Determinants and Evaluation of Nasal Airflow Perception

2017 ◽  
Vol 33 (04) ◽  
pp. 372-377 ◽  
Author(s):  
Kevin Hur ◽  
Kai Zhao ◽  
Donald Leopold ◽  
Bozena Wrobel ◽  
Jasper Shen
Keyword(s):  
Treatment Outcome ◽  
Airway Obstruction ◽  
Airway Resistance ◽  
Dynamic Change ◽  
Acoustic Rhinometry ◽  
Nasal Airway ◽  
Nasal Airflow ◽  
Nasal Patency ◽  
Airway Patency

AbstractThe sensation of nasal airflow, or nasal airway patency, is an important consideration in the treatment outcome of nasal airway obstruction. Clinicians striving to optimize the nasal passageway have relied on techniques aimed at decreasing peak airway resistance across nasal valves. Nonetheless, the evaluation of the nasal airway is multifaceted, and the objective determinants of subjective nasal patency remain incompletely elucidated. While rhinomanometry, peak nasal inspiratory airflow, and acoustic rhinometry have traditionally been used in research to focus on resistance as a measure of patency, an emerging body of evidence suggests that subjective nasal patency is more significantly correlated to the dynamic change of nasal mucosal temperature. The objective of this review is to provide the technical background on nasal airflow perception and intranasal trigeminal function as crucial to those performing functional and aesthetic rhinosurgery.

Influence of nasal airflow and resistance on nasal dilator muscle activities during exercise

1993 ◽  
Vol 74 (5) ◽  
pp. 2529-2536 ◽  
Author(s):  
D. C. Connel ◽  
R. F. Fregosi
Keyword(s):  
Airway Resistance ◽  
Minute Ventilation ◽  
Nasal Airway ◽  
Nasal Airflow ◽  
Nasal Breathing ◽  
Airway Patency ◽  
Dilator Muscle ◽  
The Face ◽  
Flow Turbulence ◽  
Nasal Flow

Our purpose was to assess the separate effects of nasal airflow and resistance on the activity of the nasal dilator [alae nasi (AN)] muscles. Nasal airflow and the AN electromyogram were recorded at rest and during progressive-intensity exercise at 60, 120, and 150–180 W in 10 healthy subjects who breathed nasally under all conditions. The activity of the AN muscles increased linearly as a function of the increase in nasal minute ventilation evoked by progressive-intensity exercise (r = 0.99, P < 0.002). Reciprocal changes in nasal airflow and resistance were produced by surreptitious substitution of 12–15 breaths of 79% He-21% O2 for air at rest and during exercise. The switch to He-O2 decreased airway resistance (anterior rhinomanometry) by approximately 30% at rest and 40–60% during exercise. He-O2 did not change nasal flow or AN activities significantly under resting conditions. In contrast, He-O2 increased nasal flow and decreased the AN electromyogram by 25–50% during exercise (P < 0.05). The results suggest that AN muscle activities during nasal breathing are regulated by mechanisms that track airway resistance or the level of flow turbulence. The increase in AN activities during exercise probably helps ensure nasal airway patency in the face of the considerable collapsing pressures that prevail under these conditions.

Comparison of Nasal Airway Patency Changes after Treatment with Oxymetazoline and Pseudoephedrine

1987 ◽  
Vol 1 (2) ◽  
pp. 87-94 ◽  
Author(s):  
John T. Connell ◽  
M. Ines Linzmayer
Keyword(s):  
Nasal Congestion ◽  
Rapid Onset ◽  
Nasal Airway ◽  
Nasal Airflow ◽  
Night Time ◽  
Duration Of Action ◽  
Airway Patency ◽  
Drug Of Choice

Oxymetazoline (Afrin) and pseudoephedrine (Sudafed) were compared by rhinomanometric measurements using nasal airflow, a parameter of nasal airway patency, and therefore airway congestion. Oxymetazoline had a more rapid onset and duration of action, greater improvement in airway patency, and longer action than pseudoephedrine, the best of the oral decongestants. The decongestive effect was more reliable for oxymetazoline with 28 of 29 subjects experiencing some degree of decongestion compared to 21 of 30 for pseudoephedrine. Utilizing a combination of oral and topical decongestants may result in the most logical regimen for treatment of nasal congestion. Oxymetazoline is the drug of choice for night time decongestion.

Airflow and the Nasal Cycle: Nasal Patency Fluctuations after Laryngectomy

1995 ◽  
Vol 9 (3) ◽  
pp. 175-178 ◽  
Author(s):  
Edward W. Fisher ◽  
Ming Liu ◽  
Valerie J. Lund
Keyword(s):  
Mean Amplitude ◽  
Afferent Input ◽  
Acoustic Rhinometry ◽  
Nasal Airflow ◽  
Nasal Patency ◽  
Cross Sectional ◽  
Exact Test ◽  
Nasal Cycle ◽  
Postoperative Time ◽  
The Mean

A periodic fluctuation in nasal patency or “nasal cycle” is observed in the majority of adults but has not hitherto been demonstrated in individuals after diversion of nasal airflow. Acoustic rhinometry, a highly sensitive technique which does not require airflow, provided the opportunity to evaluate this situation in patients who had undergone laryngectomy. We examined 21 postoperative individuals (mean postoperative time 4 years) and 14 control subjects matched for age (including 2 patients prelaryngectomy). Acoustic rhinometry was performed serially over 3–8 hours to determine minimum cross-sectional area and nasal cavity volume as indices of nasal patency. Fluctuations in nasal patency were observed in all laryngectomees and controls. These were classified as classical (reciprocal alternating), in concert (parallel) or irregular. The distribution of the control and laryngectomy subjects between the cycle categories was not statistically significant (Fisher's exact test: P > 0.05). The mean periodicity of the cycle was similar in the two groups (controls: 180 minutes, laryngectomees: 176 minutes), but the mean amplitude was significantly less in the laryngectomy group (68 versus 96 cm3; P < 0.07 Mann-Whitney U test). The nasal cycle can continue after cessation of airflow, but it is diminished in amplitude. Therefore, afferent input from nasal airflow receptors may continue to play a role in modulating the cycle's periodicity and amplitude, but are not responsible for generating the underlying cycle phenomenon.

Acoustic Rhinometry in the Study of the Acute Nasal Allergic Response

1996 ◽  
Vol 105 (10) ◽  
pp. 811-818 ◽  
Author(s):  
Burton Zweiman ◽  
Richard Doty ◽  
Andrew P. Lane ◽  
Donald C. Lanza ◽  
Hun-Jun Dhong ◽  
...  
Keyword(s):  
Nasal Cavity ◽  
Objective Assessment ◽  
Allergen Challenge ◽  
Olfactory Function ◽  
Acoustic Rhinometry ◽  
Allergic Response ◽  
Nasal Airway ◽  
Nasal Patency ◽  
Airway Caliber ◽  
Nasal Allergen Challenge

Acoustic rhinometry is a recently developed method for the objective assessment of nasal patency. In this study, acoustic rhinometry was used to measure changes in nasal cavity dimensions in the immediate response to nasal allergen challenge in eight pollen-sensitive subjects. Acoustic rhinometric changes were compared with subjective symptoms, as well as histamine in nasal secretions, cytology of nasal mucosal scrapings, and changes in olfactory function. A significantly greater decrease in nasal airway caliber occurred following allergen challenge as compared to buffer diluent challenge in the same individuals (70% ± 1% versus 22% ± 5%). During an allergic response, a strong correlation was found between the minimum cross-sectional area and the volume of the nasal cavity measured by acoustic rhinometry (r = .9). However, no correlation was observed between nasal airway caliber and concomitant subjective congestion reported by the subjects. Amodest decrease in olfactory function was seenfollowing allergen challenge (3.1 ± 1.4 fewer odors identified correctly out of 20; p = .08). However, the alterations of olfactory function did not correlate with changes in nasal patency. The results presented in this study demonstrate that acoustic rhinometry has great potential as a reproducible method for the objective assessment of nasal obstruction occurring in nasal allergen challenge studies.

Effect of geniohyoid and sternohyoid muscle contraction on upper airway resistance in the cat

1991 ◽  
Vol 71 (4) ◽  
pp. 1346-1354 ◽  
Author(s):  
D. A. Wiegand ◽  
B. Latz
Keyword(s):  
Electrical Stimulation ◽  
Muscle Contraction ◽  
Airway Resistance ◽  
Upper Airway ◽  
Muscle Stimulation ◽  
Nasal Airflow ◽  
Airway Patency ◽  
Upper Airway Resistance ◽  
Wide Range ◽  
Consistent Change

Previous investigators (van Lunteren et al. J. Appl. Physiol. 62: 582–590, 1987) have suggested that the geniohyoid and sternohyoid muscles may act as upper airway dilators in the cat. To investigate the effect of geniohyoid and sternohyoid contraction on inspiratory upper airway resistance (UAR), we studied five adult male cats anesthetized with ketamine and xylazine during spontaneous room-air breathing. Inspiratory nasal airflow was measured by sealing the lips and constructing a nose mask. Supraglottic pressure was measured using a transpharyngeal catheter placed above the larynx. Mask pressure was measured using a separate catheter. Geniohyoid and sternohyoid lengths were determined by sonomicrometry. Geniohyoid and sternohyoid contraction was stimulated by direct muscle electrical stimulation with implanted wire electrodes. Mean inspiratory UAR was determined for spontaneous breaths under three conditions: 1) baseline (no muscle stimulation), 2) geniohyoid contraction alone, and 3) sternohyoid contraction alone. Geniohyoid contraction alone produced no significant reduction in inspiratory UAR [unstimulated, 17.75 +/- 0.86 (SE) cmH2O.l-1.s; geniohyoid contraction, 19.24 +/- 1.10]. Sternohyoid contraction alone also produced no significant reduction in inspiratory UAR (unstimulated, 15.74 +/- 0.92 cmH2O.l-1.s; sternohyoid contraction, 14.78 +/- 0.78). Simultaneous contraction of the geniohyoid and sternohyoid muscles over a wide range of muscle lengths produced no consistent change in inspiratory UAR. The geniohyoid and sternohyoid muscles do not appear to function consistently as upper airway dilator muscles when UAR is used as an index of upper airway patency in the cat.

Topical active H1-antihistamines and their effect on nasal airway resistance

1995 ◽  
Vol 109 (9) ◽  
pp. 841-843
Author(s):  
R. J. van Houten ◽  
D. J. Premachandra
Keyword(s):  
Nasal Spray ◽  
Airway Resistance ◽  
Healthy Adult ◽  
Nasal Airway ◽  
Subjective Improvement ◽  
Airway Patency ◽  
Subjective Change ◽  
Nasal Airway Resistance ◽  
H1 Antihistamines ◽  
Adult Volunteers

AbstractThe introduction of a topically active H1-antihistamine nasal spray Azelastine, has given an extra dimension in the management of allergic rhinits. The drug acts rapidly and avoids the sustemic adverse effects of antihistimines. An objective prospective study was performed to detect the effect of Azelastine nasal spray on nasal airway resistance. Twelve healthy adult volunteers with no rhinological problems were included in the study. Nasal cavites were sprayed with 280 μg (two puffs) of Azelastine nasal spray and the nasal airway resistance was measured with anterior rhinomanometry at intervals of 30 minutes for up to two hours. Our study has shown statistically significant increase in the total nasal airway resistance following the use orf Azelastine nasal spray in the absence of a subjective change in nasal airway resistance. There are substances when inhaled which can cause subjective improvement in nasal airway patency without changing the measured nasal airway resistance. However this medication gives no subjective change in nasal airway patency in spite of increasing nasal airway resistance.

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