Which Nasal Airway Dimensions Correlate with Nasal Airflow and with Nasal Breathing Sensation?

2021 ◽  
Author(s):  
Rui Xavier ◽  
Sofia Azeredo-Lopes ◽  
Dirk Jan Menger ◽  
Henrique Cyrne de Carvalho ◽  
Jorge Spratley
Keyword(s):  
Nasal Airway ◽  
Nasal Airflow ◽  
Nasal Breathing ◽  
Airway Dimensions

Spreader grafts: functional or just aesthetical?

2015 ◽  
Vol 53 (4) ◽  
pp. 332-339
Author(s):  
R. Xavier ◽  
S. Azeredo-Lopes ◽  
A. Papoila
Keyword(s):  
Functional Improvement ◽  
Nasal Airway ◽  
Nasal Airflow ◽  
Functional Effect ◽  
Nasal Breathing ◽  
The Mean ◽  
The Difference ◽  
The Aesthetic ◽  
Peak Nasal Inspiratory Flow

Objective: Spreader grafts are commonly used in rhinoplasty to achieve an aesthetic improvement of the nose or a functional improvement of the nasal airway. Currently, the aesthetic role of spreader grafts is well established. The functional effect of these grafts, however, has been controversial due to the lack of studies clearly demonstrating an increase on nasal airflow assigned to spreader grafts. The purpose of this study is to evaluate the effect of spreader grafts on nasal breathing. Methods: Nasal breathing of 72 consecutive patients undergoing rhinoplasty was evaluated by measuring peak nasal inspiratory flow (PNIF) before surgery and six months after surgery. Results: The mean preoperative PNIF of the 72 patients included in this study was 79.44 l/min and the mean postoperative PNIF was 110.42 l/min (p < 0.001). In 37 patients of this study no spreader grafts were used. In this group of patients the mean PNIF values changed from 73.24 l/min before surgery to 99.46 l/min after surgery. In the group of 35 patients in whom spreader grafts were used the mean PNIF values changed from 86.00 l/min before surgery to 122.00 l/min after surgery. The increase in the mean PNIF value after rhinoplasty was slightly higher in the group of patients with spreader grafts than in the group of patients without spreader grafts. The difference in the postoperative increase of PNIF between these two groups of patients, however, is not statistically significant. Conclusions: This study suggests that patients undergoing rhinoplasty have a statistically significant improvement in nasal breathing after surgery. However, patients receiving spreader grafts in a non-randomized way do not have statistically significant greater benefit than those who do not.

An Overview of Computational Fluid Dynamics Preoperative Analysis of the Nasal Airway

2021 ◽  
Author(s):  
Rui Xavier ◽  
Dirk-Jan Menger ◽  
Henrique Cyrne de Carvalho ◽  
Jorge Spratley
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Surgical Techniques ◽  
Virtual Surgery ◽  
Nasal Airway ◽  
Cfd Analysis ◽  
Nasal Airflow ◽  
Nasal Breathing ◽  
Objective Measurements ◽  
Patient Reported

AbstractEvaluation of the nasal airway is crucial for every patient with symptoms of nasal obstruction as well as for every patient with other nasal symptoms. This assessment of the nasal airway comprises clinical examination together with imaging studies, with the correlation between findings of this evaluation and symptoms reported by the patient being based on the experience of the surgeon. Measuring nasal airway resistance or nasal airflow can provide additional data regarding the nasal airway, but the benefit of these objective measurements is limited due to their lack of correlation with patient-reported evaluation of nasal breathing. Computational fluid dynamics (CFD) has emerged as a valuable tool to assess the nasal airway, as it provides objective measurements that correlate with patient-reported evaluation of nasal breathing. CFD is able to evaluate nasal airflow and measure variables such as heat transfer or nasal wall shear stress, which seem to reflect the activity of the nasal trigeminal sensitive endings that provide sensation of nasal breathing. Furthermore, CFD has the unique capacity of making airway analysis of virtual surgery, predicting airflow changes after trial virtual modifications of the nasal airway. Thereby, CFD can assist the surgeon in deciding surgery and selecting the surgical techniques that better address the features of each specific nose. CFD has thus become a trend in nasal airflow assessment, providing reliable results that have been validated for analyzing airflow in the human nasal cavity. All these features make CFD analysis a mainstay in the armamentarium of the nasal surgeon. CFD analysis may become the gold standard for preoperative assessment of the nasal airway.

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.

Inferior turbinectomy: Comparison of four techniques

1990 ◽  
Vol 104 (3) ◽  
pp. 206-209 ◽  
Author(s):  
Samy Elwany ◽  
Robert Harrison
Keyword(s):  
Allergic Rhinitis ◽  
Surgical Technique ◽  
Deleterious Effect ◽  
Mucociliary Clearance ◽  
Nasal Airway ◽  
Nasal Airflow ◽  
Nasal Breathing ◽  
Olfactory Acuity ◽  
Non Allergic Rhinitis ◽  
One Year

AbstractAs yet, there is no totally satisfactory means for treating hypertrophied turbinates and the proper management of turbinate dysfunction remains in question. In the present series, four of the widely practiced surgical procedures for the reduction of the size of the inferior turbinates were evaluated and compared. In all cases turbinectomy was performed as an isolated procedure. Eighty patients with chronic non-allergic rhinitis and hypertrophied inferior turbinates were selected, randomly divided into four groups, and followed up post-operatively for one year. Study of the results indicated that the beneficial effect of the operation is mainly mechanical by reduction of the resistance to nasal airflow. The post-operative improvement in smell acuity correlated positively with the increased patency of the nasal airway. None of the procedures had a deleterious effect on olfactory acuity. In contrast, the operation failed to enhance the mucociliary clearance rate or significantly decrease nasal drainage. Partial inferior turbinectomy and laser turbinectomy improved nasal breathing in 77 per cent of patients, and enhanced olfactory acuity in 78 per cent of patients who had pre-operative hyposmia. The results of turbinoplasty and cryoturbinectomy were less favourable. The surgical technique, advantages, and drawbacks of each of these procedures are discussed.

scholarly journals Assessment of Nasal Airflow and Pain, Safety and Cost of an Improvised Nasal Airway (Nasogastric) Tube After Endoscopic Sinus Surgery

2020 ◽  
Vol 35 (2) ◽  
pp. 22
Author(s):  
Josephine Grace Rojo ◽  
Rachel Zita Ramos
Keyword(s):  
Pain Score ◽  
Postoperative Period ◽  
Nasogastric Tube ◽  
Endoscopic Sinus Surgery ◽  
Nasal Packing ◽  
Sinus Surgery ◽  
Nasal Airway ◽  
Nasal Airflow ◽  
Significant Difference ◽  
Group A

ABSTRACT Objective: To compare subjective nasal airflow and overall pain score (as well as safety and added cost of) using an improvised nasal airway tube (nasogastric tube) versus nasal packing after endoscopic sinus surgery (ESS) for chronic rhinosinusitis with nasal polyposis (CRSwNP). Methods:Design: Quasi - Experimental Prospective Cohort StudySetting: Tertiary Government Training HospitalParticipants: Twenty-six (26) consecutive patients aged 18 to 77 years old diagnosed with CRSwNP who underwent ESS were alternately assigned to an experimental group (A) of 13, where an improvised nasal airway (nasogastric) tube was placed in addition to the nasal pack or a control group (B) of 13 with nasal packing alone. Results: There was a significant difference in subjective nasal airflow between experimental (A) and control (B) groups during the immediate postoperative period where the mean subjective airflow was 8.07 and 0.00 over 10.00, respectively. No significant difference was noted between the groups in terms of age, gender, severity of polyposis and overall pain score. No complications such as bleeding, Toxic Shock Syndrome, vestibular or alar injury and septal necrosis were noted immediately post-op and after one week follow-up in both groups. An approximate cost of PhP 25 was added to group A. Conclusion: An improvised nasal airway using a nasogastric tube provides adequate airflow without additional pain in the immediate postoperative period. It is safe to use and an affordable option for patients in need of nasal airway stents residing in areas where a preformed nasal packing with incorporated tube stent is not available.

Pulmonary airway area by the two-microphone acoustic reflection method

1994 ◽  
Vol 76 (5) ◽  
pp. 2234-2240 ◽  
Author(s):  
B. Louis ◽  
G. M. Glass ◽  
J. J. Fredberg
Keyword(s):  
Upper Airway ◽  
Nasal Airway ◽  
Reflection Method ◽  
Acoustic Reflection ◽  
Reflection Data ◽  
Pulmonary Airway ◽  
Airway Dimensions

We noninvasively assessed airway dimensions from acoustic reflection data measured at the mouth. We recently described a two-transducer system for measurement of the nasal airway. Here we apply this approach to the measurement of the upper airway and trachea. We describe the theoretical implications of breathing on this kind of measurement and propose a new procedure that, unlike single- and dual-transducer systems used currently, does not require the use of He-O2 for inference of geometry of subglottic airways.

Effect of Ammonia on Nasal Resistance in Atopic and Nonatopic Subjects

1979 ◽  
Vol 88 (2) ◽  
pp. 228-234 ◽  
Author(s):  
J. A. McLean ◽  
K. P. Mathews ◽  
W. R. Solomon ◽  
P. R. Brayton ◽  
N. K. Bayne
Keyword(s):  
Progressive Increase ◽  
Compressed Air ◽  
Nasal Airway ◽  
Nasal Breathing ◽  
Short Term ◽  
Flow Curves ◽  
Simple Method ◽  
Significant Difference ◽  
The Mean ◽  
Small Change

Nasal airway resistance (NAR) was assessed from the slope of pressure-flow curves obtained during normal nasal breathing. Volunteers were classified as atopic or nonatopic according to strict criteria. 100 ppm NH3 was introduced into each nostril for periods ranging from 5 to 30 seconds with frequent NAR monitoring. A progressive increase in NAR responses was obtained with incremental NH3 exposures, but no significant difference was noted between the mean response of atopic and nonatopic subjects. Control exposures to compressed air under the same pressure generally produced only a small change in NAR, while aerosolized buffered saline increased NAR more than compressed air. The nasal response to NH3 was effectively inhibited by intranasal atropine administration but not by chlorpheniramine. The described procedure provides a safe and simple method for studying semiquantitatively the short-term effects of inhaled irritants on the nose.

Objective Assessment of the Breathe-Right Device during Exercise in Adult Males

1997 ◽  
Vol 11 (5) ◽  
pp. 393-398 ◽  
Author(s):  
Louis G. Portugal ◽  
Rajeev H. Mehta ◽  
Bonnie E. Smith ◽  
Jaishiri B. Sabnani ◽  
Matthew J. Matava
Keyword(s):  
African American ◽  
Objective Assessment ◽  
Acoustic Rhinometry ◽  
Nasal Airway ◽  
Nasal Resistance ◽  
Adult Males ◽  
Nasal Breathing ◽  
Cross Sectional ◽  
American Group ◽  
Paradoxical Worsening

In order to improve nasal breathing during competition, many athletes recently have been wearing a spring-loaded, external nasal dilator referred to as the Breathe-Right device (BRD). Although there are many subjective claims that this device improves breathing during exercise, there are currently no controlled studies documenting its efficacy. To determine objectively whether the device improves the nasal airway, 20 subjects (10 Caucasian and 10 African-American) were studied during rest and after 15 minutes of exercise using anterior rhinomanometry and acoustic rhinometry to measure changes in airway resistance and minimal cross-sectional area, respectively. We found that the BRD exerts its main effect in the region of the nasal valve improving the airway an overall 21% in our group of subjects. This anatomic improvement in nasal airway resulted in an overall 27% reduction in nasal resistance in the Caucasian group. However, in the African-American group, a wider range of resistance changes was observed with application of the BRD with significant improvement in nasal resistance in some subjects but paradoxical worsening in others. In the African-American group as a whole, no significant change in nasal resistance occured with application of the BRD. These measured differences are likely due to variations in nasal anatomy that exist not only between races but also between individuals within a given race. In addition, this study confirms the well known decongestant effects of exercise providing anatomic data with acoustic rhinometry not previously documented in the literature. Overall improvement in nasal airway seen with application of the BRD occured independent of these exercise-related decongestant effects.

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.

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