

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