Comparison of acoustic rhinometry and nasal inspiratory peak flow as objective tools for nasal obstruction assessment in patients with chronic rhinosinusitis

Background: The nose plays an important role in sleep quality. Very little is known about sleep problems in patients with chronic rhinosinusitis (CRS). The aim of this study was to investigate the impact of CRS on sleep-disordered breathing. Methodology: CRS patients who underwent functional endoscopic sinus surgery were collected between July 2010 and May 2015. Before surgery, they filled 20-item Sino-Nasal Outcome Test and Epworth Sleepiness Scale questionnaires, were asked about the severity of nasal obstruction, and received acoustic rhinometry, smell test, an endoscopic examination, sinus computed tomography, and a one-night polysomnography. Sleep quality was evaluated in these patients and was correlated with the severity of rhinosinusitis. Results: One hundred and thirty-nine CRS patients were enrolled in the study. Among them, 38.1% complained of daytime sleepiness, and this sleep problem was correlated with the symptom of nasal obstruction. Obstructive sleep apnea syndrome (OSAS) was diagnosed in 64.7% of the patients, but there was no correlation with the severity of rhinosinusitis. Nasal polyps did not worsen sleep problems in the CRS patients. Conclusions: This study showed that CRS patents had a high prevalence of OSAS, and worse OSAS in CRS patients was not correlated with the severity of rhinosinusitis.

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Nasal inspiratory peak flow rates after cold stimulation of the feet in allergic rhinitis and normals

Journal of Allergy and Clinical Immunology ◽

10.1016/s0091-6749(02)81394-x ◽

2002 ◽

Vol 109 (1) ◽

pp. S97-S97

Author(s):

Renata Witkowska ◽

Alan Wolff ◽

Kumar Patel ◽

Stanley Weiss ◽

Leonard Bielory

Keyword(s):

Allergic Rhinitis ◽

Peak Flow ◽

Cold Stimulation ◽

Flow Rates ◽

Nasal Inspiratory Peak Flow ◽

Stimulation Of

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Patient experience of nasal obstruction and its clinical assessment

The Journal of Laryngology & Otology ◽

10.1017/s0022215117002146 ◽

2018 ◽

Vol 132 (4) ◽

pp. 318-322 ◽

Cited By ~ 3

Author(s):

L Nip ◽

M Tan ◽

K L Whitcroft ◽

R Gupta ◽

T S Leung ◽

...

Keyword(s):

Nasal Obstruction ◽

Patient Experience ◽

Flow Measurement ◽

Prospective Survey ◽

Type Method ◽

Novel Device ◽

Nasal Inspiratory Peak Flow ◽

Assessment Techniques ◽

Current Assessment ◽

One Year

AbstractBackground:The correlation between objective and subjective nasal obstruction is poor, and dissatisfaction rates after surgery for nasal obstruction are high. Accordingly, novel assessment techniques may be required. This survey aimed to determine patient experience and preferences for the measurement of nasal obstruction.Method:Prospective survey of rhinology patients.Results:Of 72 questionnaires distributed, 60 were completed (response rate of 83 per cent). Obstruction duration (more than one year) (χ2 = 13.5, p = 0.00024), but not obstruction severity, affected willingness to spend more time being assessed. Questionnaires (48 per cent) and nasal inspiratory peak flow measurement (53 per cent) are the most commonly used assessment techniques. Forty-nine per cent of participants found their assessment unhelpful in understanding their obstruction. Eighty-two per cent agreed or strongly agreed that a visual and numerical aid would help them understand their blockage.Conclusion:Many patients are dissatisfied with current assessment techniques; a novel device with visual or numerical results may help. Obstruction duration determines willingness to undergo longer assessment.

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The Role of Rhinomanometry, Acoustic Rhinometry, and Mucociliary Transport Time in the Assessment of Nasal Patency

Ear Nose & Throat Journal ◽

10.1177/014556130007900515 ◽

2000 ◽

Vol 79 (5) ◽

pp. 397-400 ◽

Cited By ~ 32

Author(s):

Desiderio Passàli ◽

Chiara Mezzedimi ◽

Giulio Cesare Passàli ◽

Daniele Nuti ◽

Luisa Bellussi

Keyword(s):

Nasal Obstruction ◽

Acoustic Rhinometry ◽

Mucociliary Transport ◽

Nasal Patency ◽

Analog Scale ◽

Transport Time ◽

Subjective Assessments ◽

Symptom Scores ◽

Objective Tests

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.

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Acoustic rhinometry in the evaluation of nasal obstruction

The Laryngoscope ◽

10.1288/00005537-199503000-00010 ◽

1995 ◽

Vol 105 (3) ◽

pp. 275-281 ◽

Cited By ~ 101

Author(s):

Renato Roithmann ◽

Philip Cole ◽

Jerry Chapnik ◽

Isaac Shpirer ◽

Victor Hoffstein ◽

...

Keyword(s):

Nasal Obstruction ◽

Acoustic Rhinometry

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Nasal obstruction has a limited impact on sleep quality and quality of life in patients with chronic rhinosinusitis

The Laryngoscope ◽

10.1002/lary.25956 ◽

2016 ◽

Vol 126 (9) ◽

pp. 1971-1976 ◽

Cited By ~ 5

Author(s):

Andrew J. Thomas ◽

Richard R. Orlandi ◽

Shaelene Ashby ◽

Jess C. Mace ◽

Timothy L. Smith ◽

...

Keyword(s):

Quality Of Life ◽

Sleep Quality ◽

Chronic Rhinosinusitis ◽

Nasal Obstruction ◽

Limited Impact

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Intranasal lysine-aspirin administration decreases polyp volume in patients with aspirin-intolerant asthma

The Journal of Laryngology & Otology ◽

10.1017/s0022215107000515 ◽

2007 ◽

Vol 121 (12) ◽

pp. 1156-1160 ◽

Cited By ~ 34

Author(s):

N Ogata ◽

Y Darby ◽

G Scadding

Keyword(s):

Nitric Oxide ◽

Peak Expiratory Flow ◽

Flow Rate ◽

Nasal Polyp ◽

Peak Expiratory Flow Rate ◽

Peak Flow ◽

Peak Flow Rate ◽

Nasal Symptoms ◽

Nasal Inspiratory Peak Flow ◽

Before And After

AbstractIntroduction:Nasal polyposis associated with aspirin-intolerant asthma tends to be difficult to control, with frequent recurrences. We examined the effect of intranasal lysine-aspirin administration on resistant nasal polyps of asthmatic, aspirin-intolerant patients, when used in addition to routine therapy.Patients and methods:Thirteen patients with asthma and intolerance to aspirin were recruited. All but one had undergone numerous polypectomies and were uncontrolled on standard therapy with intranasal corticosteroids, leukotriene receptor antagonists and nasal douching. Aspirin treatment involved one drop (100 µl) of 30 mg/ml lysine-aspirin solution to each nostril, initially daily, increased every two or three days up to a maximal of 18 drops (54 mg lysine-aspirin) a day. Nasal symptoms, nitric oxide level, nasal inspiratory peak flow rate, peak expiratory flow rate and nasendoscopic grading were assessed prior to therapy and three months later. We also compared the change in endoscopic polyp scores during three months of lysine-aspirin administration with the changes which had occurred during the three months prior to administration (during which time other therapies had been identical).Results:Nasal blockage symptoms tended to decrease; other nasal symptoms were unchanged. Significant changes were seen in nasal inspiratory peak flow rate (103.3 ± 18.9 and 140.0 ± 16.7 l/min before and after aspirin, respectively; p = 0.014), but not in peak expiratory flow rate (438.7 ± 33.4 and 440.0 ± 28.4 l/min before and after aspirin, respectively; p = 0.700). Nasal nitric oxide levels rose significantly (in both sides, p = 0.028). Expired chest nitric oxide levels did not change. Nasal polyp scores on nasendoscopic examination were significantly reduced (right side, p = 0.027; left side, p = 0.018). Compared with the preceding three months, adding intranasal lysine-aspirin application had the effect on decreasing nasal polyp volume (right side, p = 0.031; left side, p = 0.016).Conclusion:This open study suggests that intranasal lysine-aspirin administration reduces nasal polyp volume in aspirin-intolerant patients, without any adverse affect on concomitant asthma. This was a preliminary study and should be followed by a placebo-controlled, double-blind trial.

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