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The importance of side difference in nasal obstruction and rhinomanometry: a retrospective correlation of symptoms and rhinomanometry in 1000 patients
Author(s) -
Thulesius H.L.,
Cervin A.,
Jessen M.
Publication year - 2012
Publication title -
clinical otolaryngology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.914
H-Index - 68
eISSN - 1749-4486
pISSN - 1749-4478
DOI - 10.1111/j.1749-4486.2011.02420.x
Subject(s) - rhinomanometry , medicine , nose , visual analogue scale , airway , anesthesia , airway resistance , mucous membrane of nose , significant difference , surgery , anatomy
Clin. Otolaryngol. 2012, 37 , 17–22 Objectives: The correlation between subjective and objective outcomes of nasal obstruction is still a matter of controversy. The aim of this study was to determine the minimal level of side difference in nasal airway resistance (NAR measured by Broms’ v 2 ) between the two nasal cavities, which could be discerned subjectively by the patient on a visual analogue scale (VAS). Nasal airway resistance was calculated from rhinomanometric measurements of nasal airflow and transnasal pressure after decongestion of the nasal mucosa. Design: A retrospective study. Setting: ENT department, Vaxjo Central Hospital, Sweden. Participants: We studied 1000 active anterior rhinomanometries from patients with nasal obstructions. Main outcome measures: We compared the side difference of nasal airway resistance with the side difference of VAS estimated immediately prior to the rhinomanometry. Each measurement was performed after nasal decongestion. Results: When the difference in nasal airway resistance between the two nasal cavities was larger than 20° (Broms’ v 2 ) or R 2 > 0.36 Pa/cm 3 /s, we found a significant correlation between side differences of the objective measurement and the subjective assessment (VAS). With a nasal airway resistance side difference over 20°, an additional 20° difference corresponded to a 0.9 centimetre average VAS change. The more obstructed side of the nose could be determined by VAS in 823 (82.3%) of 1000 patients. Yet, 177 (17.7%) patients had a paradoxical sensation of nasal obstruction with the low resistance side of the nose experienced as the most congested side. Conclusion: A significant correlation between the side differences of nasal airway resistance and VAS can serve as a supplement to rhinoscopy in decisions about nasal surgery. This study also showed that in 17.7% of patients, there was a negative correlation between subjective and objective evaluations of nasal airway resistance. But in this group, the nasal airway resistance side difference was mostly under 20°.