Nasal resistance asymmetry as a predictor of satisfaction following nasal airway obstruction surgeries

2017 ◽  
Vol 6 (4) ◽  
pp. 1-9
Author(s):  
Monika Prus ◽  
Jarosław Wysocki ◽  
Marta Krasny ◽  
Kazimierz Niemczyk
Keyword(s):  
Airway Obstruction ◽  
Subjective Assessment ◽  
Subjective Perception ◽  
Nasal Airway ◽  
Nasal Resistance ◽  
Nasal Patency ◽  
Self Evaluation ◽  
Before And After ◽  
The Right ◽  
Medical University

Patients’ subjective assessment of nasal patency often does not correspond to the objective results of functional and imaging examinations. The objective of this study was to identify the rhinometry (AR) and rhinomanometry (RMM) parameters that were best correlated to patients’ self-evaluation of nasal patency before and after nasal airway obstruction surgery. The study material consisted of RMM and AR results as well as SNOT-20 self-evaluation questionnaires completed by 233 patients presenting with rhinological problems and routinely diagnosed at the RMM Lab of the Department and Clinic of Otolaryngology of the Medical University of Warsaw. Data were collected from 70 females (31.4%) aged 18 through 81 years and 153 males (68.6%) aged 16 through 81 years. The results were subjected to statistical analysis by a licensed statistician using the Statistica 10 software package. A statistically significant relationship was demonstrated between the subjective perception of nasal patency and RMM results. The higher the asymmetry of air flow within the left and the right nasal cavity, the higher the perceived restriction of nasal patency. Significant differences were observed between patients reporting maximum discomfort regarding impaired nasal patency and the remaining patients: the former were characterized by nasal resistance values being several-fold higher than that observed in the latter while nearly always improving after nasal airway obstruction surgeries. No significant reflection of patients’ self-evaluation of nasal patency was found in the acoustic rhinometry measurements.

Rhinomanometry Versus Computational Fluid Dynamics: Correlated, but Different Techniques

2020 ◽  
pp. 194589242095015
Author(s):  
Giancarlo B. Cherobin ◽  
Richard L. Voegels ◽  
Fábio R. Pinna ◽  
Eloisa M. M. S. Gebrim ◽  
Ryan S. Bailey ◽  
...  
Keyword(s):  
Fluid Dynamics ◽  
Computational Fluid Dynamics ◽  
Nasal Resistance ◽  
Nasal Patency ◽  
Low Correlation ◽  
Before And After ◽  
Computational Fluid Dynamics Cfd ◽  
Flow Experiments

Background Past studies reported a low correlation between rhinomanometry and computational fluid dynamics (CFD), but the source of the discrepancy was unclear. Low correlation or lack of correlation has also been reported between subjective and objective measures of nasal patency. Objective: This study investigates (1) the correlation and agreement between nasal resistance derived from CFD (RCFD) and rhinomanometry (RRMN), and (2) the correlation between objective and subjective measures of nasal patency. Methods Twenty-five patients with nasal obstruction underwent anterior rhinomanometry before and after mucosal decongestion with oxymetazoline. Subjective nasal patency was assessed with a 0-10 visual analog scale (VAS). CFD simulations were performed based on computed tomography scans obtained after mucosal decongestion. To validate the CFD methods, nasal resistance was measured in vitro (REXPERIMENT) by performing pressure-flow experiments in anatomically accurate plastic nasal replicas from 6 individuals. Results Mucosal decongestion was associated with a reduction in bilateral nasal resistance (0.34 ± 0.23 Pa.s/ml to 0.19 ± 0.24 Pa.s/ml, p = 0.003) and improved sensation of nasal airflow (bilateral VAS decreased from 5.2 ± 1.9 to 2.6 ± 1.9, p < 0.001). A statistically significant correlation was found between VAS in the most obstructed cavity and unilateral airflow before and after mucosal decongestion (r = −0.42, p = 0.003). Excellent correlation was found between RCFD and REXPERIMENT (r = 0.96, p < 0.001) with good agreement between the numerical and in vitro values (RCFD/REXPERIMENT = 0.93 ± 0.08). A weak correlation was found between RCFD and RRMN (r = 0.41, p = 0.003) with CFD underpredicting nasal resistance derived from rhinomanometry (RCFD/RRMN = 0.65 ± 0.63). A stronger correlation was found when unilateral airflow at a pressure drop of 75 Pa was used to compare CFD with rhinomanometry (r = 0.76, p < 0.001). Conclusion CFD and rhinomanometry are moderately correlated, but CFD underpredicts nasal resistance measured in vivo due in part to the assumption of rigid nasal walls. Our results confirm previous reports that subjective nasal patency correlates better with unilateral than with bilateral measurements and in the context of an intervention.

Nasal Patency, Aerobic Capacity, and Athletic Performance

1992 ◽  
Vol 107 (1) ◽  
pp. 101-104 ◽  
Author(s):  
Michael S. Benninger ◽  
J. R. Sarpa ◽  
Tariq Ansari ◽  
Joseph Ward
Keyword(s):  
Aerobic Capacity ◽  
Athletic Performance ◽  
Pulmonary Ventilation ◽  
Work Load ◽  
Saline Control ◽  
Nasal Airway ◽  
Nasal Resistance ◽  
Nasal Patency ◽  
Maximal Aerobic Capacity ◽  
Test Conditions

The patency of the nasal airway may directly affect pulmonary ventilation, with obstruction and increased nasal resistance resulting in increased pulmonary resistance, hypoxia, and hypercapnea. Nine aerobic athletes were evaluated to assess the role of the nasal airway on aerobic capacity and athletic performance. A step-ladder graded maximal aerobic capacity test was performed under three test conditions: obstructed, decongested with oxymetazoline hydrochloride, and saline control. No differences in maximum VO2, work load, oxygen saturation, maximal blood pressure, heart rate, or respiratory rate were noted between test conditions. Pre-exercise nasal resistance was lower in the decongested compared to control conditions, but no differences were found after exercise. Athletic performance was not influenced by nasal patency in this model.

scholarly journals Computational Fluid Dynamics Analysis of Nasal Airway Changes after Treatment with C-Expander

2021 ◽  
Vol 2021 ◽  
pp. 1-11
Author(s):  
Wang Xiao ◽  
Siling Liu ◽  
Yanqin Lu ◽  
Lei Lei ◽  
Ning Liu ◽  
...  
Keyword(s):  
Maximum Velocity ◽  
Study Data ◽  
Nasal Airway ◽  
Nasal Resistance ◽  
Effective Treatment Modality ◽  
Computational Fluid Dynamics Analysis ◽  
Before And After ◽  
Reduce Life Expectancy ◽  
Nasal Pressure ◽  
Age Range

The use of the C-expander is an effective treatment modality for maxillary skeletal deficiencies which can cause ailments and significantly reduce life expectancy in late adolescents and young adults. However, the morphological and dynamic effects on the nasal airway have not been reported. The main goal of this study was to evaluate the nasal airway changes after the implementation of a C-expander. A sample of nine patients (8 females, 1 male, age range from 15 to 29 years) was included. The morphology parameters and nasal airway ventilation parameters of pretreatment and posttreatment were measured. All study data were normally distributed. A paired t -test was used to evaluate the changes before and after treatment. After expansion, the mean and standard deviation values of intercanine maxillary width (CMW) and intermolar maxillary width (MMW) increased from 35.75 ± 2.48  mm and 54.20 ± 3.17  mm to 37.87 ± 2.26  mm ( P < 0.05 ) and 56.65 ± 3.10  mm ( P < 0.05 ), respectively. The nasal cavity volume increased from 20320.00 ± 3468.25  mm3 to 23134.70 ± 3918.84  mm3 ( P < 0.05 ). The nasal pressure drop decreased from 36.34 ± 3.99  Pa to 30.70 ± 3.17  Pa ( P < 0.05 ), while the value of the maximum velocity decreased from 6.50 ± 0.31  m/s to 5.85 ± 0.37  m/s ( P < 0.05 ). Nasal resistance dropped remarkably from 0.16 ± 0.14  Pa/ml/s to 0.08 ± 0.06  Pa/ml/s ( P < 0.05 ). The use of C-expander can effectively broaden the area and volume of the nasal airway, having a positive effect in the reduction of nasal resistance and improvement of nasal airway ventilation. For patients suffering from maxillary width deficiency and respiratory disorders, a C-expander may be an alternative method to treat the disease.

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.

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.

scholarly journals The effect of decongestion on nasal airway patency and airflow

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Qiwei Xiao ◽  
Alister J. Bates ◽  
Raul Cetto ◽  
Denis J. Doorly
Keyword(s):  
Nasal Airway ◽  
Nasal Resistance ◽  
Nasal Airflow ◽  
Cross Sectional ◽  
Airway Patency ◽  
Flow Rates ◽  
High Resolution Mri ◽  
Nasal Anatomy ◽  
Before And After ◽  
Flow Through

AbstractNasal decongestant reduces blood flow to the nasal turbinates, reducing tissue volume and increasing nasal airway patency. This study maps the changes in nasal anatomy and measures how these changes affect nasal resistance, flow partitioning between superior and inferior cavity, flow patterns and wall shear stress. High-resolution MRI was applied to capture nasal anatomy in 10 healthy subjects before and after application of a topical decongestant. Computational fluid dynamics simulated nasal airflow at steady inspiratory flow rates of 15 L.min$$^{-1}$$ - 1 and 30 L.min$$^{-1}$$ - 1 . The results show decongestion mainly increases the cross-sectional area in the turbinate region and SAVR is reduced (median approximately 40$$\%$$ % reduction) in middle and lower parts of the cavity. Decongestion reduces nasal resistance by 50$$\%$$ % on average, while in the posterior cavity, nasal resistance decreases by a median factor of approximately 3 after decongestion. We also find decongestant regularises nasal airflow and alters the partitioning of flow, significantly decreasing flow through the superior portions of the nasal cavity. By comparing nasal anatomies and airflow in their normal state with that when pharmacologically decongested, this study provides data for a broad range of anatomy and airflow conditions, which may help characterize the extent of nasal variability.

Normal Nasal Resistance

1985 ◽  
Vol 93 (6) ◽  
pp. 778-785 ◽  
Author(s):  
John F. Pallanch ◽  
Thomas V. McCaffrey ◽  
Eugene B. Kern
Keyword(s):  
Flow Curve ◽  
Nasal Resistance ◽  
Pressure Flow ◽  
Log Transformation ◽  
Nasal Symptoms ◽  
Before And After ◽  
The Mean ◽  
The Right ◽  
Normal Adults

Eighty normal adults without nasal symptoms were studied to determine normal nasal resistance values and the variation of nasal resistance in normal adults. A microprocessor-based system for collection and analysis of transnasal pressure and flow was used to obtain nasal resistance values. Unilateral and total transnasal pressure and flow values were determined before and after decongestion of the nose with 1% phenylephrine spray. The distribution of the 80 resistance values was found to be skewed to the right. Log transformation of the resistance values was the best method to normalize their distribution. The mean and variation of normal nasal resistance are reported at flows of 0.1 and 0.2 L/sec, at pressures of 0.5 and 1 cm H2O, and at radii of 1, 2, and 3 on the pressure-flow curve.

scholarly journals A hierarchical stepwise approach to evaluate nasal patency after virtual surgery for nasal airway obstruction

2019 ◽  
Vol 61 ◽  
pp. 172-180 ◽  
Author(s):  
Dennis O. Frank-Ito ◽  
Julia S. Kimbell ◽  
Azadeh A.T. Borojeni ◽  
Guilherme J.M. Garcia ◽  
John S. Rhee
Keyword(s):  
Airway Obstruction ◽  
Virtual Surgery ◽  
Nasal Airway ◽  
Nasal Patency ◽  
Stepwise Approach

The Nasal Valve: A Rhinomanometric Evaluation of Maximum Nasal Inspiratory Flow and Pressure Curves

1986 ◽  
Vol 95 (3) ◽  
pp. 229-232 ◽  
Author(s):  
Julian Santiago-Diez de Bonilla ◽  
Thomas V. McCaffrey ◽  
Eugene B. Kern
Keyword(s):  
Airway Obstruction ◽  
Nasal Obstruction ◽  
Airway Resistance ◽  
Nasal Airway ◽  
Nasal Resistance ◽  
Nasal Valve ◽  
Nasal Deformity ◽  
Asymptomatic Group ◽  
Nasal Airway Resistance ◽  
Anatomical Evidence

The nasal valve is defined as the region of the nasal airway bounded by the caudal end of the upper lateral cartilages and the nasal septum. During inspiration this region of the nasal airway may collapse and produce a marked increase in nasal airway resistance. To define the function of this region, measurements of the nasal airway resistance in 38 subjects were performed. Using anterior mask rhinomanometry, right and left total nasal resistance, right and left upstream nasal resistance, right and left downstream nasal resistance, and right and left transmural collapsing pressure of the nasal valve were measured. Subjects who complained of nasal obstruction and had anatomical evidence of anterior nasal deformity showed a reduced level of transmural closing pressure compared with subjects complaining of no airway obstruction or those with anatomical evidence of posterior nasal deformity. This suggests that premature collapse of the nasal valve due to inadequate cartilaginous support is an important factor in producing nasal airway obstruction in individuals with anterior nasal septal abnormality. In those individuals with nasal airway obstruction and anatomical evidence of posterior nasal deformity, downstream nasal resistance was elevated compared with the asymptomatic group and the group with anatomical evidence of anterior nasal septal deformity. This paper demonstrates that premature collapse of the nasal valve is responsible for the symptom of nasal obstruction in many patients with anterior nasal septal deformity.

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