The validity of peak nasal inspiratory flow as a screening tool for nasal obstruction.
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The peak nasal inspiratory flow (PNIF) is used as an outcome measure in post-treatment clinical and research evaluation. It is simple and cost effective. The validity of the use as a screening tool has never been assessedTo assess its validity and to define the cut-off point of determining the nasal obstructionThe nasal patency of 141 ambulatory subjects with or without sino-nasal diseases was measured by the PNIF and active anterior rhinomanometry. Inclusion criteria was all subjects aged 18 to 75-years-old, sinonasal diseases/ symptoms(nasal congestion, nasal discharge, nasal polyp, deviated nasal septum, nasal tumor inferior turbinate hypertrophy, sinusitis, and allergic rhinitis), instant sensation of nasal obstruction, and nasal endoscopy finding were recorded. All subjects signed written consent. Compared with the active anterior rhinomanometry as the gold standard, the sensitivity, specificity, likelihood ratio, positive predictive value, and negative predictive value of the PNIF was analyzed. The cut-off point of nasal obstruction was defined from the Receiver Operating Characteristic curve analysis. The agreement between the PNIF and the stuffiness and between the PNIF and the presence of sino-nasal diseases were assessed by using Kappa.With the cut-off point of 90 L/min, the sensitivity of the peak nasal inspiratory flow was 0.87 (0.753-0.989). The specificity was 0.52 (0.429-0.617). The negative predictive value was 0.93 (0.872-0.997). The positive predictive value was 0.34 (0.237-0.446). The likelihood ratio was 1.81 (1.438-2.318). The mean of the PNIF in normal subjects was 97.11 +/- 31.15. The agreement between the PNIF and the instant sensation of nasal blockage was 0.14 (-0.024-0.321) and the agreement between the PNIF and the sino-nasal diseases was 0.09 (-0.083-0.265).The PNIF regarding the cut-off point of 90 L/min, revealed good sensitivity and high negative predictive value but it had low specificity and low positive predictive value. The nasal peak flow did not agree well with the subjects' symptoms of blockage and sino-nasal diseases.Keywords:
Rhinomanometry
Gold standard (test)
Nasal congestion
Deviated nasal septum
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Objective To discuss the comprehensive evaluation methods of endoscopic nasal septum-nasal plastic surgery.Methods Select 176 cases of nasal and nasal septum deviation patients from 2006 December to 2011 December who in the Department of plastic surgery and Department of ENT in our hospital for operation treatment,to apply the VAS subjective assessment of nasal shape satisfaction and nasal congestion,nasal shape indexing,nasal resistance determination,external nasal index measuring to evaluate the operation effect.Results In the 176 cases,the satisfaction of postoperative nasal appearance was 96.02%,100% patients with nasal obstruction improved.From the nasal shape indexing,92.04% patients recovered to normal nasal shape,100% patients are effective.Measurement of nasal resistance,postoperative nasal cavity volume(0 ～5cm NCV0 ～5) increased significantly than that before operation;postoperative obstruction of the nasal airway resistance(NAR) of the lateral nasal was smaller than before surgery.Measurement of relevant indicators of external nose,the length of nose and deep of nose after surgery has increased than before surgery,the length dorsal nasal slope,the angle of nose and face,the angle of nose and forehead,the angle of nosewing after surgery has narrowed than before surgery,the difference was statistically significant(P0.05).Conclusion The curative effect evaluation method,is proposed to evaluate the comprehensive approach,including the subjective satisfaction of patients with nasal shape,improve the degree of subjective nasal congestion,nasal shape indexing,nasal resistance determination,measurement indicators of external nose.
Deviated nasal septum
Nasal congestion
Nasal dorsum
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The peak nasal inspiratory flow (PNIF) is used as an outcome measure in post-treatment clinical and research evaluation. It is simple and cost effective. The validity of the use as a screening tool has never been assessedTo assess its validity and to define the cut-off point of determining the nasal obstructionThe nasal patency of 141 ambulatory subjects with or without sino-nasal diseases was measured by the PNIF and active anterior rhinomanometry. Inclusion criteria was all subjects aged 18 to 75-years-old, sinonasal diseases/ symptoms(nasal congestion, nasal discharge, nasal polyp, deviated nasal septum, nasal tumor inferior turbinate hypertrophy, sinusitis, and allergic rhinitis), instant sensation of nasal obstruction, and nasal endoscopy finding were recorded. All subjects signed written consent. Compared with the active anterior rhinomanometry as the gold standard, the sensitivity, specificity, likelihood ratio, positive predictive value, and negative predictive value of the PNIF was analyzed. The cut-off point of nasal obstruction was defined from the Receiver Operating Characteristic curve analysis. The agreement between the PNIF and the stuffiness and between the PNIF and the presence of sino-nasal diseases were assessed by using Kappa.With the cut-off point of 90 L/min, the sensitivity of the peak nasal inspiratory flow was 0.87 (0.753-0.989). The specificity was 0.52 (0.429-0.617). The negative predictive value was 0.93 (0.872-0.997). The positive predictive value was 0.34 (0.237-0.446). The likelihood ratio was 1.81 (1.438-2.318). The mean of the PNIF in normal subjects was 97.11 +/- 31.15. The agreement between the PNIF and the instant sensation of nasal blockage was 0.14 (-0.024-0.321) and the agreement between the PNIF and the sino-nasal diseases was 0.09 (-0.083-0.265).The PNIF regarding the cut-off point of 90 L/min, revealed good sensitivity and high negative predictive value but it had low specificity and low positive predictive value. The nasal peak flow did not agree well with the subjects' symptoms of blockage and sino-nasal diseases.
Rhinomanometry
Gold standard (test)
Nasal congestion
Deviated nasal septum
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Methods for assessing the nasal patency are needed in the evaluation of patients with symptoms of nasal stenosis. Apart from the commonly used rhinomanometric method spirometric forced volume measurements as well as nasal peak flow rate have gained interest especially in studies concerning allergic rhinitis and nasal hyperreactivity. We have measured the expiratory and inspiratory forced volume in 0.5 second through the mouth and nose in 12 patients before and after septoplasty and in ten controls. A nasal patency index (NPI) was calculated from the ratio between nasal and oral measurements. The expiratory and inspiratory NPI for the preoperative worst cavity and the expiratory NPI for the total nose showed significant improvement. These indices from the patients preoperative measurements also differed significantly from controls. We found the method easy to handle and sensitive enough to detect changes of the nasal patency after septoplasty.
Rhinomanometry
Vital capacity
Deviated nasal septum
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Nasal obstruction and complaints are common attendance causes in otorhinolaryngology clinics. Obese patients are especially more vulnerable for these complaints. There is not enough data about nasal resistance and weight.One hundred ten patients who had no nasal complaint and nasal pathology were investigated by peak nasal inspiratory flow meter, nasal symptom evaluation scale (NOSE), and visual analog scale (VAS) calculation.According to the statistical analyses among the BMI groups, there is no significant difference detected. Peak nasal inspiratory flow values highly correlated with height. Height correlated with VAS and weight correlated with NOSE scores. VAS score highly correlated with NOSE score. Also, there is a negative statistically significant correlation between BMI and nasal congestion index.All these data show that there is no relation between BMI and nasal resistance, and although the nasal congestion cycle is preserved in all BMI groups, nasal congestion index is decreased when the weight is raised.
Nasal congestion
Rhinomanometry
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Rhinomanometry
Gold standard (test)
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Objective To improve the curative effect of endoscopic sinus surgery.Methods The clinical data of 268 cases of nasal cavity and nasal sinus diseases treated by endoscopic sinus surgery were summarized.In the 268 cases,242 cases were followed up for over six months.Results In the 268 cases,235 cases were cured,30 were improved and 3 were ineffective,with the effective rate of 98.88% and with no serious operative complication.Conclusion Cleaning the operation cavity after surgery can promote healing.
Endoscopic sinus surgery
Sinus (botany)
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The aim of this study was to ascertain the most reliable objective measurement for the assessment of nasal patency by investigating the relationship between peak nasal inspiratory flow, peak oral inspiratory flow, and the nasal patency index in relation to the patient's subjective perception regarding nasal obstruction.Prospective cohort study.This study included 131 volunteers of both genders, aged 18 years or older, with or without nasal symptoms, who were able to give informed consent, completed the study protocol, and could speak and write Dutch fluently. Peak nasal inspiratory flow and peak oral inspiratory flow were performed and nasal patency index was computed. The results were evaluated and compared with the subjective perception of nasal passage, using the validated Nasal Obstruction Symptom Evaluation scale and visual analog scale for nasal passage.Our study showed that peak nasal inspiratory flow, nasal patency index and nasal patency visual analog scale correlate with the Nasal Obstruction Symptom Evaluation scale in contrast to peak oral inspiratory flow. Peak nasal inspiratory flow and nasal patency index also showed significant association with the Nasal Obstruction Symptom Evaluation scale after adjustment for confounders.Peak nasal inspiratory flow is the most reliable method for the assessment of nasal patency. It is quick, inexpensive, and easy to perform, and correlates significantly with the subjective feeling of nasal obstruction. There is no clinical need to measure peak oral inspiratory flow or to calculate the nasal patency index in the evaluation of nasal patency.4
Rhinomanometry
Peak flow meter
Deviated nasal septum
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Citations (31)
Objective This article describes a simplified endonasal approach compared with traditional techniques for the correction of crooked noses by using endoscopic tension-relaxing septoplasty in the absence of nasal splints, with attempts to improve both the aesthetic appearance and functionality. Study Design A retrospective study was conducted at our institution with all 26 patients who underwent tension-relaxing rhinoseptoplasty by endoscope between November 2008 and January 2013. Methods Patients who were concerned about their aesthetic appearance and nasal obstruction were subjected to anterior rhinoscopy, endoscopic examination of the nasal cavity, and computed tomography for the evaluation of correlations among deformity of the nasal structures and nasal airway. The tension-relaxing method was used in the endoscopic rhinoseptoplasty by an endonasal approach. We introduced this technique in the surgery for patients with a C- or an I-shaped crooked nose. Subjective (visual analog scale) and objective (quantitative electronic meter measurement) assessments were used to evaluate aesthetic appearance. Validated Nasal Obstruction Symptom Evaluation scale and active anterior rhinomanometry were used to assess nasal obstruction. Results All the patients indicated cosmetic satisfaction and reduced nasal obstruction. In cases with I-shaped and C-shaped crooked nose deformities, pre-and postoperative angle values (mean ± standard deviation) were 13.35 ± 3.36° versus 1.85 ± 1.66° (n = 15) and 153.69 ± 6.48° versus 176.64 ± 2.32° (n = 11), respectively. Postoperative correction rates were statistically significant (p < 0.001) in both groups. Results from active anterior rhinomanometry indicated significant improvement in objective nasal obstruction from a mean baseline value of 0.56 ± 0.07 Pa/cm 3 /s (range, 0.43- 0.69 Pa/cm 3 /s), to a 12-month value of 0.26 ± 0.02 Pa/cm 3 /s (range, 0.23-0.29 Pa/cm 3 /s) (p < 0.001). The mean rhinoseptoplasty duration time was 19.00 ± 3.53 minutes. The nose deformities were significantly improved, with no recurrences of septal deviation or crooked nose, nor complications of septal perforation and nasal infection 12 months after the operation. Conclusion This simple technique is feasible and minimally invasive, and may be particularly beneficial to patients with a deviated septum who seek to improve both their aesthetic appearance and nasal functionality. However, this method is not appropriate for those with a crooked nose caused by nasal bone deformity, lateral cartilages, and severe septal deformity.
Rhinomanometry
Deviated nasal septum
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Background . Nasal cavity and nasopharyngeal pathology are crucial and common issue in pediatric otorhinolaryngology. One of the major reasons for the nasal breathing difficulties are adenoids, allergic rhinitis, acute rhinitis, rhinosinusitis, nasal septum deviation. All these diseases can occur individually and in combination with each other, while clinical signs can be similar. Objective. The aim of the study is study and estimate the condition of nasal breathing and sense of smell in children with different nasal and nasopharyngeal pathology. Methods. The study included 128 children, all children were divided into 3 groups comparable by gender and age. Children with confirmed acute ENT organ disease were included in the 1st group, children with allergic disease exacerbation were included in the 2nd group, and clinically healthy children (control group) were included in the 3rd group. Survey methodology: rhinomanometry (RMM), rhinoresistometry (RRM), olfactometry. Results. It was revealed that nasal resistance in children with allergic diseases exacerbation is significantly higher both before and after anemisation of nasal mucosa with a solution of nasal decongestants than in children of the control group (according to the RRM). The air flow rate increases by average of 25% in children with various ENT organs diseases, and in children with allergic diseases — by average of 43% after anemisation of the nasal mucosa. The obtained data shows the role of nasal mucosal edema in patients with allergic diseases during exacerbation. Analysis of our RMM and RRM data suggests the importance of further use of these methods in children. Conclusion. The obtained results will allow us to optimize the diagnosis approach and personalize the management of patients with various nasal cavity and nasopharynx pathologies. Nowadays, the study is ongoing.
Rhinomanometry
Deviated nasal septum
Turbinates
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Nasal obstruction is one of the most common complaints presenting to ear, nose and throat surgeons, but treatment is usually initiated without any objective measurement of nasal airflow. 'Anatomical' nasal patency is the nasal patency measured after decongestion of the nasal blood vessels by application of a topical nasal decongestant or by standard exercise. Anatomical nasal patency is a useful measure for the nasal surgeon, as it is determined solely by the hard tissues of nose such as cartilage and bone. Rhinomanometry provides a functional measure of nasal patency, whereas acoustic rhinometry provides an anatomical measurement of cross-sectional area or nasal volume. Nasal peak inspiratory flow can also provide useful measures of nasal patency. Acoustic rhinometry consists of generating an acoustic pulse from a spark source or speaker, and sound pulse is transmitted along a tube into the nose. Congestion in the ethmoid region may cause a sensation of pressure and obstruction that has no relationship to nasal airway resistance.
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