Nasal Patency and the Aerodynamics of Nasal Airflow: Measurement by Rhinomanometry and Acoustic Rhinometry, and the Influence of Pharmacological Agents

2003 ◽  
pp. 788-821
1995 ◽  
Vol 9 (3) ◽  
pp. 175-178 ◽  
Author(s):  
Edward W. Fisher ◽  
Ming Liu ◽  
Valerie J. Lund

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.


2017 ◽  
Vol 33 (04) ◽  
pp. 372-377 ◽  
Author(s):  
Kevin Hur ◽  
Kai Zhao ◽  
Donald Leopold ◽  
Bozena Wrobel ◽  
Jasper Shen

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.


2000 ◽  
Vol 79 (5) ◽  
pp. 397-400 ◽  
Author(s):  
Desiderio Passàli ◽  
Chiara Mezzedimi ◽  
Giulio Cesare Passàli ◽  
Daniele Nuti ◽  
Luisa Bellussi

We conducted a study of 60 patients with different nasal pathologies who complained of nasal obstruction. Our goal was to evaluate the reliability of rhinomanometry, acoustic rhinometry, and the measurement of mucociliary transport time in helping make the diagnosis of nasal pathologies. We also sought to discover whether there is a correlation between the findings of these objective tests and the results of patients’ own subjective assessments of nasal obstruction. We found that acoustic rhinometry was more specific and more sensitive than rhinomanometry in diagnosing rhinopathies inpatients with structural anomalies. Symptom scores as rated by patients on the visual analog scale frequently did not correlate with objective measures, as patients often overestimated the severity of their obstruction. However, for a few patients, there was a correlation between symptom scores and mucociliary transport times.


2014 ◽  
Vol 5 (2) ◽  
pp. ar.2014.5.0089 ◽  
Author(s):  
Natalia Zanellato Fabbri ◽  
Eduardo Abib ◽  
Ricardo de Lima Zollner

The aim of this study was to objectively evaluate the effects of intranasal therapy with azelastine (AZE), budesonide (BUD), and combined AZE plus BUD (AZE/BUD) using a nasal provocation test (NPT) and acoustic rhinometry in patients with allergic rhinitis. A randomized, single-blind, crossover study with three treatment sequences was used. Thirty patients with persistent AR received the three treatments using a nasal spray twice daily for 30 days and were evaluated by an NPT with histamine before and after each period of treatment. The treatment comparison, assessed by the nasal responsiveness to histamine, was monitored based on subjective (symptom score) and objective parameters (acoustic rhinometry). The minimal cross-area 2 (MCA2) was measured by acoustic rhinometry at 1, 4, 8, and 12 minutes after NPT for each histamine concentration administered (0.5,1, 2, 4, and 6 mg/mL) up to at least a 20% reduction in the MCA2 from baseline (NPT20). The subjects were scored regarding nasal response encompassing histamine dose and time after histamine administration that caused nasal obstruction (NPT20 score) to assess the treatments' effects. Combination therapy produced a significant increase in baseline MCA2, viz., the improvement of nasal patency (p = 0.005). The symptoms score was significantly decreased after treatment with AZE (p = 0.03), BUD (p < 0.0001), and AZE/BUD (p < 0.0001), compared with pretreatment. The NPT20 score was significantly higher (p = 0.0009) after AZE/BUD, compared with AZE and BUD on their own. Thus, AZE therapy combined with BUD might provide more therapeutic benefits than the isolated drugs for improving nasal patency.


2006 ◽  
Vol 20 (5) ◽  
pp. 456-462 ◽  
Author(s):  
Devyani Lal ◽  
Melissa L. Gorges ◽  
Girapong Ungkhara ◽  
Patrick M. Reidy ◽  
Jacquelynne P. Corey

2007 ◽  
Vol 21 (4) ◽  
pp. 474-477 ◽  
Author(s):  
Roberto Castano ◽  
Gilles Thériault ◽  
Denyse Gautrin ◽  
Heberto Ghezzo ◽  
Carole Trudeau ◽  
...  

Background To diagnose occupational rhinitis, it is mandatory to conduct an objective assessment of changes in nasal patency during specific inhalation challenge (SIC). The reproducibility of acoustic rhinometry measurements in the setting of occupational challenges has never been examined. This study assessed the reproducibility of acoustic rhinometry during SIC investigation of occupational rhinitis. Methods Twenty-four subjects underwent acoustic rhinometry measurements during SIC investigation of occupational rhinitis. Subjects attended 3–6 days of SIC within a week by means of a realistic or closed-circuit apparatus methodology Results All of the within-day intraclass correlation coefficients (ICCs) for nasal volume (2–5 cm) and minimum cross-sectional area (MCA) based on a different number of measurements (2–7) were above 0.85; all of the coefficients of variation (CVs) for the same parameters were low (below 10%). The between-day CVs based on different numbers of SIC sessions ranged from 8.0 to 8.8% and from 6.8 to 8.8% for nasal volume and MCA, respectively. The between-day ICCs ranged from 0.80 to 0.88 and from 0.83 to 0.94 for nasal volume and MCA, respectively. Conclusion Acoustic rhinometry showed good within- and between-day reproducibility and can be recommended for the objective monitoring of nasal patency during SIC investigating occupational rhinitis.


1996 ◽  
Vol 110 (3) ◽  
pp. 221-224 ◽  
Author(s):  
Samy Elwany ◽  
Hossam Thabet

AbstractObstruction of the nasal valve is an important cause of chronic nasal obstruction in adults. In a series of 500 patients, obstruction at the level of the nasal valve was diagnosed in 65 of them (13 per cent). The obstruction was unilateral in 57 patients (88 per cent). Forty-seven patients (72 per cent) had history of previous nasal surgery of accidental trauma. Causes of obstruction of the nasal valve included high septal deviations, a weak or deformed upper lateral cartilage, adhesions, and alar collapse. All patients underwent corrective nasal surgery and the surgical procedures were tailored according to the existing pathology. Post-operatively, the mean nasal patency score increased from 2.9 to 8.6, the mean nasal airflow increased from 579.5 to 727 cm/sec (at 150 Pa), and the mean nasal resistance decreased from 0.31 to 0.23 Pa/cm3sec-1.


1996 ◽  
Vol 105 (10) ◽  
pp. 811-818 ◽  
Author(s):  
Burton Zweiman ◽  
Richard Doty ◽  
Andrew P. Lane ◽  
Donald C. Lanza ◽  
Hun-Jun Dhong ◽  
...  

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.


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