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The importance of side difference in nasal obstruction and rhinomanometry: a retrospective correlation of symptoms and rhinomanometry in 1000 patients

Thulesius, Helle LU ; Cervin, Anders LU and Jessen, Max (2012) In Clinical Otolaryngology 37(1). p.17-22
Abstract
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' v2) 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... (More)
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' v2) 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 degrees (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 degrees, an additional 20 degrees 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 degrees. Results: When the difference in nasal airway resistance between the two nasal cavities was larger than 20 degrees (Broms' v2) or R2 > 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 degrees, an additional 20 degrees 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 degrees. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Clinical Otolaryngology
volume
37
issue
1
pages
17 - 22
publisher
Wiley-Blackwell
external identifiers
  • wos:000301779300002
  • scopus:84858763461
  • pmid:22136145
ISSN
1749-4486
DOI
10.1111/j.1749-4486.2011.02420.x
language
English
LU publication?
yes
id
3c8844ac-462e-4ceb-a5e8-37d828fb0596 (old id 2494890)
date added to LUP
2012-05-07 14:02:43
date last changed
2017-05-14 03:05:25
@article{3c8844ac-462e-4ceb-a5e8-37d828fb0596,
  abstract     = {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' v2) 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 degrees (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 degrees, an additional 20 degrees 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 degrees. Results: When the difference in nasal airway resistance between the two nasal cavities was larger than 20 degrees (Broms' v2) or R2 > 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 degrees, an additional 20 degrees 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 degrees.},
  author       = {Thulesius, Helle and Cervin, Anders and Jessen, Max},
  issn         = {1749-4486},
  language     = {eng},
  number       = {1},
  pages        = {17--22},
  publisher    = {Wiley-Blackwell},
  series       = {Clinical Otolaryngology},
  title        = {The importance of side difference in nasal obstruction and rhinomanometry: a retrospective correlation of symptoms and rhinomanometry in 1000 patients},
  url          = {http://dx.doi.org/10.1111/j.1749-4486.2011.02420.x},
  volume       = {37},
  year         = {2012},
}