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Nasal obstruction when lying down is a common complaint in patients with chronic nasal obstruction, but rhinomanometry is typically performed in the sitting position. This study aimed to analyse whether adding rhinomanometry in a supine position is a useful examination.
Method
A total of 41 patients with chronic nasal obstruction underwent rhinomanometry and acoustic rhinometry, sitting and supine, before and after decongestion, as well as an over-night polygraphy.
Results
Total airway resistance was measurable in a supine position in 48 per cent (14 of 29) of the patients with total airway resistance of equal to or less than 0.3 Pa/cm3/second when sitting and in none (0 of 12) of the patients with total nasal airway resistance of more than 0.3 Pa/cm3/second when sitting. After decongestion, this increased to 83 per cent and 58 per cent, respectively.
Conclusion
Increased nasal resistance when sitting predicts nasal breathing problems when supine. Rhinomanometry in a supine position should be performed to diagnose upper airway collapse when supine.
The patency and volume of the nasal cavity affect the acoustic characteristics of the voice. The aim of this study was to investigate the effect of a nasal decongestant on nasal volumes and nasalance scores, and to determine the relationship between these measures.
Methods:
Acoustic rhinometry and nasometry were performed in a group of 21 adult volunteers both prior to and following application of a nasal decongestant. The relationship between changes in nasalance scores and acoustic rhinometric parameters was investigated.
Results:
After the application of nasal decongestant, statistically significant increases were observed in nasalance scores and in all of the acoustic rhinometric parameters assessed (i.e. minimal cross-sectional area, three cross-sectional areas, three volumes and total volume). However, no significant correlation was found between the changes in nasalance scores and acoustic rhinometric parameters.
Conclusions:
Nasal decongestion causes an increase in nasalance scores and nasal cavity volumes. However, the findings of this study indicate that changes in nasalance scores may result from factors other than nasal cavity volume changes.
Control and recording of the position of the acoustic rhinometer in relation to the nostrils is important for serial measurements. Several technical factors must be controlled, including the angle of the incident acoustic wave. We describe a simple, newly-designed, rhinometer stand which allows control of height and angle, and hence improves the reliability of serial measurements in clinical and physiological work.
Simple rhinohygrometry and passive rhinomanometry studies have suggested that the ‘nasal cycle’ in children is often different in pattern of that of adults and experimental animals. We aimed to establish whether this assertion was correct, using a reliable and sensitive method, acoustic rhinometry (AR), and to compare results with those of simple rhinohygrometry (RH). Healthy children with no evidence of nasal disease were examined (n = 15; age range three to 10 years; mean age six years). Simultaneous recordings using AR and RH were made on each child every 10–15 minutes over two to four hour periods. Six children underwent nine additional AR studies on separate occasions. ‘Classical’ reciprocal alternating patterns were evident in 80 per cent (12/15) AR and 53 per cent (8/15) RH studies, ‘in concert’ patterns in seven per cent (1/15) AR and 20 per cent (3/15) RH studies and ‘irregular’ patterns in 13 per cent (2/15) AR and 27 per cent (4/15) RH studies. The agreement between the two methods was 47 per cent, with a kappa (K) value of −0.17 (poor agreement compared to chance). Agreements between the acoustic rhinometry parameters were ‘fair’ for all data (K = 0.34) and excellent (K = 1.0) if irregular patterns were ignored. Repeated studies showed that the pattern of fluctuation varies within any particular individual. The nasal cycle is similar in pattern in children and adults, and acoustic rhinometry is currently the method of choice to further investigate and clarify this phenomenon.
Acoustic rhinometry is a new method which describes the geometry of the nasal cavity and the epipharynx. The method, based on the reflection of an acoustic signal entered into the nasal cavity, can be used to evaluate the cross-sectional area of the nasal cavity asa function of distance from the nostril. The method has, together with nasal expiratory peak flow (NPF) and nasal index based upon a self assessment score, been used to evaluate, in an objective and dynamic way, the effect of systemic treatment of nasal polyps with steroids in a series of eight patients with recurrent nasal polyposis. The study shows a significant relationship between these three parameters before and after systemic treatment of nasal polyps with steroids. It is concluded that in this study acoustic rhinometry had an accurate and objective method for measuring the geometry of the nasal cavity before and after treatment for processes which block the nasal cavity.
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