A Preliminary Report on the Correlation Between Nasal Function and the Different Phases of the Nasal Cycle

Objective: To explore whether the different phases of the nasal cycle have a significant effect on nasal temperature, the nasal mucosal clearance rate, and levels of nasal nitric oxide (nNO) and to investigate the correlation between these nasal conditions. Methods: The study participants were divided into 2 groups: the control group and the rhinitis group. The participants’ nasal temperature, cilia clearance rate, and nNO levels were measured during different phases of the nasal cycle (the congestion phase and decongestion phase) in the control group and before and after undergoing inferior turbinate ablation in the rhinitis group. Results: The temperature of the nasal cavity in the control group was significantly higher in the congestion phase than in the decongestion phase ( P = .0025), while in the rhinitis group, the temperature of the nasal cavity decreased significantly after inferior turbinate ablation ( P = .001). In the control group, the nasal mucosa clearance time was significantly shorter in the congestion phase than in the decongestion phase ( P = .001), and in the rhinitis group, the clearance time of the nasal mucosa was significantly shortened after the operation ( P = .0025). In the control group, the levels of nNO were significantly higher in the congestion phase than in the decongestion phase ( P = .025), while in the rhinitis group, nNO levels decreased significantly after the operation ( P = .005). Conclusion: The function of the nasal cavity changes in different phases of the nasal cycle. Therefore, when evaluating the impact of various factors on nasal function, factors associated with the nasal cycle should also be considered. Inferior turbinate plasma ablation can improve the ciliary function of the nasal mucosa, reduce the temperature of the nasal cavity, and reduce nNO levels.

Re-evaluating the nasal cycle by long-term rhinoflowmetry: most individuals demonstrate a “mixed” nasal cycle

Background: The nasal cycle seems to be more complex than a strictly alternating swelling of the nasal mucosa. Long-term rhinoflowmetry (LRFM) allows continuous investigation of changes in nasal airflow over 24 hours (24h). We evaluated the various types of nasal cycle with LRFM over 24 hours and investigated the influence of age and gender. Methods: LRFM was continuously performed over 24h in 55 rhinologically healthy subjects (36 female, 19 male). The LRFM flow curves were examined for phases of the “classical”, “in-concert”, “one-sided” and “no-cycle” cycle types. Subjects were divided into 4 age subgroups (19-29; 30-49; 50-69; >70 years). Correlations of age and gender with the individual cycle forms were analyzed. Results: 85.5% of the subjects presented a “mixed” nasal cycle within 24h. The “classical” nasal cycle was seen most often (92.7% vs. “in-concert”; 56.4% vs. “one-sided”; 18.2% vs. “no-cycle”; 5.5%). Older age groups significantly more often presented the "no-cycle" type. A tendency was seen towards a mixed nasal cycle with increasing age. The mixed nasal cycle was significantly more often seen in the female subjects. Conclusions: LRFM is an easy-to-use measurement tool. The “mixed” nasal cycle predominates. However, all 4 different cycle types can be detected, alternating over 24h in each subject. Moreover, the cycle type varies with age.

Inhaled nasopharyngeal nitric oxide concentrations during unilateral nostril breathing – a pilot study

Objective: To assess the influence unilateral nostril breathing has on mean inhaled nasopharyngeal nitric oxide (NO) concentrations compared with unobstructed bilateral nostril breathing in individuals demonstrating a nasal cycle.Methods: After determining the patent and congested nasal sides in healthy adult volunteers (N=10), and sampling air at both nostrils, a small diameter gas sampling tube was passed along the floor of the nose into the volunteer's patent nostril, until it was stationed in the nasopharynx. Nasopharyngeal NO concentrations were then assessed during normal nasal at-rest tidal breathing during three different nasal breathing states: first both nostrils, then allocated in randomised order, patent side only, and congested side only.Results: Nasopharyngeal NO concentrations were consistently higher on both exhalation and inhalation during unilateral congested side nostril breathing, when compared with unilateral patent side nostril breathing, and breathing through both nostrils.Conclusions: During unilateral nostril breathing, inhaled nasopharyngeal NO concentrations are consistently higher on the congested side of the nose.

Stabilizing Effect of Yawning on Nasal Cycle

The dominant passability of the left or right nostril in terms of nasal air resistance can be classified into 4 main modes. In the first mode, both nostrils are closed and have equal and low air passability. In the second mode, the passability of the right nostril is higher than the left. In the third mode, the passability of the left nostril is higher than the right. In the fourth mode, both nostrils are open and passability of nostrils is equal and high. The first and fourth modes are unstable (with duration- minutes). The second and third modes are stable (with duration-hours). Author presents a yawning as physiological reflex leading to transition from unstable to stable modes.

Relationship Between Nasal Cycle, Nasal Symptoms and Nasal Cytology

Background The nasal cycle is the spontaneous congestion and decongestion of nasal mucosa that happens during the day. Classically, 4 types of nasal cycle patterns have been described: (1) classic, (2) parallel, (3) irregular, and (4) acyclic. Hypothalamus has been considered as the central regulator even if several external factors may influence its activity. Objective The aim of the study was to evaluate the presence of a correlation between nasal cycle pattern, nasal cytology and nasal symptoms. Methods Thirty healthy volunteers have been enrolled in the study. All subjects completed a Sino-Nasal Outcome Test-22 questionnaire and a Visual Analog Scale (VAS) for nasal obstruction. The nasal cycle was studied by means of peak nasal inspiratory flow. Nasal cytology has been used to evaluate the presence of local nasal inflammation. Results Nineteen subjects showed a parallel nasal cycle pattern, while 11 showed a regular one. A parallel pattern was present in 60% of asymptomatic subjects and in 67% of the symptomatic one ( P = 1). VAS for nasal obstruction did not show a significant difference between the 2 patterns of the nasal cycle ( P = .398). Seventeen subjects had a normal rhinocytogram, while 13 volunteers showed a neutrophilic rhinitis; 53.8% of the subjects with a neutrophilic rhinitis showed a parallel pattern, while the remaining 46.2% had a regular one. In the case of a normal cytology, 70.6% of the volunteers had a parallel pattern and 29.4% had a regular one. Differences between the 2 groups were not statistically significant ( P = .575). Conclusion Rhinitis with neutrophils seems to not influence the nasal cycle pattern. Based on the present results, the pattern of nasal cycle does not influence subjective nasal obstruction sensation.