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.

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.

Neural drive to nasal dilator muscles: influence of exercise intensity and oronasal flow partitioning

1995 ◽  
Vol 79 (4) ◽  
pp. 1330-1337 ◽  
Author(s):  
R. F. Fregosi ◽  
R. W. Lansing
Keyword(s):  
Exercise Intensity ◽  
Respiratory Drive ◽  
Nasal Airway ◽  
Nasal Airflow ◽  
Neural Drive ◽  
Dilator Muscle ◽  
Turbulent Airflow ◽  
Flow Turbulence ◽  
Highly Correlated ◽  
Ventilation Rates

Our aim was to test the following hypotheses: 1) neural drive to the muscles of the alae nasi (AN) is proportional to nasal airflow and is independent of the overall level of central respiratory drive, and 2) the switch from nasal to oronasal breathing corresponds to the onset of marked flow turbulence in the nasal airway. Total and nasal inspired ventilation rates (VI) and the electromyogram (EMG) of the AN muscles were measured in seven subjects during progressive-intensity bicycling exercise. In separate experiments in six subjects the nasal VI corresponding to the transition from laminar to turbulent airflow was determined by measuring the pressure-flow relationship of the nasal airway with anterior rhinomanometry. Nasal VI accounted for 70 +/- 11% of total VI at rest and 27 +/- 8% (SE) at 90% of the maximal attainable power (max). Nasal VI and integrated AN EMG activities increased linearly with exercise intensity up to 60% of the max power, but both variables plateaued at this level even though total VI (and central respiratory drive) began to increase exponentially as exercise intensity increased to 90% max. The onset of the exponential rise in total VI was associated with a sharp increase in oral VI and with the onset of marked flow turbulence in the nasal airway. The results suggest that during incremental exercise 1) changes in AN EMG activities are highly correlated with changes in nasal VI, 2) turbulent flow in the nose may be the stimulus for the switch to oronasal breathing so that total pulmonary resistance is minimized, and 3) the correlation between nasal airflow and neural drive to the AN muscles is probably mediated by mechanisms that monitor airway resistance. Although these mechanisms were not identified, the most likely possibilities are receptors in the upper and/or lower airways that are sensitive to negative transmural pressure, or to effort sensations leading to greater corollary motor discharge to nasal dilator muscle motoneurons.

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.

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.

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.

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.

scholarly journals Olfactory improvement in acromegaly after transnasal transsphenoidal surgery

2010 ◽  
Vol 29 (4) ◽  
pp. E10 ◽  
Author(s):  
Bertrand Actor ◽  
Johannes Sarnthein ◽  
Peter Prömmel ◽  
David Holzmann ◽  
René L. Bernays
Keyword(s):  
Transsphenoidal Surgery ◽  
Fisher Exact Test ◽  
Significant Shift ◽  
Nasal Airway ◽  
Nasal Breathing ◽  
Airway Patency ◽  
Exact Test ◽  
Cross Tabulation ◽  
Olfactory Disturbance ◽  
Nasal Complications

Object The direct transnasal transsphenoidal approach to the sellar region has become a widely adopted surgical procedure among neurosurgeons and ear, nose, and throat specialists. Nasal complications and their incidence have been investigated, but a systematic testing of olfactory disturbance has not previously been performed. Considering that the sense of smell is deeply anchored and interwoven within the CNS, and that its impairment implies a considerable loss in quality of life, surgical practice should aim at its preservation. Methods In this retrospective study, pre- and postoperative olfactory performance, nasal airway passage, septal perforation, and epistaxis were assessed in 96 patients who underwent direct transnasal transsphenoidal microsurgery at the authors' department between January 2007 and August 2009. Olfactory performance was assessed using the Sniffin' Sticks test and/or the Zürcher Geruchstest. Results After surgery, 47 (49%) of 96 patients improved, 34 (35%) of 96 deteriorated, and 15 (16%) of 96 presented with unchanged olfactory performance. With respect to the underlying pathological entity, the authors noticed a remarkable difference between patients with acromegaly (23 cases) and all other patients (73 cases). Fifteen (65%) of 23 patients with acromegaly improved (others 44%), only 3 (13%) of 23 deteriorated (others 42%), and 5 (22%) of 23 remained unchanged (others 14%) in their ability to distinguish odors. This illustrates a significant shift toward improved postoperative olfactory performance (cross-tabulation, Fisher exact test; p = 0.028) in patients with acromegaly. In nasal breathing, 77 (80%) of 96 patients noticed no change, 11 (12%) of 96 improved, and 8 (8%) of 96 worsened postoperatively. Of the 11 patients with improved breathing, 6 (55%) had acromegaly. Improved nasal airway patency was more frequent in patients with acromegaly (cross-tabulation, Fisher exact test; p = 0.002). Conclusions The data provide the first significant evidence for improvement in olfactory performance in patients with acromegaly after transsphenoidal surgery (TSS) of growth hormone–producing adenomas. Furthermore, postoperative olfactory disturbance in patients treated with transnasal TSS is more frequent than previously reported. Nevertheless, recurrent transnasal TSS can be performed successfully, even multiple times, and does not involve a higher risk of nasal complications.

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.

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.

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