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PubMed2001

[Nasal lavage, rhinomanometry and rhinoscopy in diagnosing occupational airway allergy].

The aim of the study was to estimate the usefulness of nasal lavage, rhinomanometry and rhynoscopy in diagnosing occupational allergic rhinitis and bronchial asthma. 26 subjects with suspected bronchial asthma and allergic rhinitis due to occupational allergens were examined. Each subject had medical history collected and underwent physical examination, skin prick tests (SPT) with common and occupational allergens, determination of total and specific IgE, specific bronchial or nasal provocation with determination of spirometric parameters, morphological and biochemical changes in nasal lavage fluid (NLF). Moreover the anterior rhinomanometry and rhynoscopy were performed before and after the provocation. A significant increase in the percentage of eosinophils and albumin was observed in NLF up till 24 hr after the specific challenge, but only in the group of 16 subjects with diagnosed occupational airway allergy. The authors observed also the presence of mucosal oedema and rhinorrhea in this group of patients more frequently than in the group of patients without diagnosed occupational airway disease. No significant changes were observed in the frequency of positive rhinomanometry test between the analysed groups of patients.

Adult↗
PubMedDate not supplied

Nasal dyspnea: the place of rhinomanometry in its objective assessment.

BACKGROUND: "Nasal dyspnea" describes the common symptom of nasal airway obstruction, which usually is assessed subjectively. Objective, quantitative methods are needed to assess the nasal airway adequately. METHODS: Rhinomanometry, in use for >30 years, was reviewed. RESULTS: No other symptom of rhinitis can be measured as objectively and accurately as that of nasal obstruction. Determinations by rhinomanometry are precise, usually better than 5%. Most rhinomanometers meet the published requirements of standardization by the International Rhinologic Society. An improved system for scoring symptoms of nasal dyspnea is suggested. Rhinomanometry, potentially a gold standard for the objective measurement of obstructed nasal airflow, has a proven place in the selection of patients for septal and nasal valve reconstruction. CONCLUSION: Recommendations are given for extension of the standards to account for the near universal computerization of equipment. Miniaturization of equipment will increase its application to trials of drugs for rhinitis.

Dyspnea↗
PubMed1997

Current advances in rhinomanometry.

Current advances in rhinomanometry were reviewed in this paper. Active posterior rhinomanometry with a "head-out" body plethysmography may be the least invasive method currently available for measuring nasal patency. In general, active anterior rhinomanometry with a face mask or a nasal nozzle has been employed in various studies throughout the world. Nasal resistance as calculated from the equation R = 0.78 (delta P/V)1.33 at any points on a pressure/flow curve, or averaged nasal resistance may be the most suitable expression for nasal patency. Values for nasal resistance at delta P 100 Pa in Japanese patients or delta P 150 Pa in Caucasians have been widely employed as standard objective data for nasal obstruction, although rhinomanometric results sometimes do not agree with subjective evaluation of nasal obstruction. Nasal airflow acceleration or peak flow index during nasal breathing at rest can be applied as warranted to confirm an objective diagnosis of symptomatic nasal obstruction. Further, nationality and anthropological characteristics can be related to the severity and type of stuffiness.

Humans↗
PubMed1998

Correlation between nasal obstruction symptoms and objective parameters of acoustic rhinometry and rhinomanometry.

Acoustic rhinometry and rhinomanometry have been used to assess nasal airway patency objectively. We compared nasal obstruction symptoms before and after decongestion with several parameters of these objective tests. The patients assessed their nasal obstruction using a visual analogue scale (VAS). Cross-sectional areas and nasal resistance were measured by acoustic rhinometry and rhinomanometry before and after topical application of 1% phenylephrine solution in 32 patients with nasal obstruction symptoms. There was no significant correlation between the difference in the VAS and the difference in nasal resistance. There was also no significant correlation between the difference in the VAS and minimal cross-sectional area and cross-sectional areas at 3.3 cm (CA3.3), CA4.0 and CA6.4 from the nosepiece both in the wide and narrow sides and in both nasal cavities before and after nasal decongestion. It is concluded that rhinomanometry and acoustic rhinometry may have no diagnostic value in estimating the severity of nasal obstruction symptoms.

Acoustics↗
PubMed1985

Rhinomanometry in routine allergen challenge.

Ten patients with allergic rhinitis due to grass pollen were challenged out of season with increasing concentrations of a well defined grass pollen extract. The reactions to challenge were followed by active anterior rhinomanometry at rest and just after exercise, rhinoscopy, counting of sneezes, measurement of secretion, and registration of the patient's subjective symptoms. It was not possible to detect a positive reaction earlier with rhinomanometry than the other methods. Thus, rhinomanometry does not seem necessary in routine allergologic work.

Adolescent↗
PubMed1987

Rhinomanometry: do the anterior and posterior methods give equivalent results?

Nasal resistance to airflow was measured by both anterior and posterior rhinomanometry in 15 healthy volunteers. It was found that the posterior method gave values on average 16% higher than the anterior method. This difference was statistically significant. We propose that this is due to posterior rhinomanometry measuring the resistance of the nasopharynx as well as the resistance of the nose. In the past a discrepancy between the 2 methods has been claimed to be due to an error in the standard form of the parallel resistance equation. This hypothesis was tested by measuring total nasal resistance by posterior rhinomanometry and comparing this with a total nasal resistance value derived from posterior rhinomanometric measurements of the resistance of the individual nasal cavities. The standard form of the parallel resistance formula was used to derive the total nasal resistance. There was no significant difference between the 2 values for total nasal resistance. We conclude that if measurements are made at the same pressure gradient then the use of this equation is valid.

Adult↗
PubMed1994

Acoustic rhinometry compared with anterior rhinomanometry in the assessment of the response to nasal allergen challenge.

Acoustic rhinometry was used to assess nasal airway patency objectively and was compared with the more established method of anterior rhinomanometry. Ten patients with allergic rhinitis underwent 15 nasal challenges with allergen to which they showed positive skin-prick tests. Responses were assessed by measuring the minimum nasal cross-sectional area (Amin.) using acoustic rhinometry and by measuring nasal airway resistance (NAR) using anterior rhinomanometry. The measurements of Amin. and NAR showed a significant negative correlation. Acoustic rhinometry appears to be superior to anterior rhinomanometry in quantifying the response to nasal allergen challenge and may be particularly useful in patients with initial nasal blockage.

Administration, Intranasal↗
PubMed2005

An improved device for posterior rhinomanometry to measure nasal resistance.

Rhinomanometry is a method for measuring nasal resistance for the purpose of providing an objective evaluation of nasal patency. Posterior rhinomanometry is accomplished without the use of a mask, thus allowing the patient to breathe naturally. Here, we report on the improvements we have made to the existing posterior rhinomanometry system. In this system, nasal airflow is measured indirectly by measuring the pressure differential across a small mesh window in the body plethysmograph. We have calibrated this measurement and developed software that automatically provides the correct values for all airflow rates. Also, we have developed software that automatically corrects for the phase shift caused by the plethysmograph structure. These refinements should provide more accurate values for nasal resistance.

Adult↗
PubMed1996

Diagnosing nasal hyperreactivity with positional rhinomanometry.

Positional rhinomanometry is a physiologic method for estimating nasal resistance, which is variable, difficult to predict, and linked to vasomotor activity of the functional system culminating in the turbinate valves. Thirty subjects suffering from allergic rhinitis, 25 patients affected by aspecific rhinitis, and 40 healthy controls underwent positional rhinomanometry. Test positions included the seated (baseline), supine, and recumbent (homolateral and contralateral to the nasal fossa under examination). In patients with perennial allergic rhinitis and in those with aspecific rhinitis, positional rhinomanometry elicited two pathologic responses: either an average percentage rise of more than 80% in nasal resistance in the supine and homolateral and contralateral recumbent positions compared with basal values, or a paradoxical fall in the supine and homolateral recumbent positions.

Adult↗
PubMed1999

Protruding the tongue improves posterior rhinomanometry in obstructive sleep apnoea syndrome.

In posterior rhinomanometry (PRM), oropharyngeal pressure is measured using a tube placed between the tongue and the hard palate. For valid results the patient must position the tongue and soft palate so that both the oropharynx and nasopharynx remain open. A high rate of failure of conventional PRM has been reported in normal individuals. In patients with obstructive sleep apnoea syndrome (OSAS), upper airway abnormalities may further increase the failure rate. This study proposes a modification of the technique in which protrusion of the tongue enhances pressure transmission between the nasopharynx and the mouth. In eight normal subjects, resistance was similar when measured by both methods. Of 24 OSAS patients, conventional PRM was unsuccessful in 11. In the remaining 13 patients, a significant correlation between the two methods was found, but resistance was lower by "tongue-out" than by conventional PRM, consistent with a decrease, during tongue protrusion, in retropalatal resistance, which is a component of the "nasal" resistance measured by PRM. In 26 OSAS patients, unilateral nasal resistance values measured by "tongue-out" PRM were similar to those measured by anterior rhinomanometry. When the "tongue-out" method was used routinely in 541 snorers, failure rates were 1.1% in the 272 non-OSAS patients and 3.7% in the 269 OSAS patients. These results indicate that posterior rhinomanometry with tongue protrusion is a highly effective tool for measuring nasal resistance in snorers.

Adolescent↗
PubMed1991

An international comparison of rhinomanometry between Canada and Japan.

International discussions concerning rhinomanometry have been held but no numerical comparisons have been reported. In an attempt to make international comparisons between different rhinomanometric results, nasal resistances were measured by active posterior rhinomanometry with a head-out body plethysmograph produced in Canada and by active posterior and anterior methods with a Japanese commercial rhinomanometer, and the results were compared. No significant differences were found between measurements obtained from the two types of equipment. It is believed that this study is the first project of international comparison of rhinomanometry.

Adolescent↗
PubMed1990

Use of nasal valve stent with anterior rhinomanometry to quantitate nasal valve obstruction.

Some patients have increased resistance in the nasal valve area that is static and does not collapse. Anterior rhinomanometry is unable to document nasal valve disorders in these instances. A simple stent was devised to open the nasal valve area during anterior mask rhinomanometry. Three groups of subjects were studied with and without the stent. These groups were 1) patients with anatomic findings of nasal valve obstruction, 2) normal control subjects, and 3) normal control subjects with artificially created midseptal nasal obstructions. At peak inspiration the median decrease in resistance with the stent in place when compared to nonstented values was 0.91 Pa.cm-3.s-1 for group 1, 0.27 Pa.cm-3.s-1 for group 2, and 0.25 Pa.cm-3.s-1 for group 3. Comparisons using the nonparametric Wilcoxon test had a significance level of p less than .001. An easily fashioned, well-tolerated nasal valve stent can be readily incorporated in anterior mask rhinomanometry technique. With use of the stent, nasal valve obstruction can be accurately diagnosed and quantitated.

Adult↗
PubMedDate not supplied

[Evaluation of chronic nasal respiratory obstruction in children using optic fiber rhinopharyngoscopy and rhinomanometry].

Traditional clinical examination is frequently inadequate to evaluate children affected by chronic nasal obstruction: radiology may be of some use but it exposes children to radiation and gives only a limited lateral view of the nasopharynx. Therefore other means need to be tested for the anatomical and functional examination of the nasal and nasopharyngeal cavities. Adenoid hypertrophy and chronic nasal congestion are the most common causes of nasal respiratory impairment in children. The clinical expressions of adenoid enlargement are influenced by the osteo-cartilaginous nasal conformation and by functional alterations of nasal mucosa. Therefore a correct clinical examination is necessary to determine the indications for adenoidectomy so as to prevent unsatisfactory results. The aim of this study was to test the efficacy of rhinopharyngoscopy and rhinomanometry in the quantitative and qualitative evaluation of nasal and nasopharyngeal airways in 50 children (age-range 5-12 years) affected by nasal obstruction. Based on the rhinopharyngoscopic evaluation of adenoid volume, the children were divided into 3 groups affected by choanal obstruction defined as: severe (28 cases); partial (14 cases); minimal (8 cases). In these 3 groups anterior rhinomanometry, performed before and after administration of a nasal decongestant, allowed to evidence the role played by functional and organic factors in determining nasal stenosis. Abnormal values of total nasal resistance were found in 42 of the 50 children in the study. In 12 of these cases there was a marked decrease in nasal resistance following decongestion, evidencing the prevalence of functional factors in determining nasal obstruction and contra-indicating adenoidectomy. Rhinopharyngoscopy and rhinomanometry were well tolerated by all examined patients; the combined use of the two techniques allowed a more accurate diagnostic assessment of functional and anatomical causes of nasal obstruction in order to predict the benefits which can be obtained through adenoidectomy.

Airway Resistance↗
PubMed1989

Anterior and posterior rhinomanometry.

Three rhinomanometric techniques for detection of transnasal pressures were compared by computer aided plethysmographic rhinomanometry. Mean unilateral resistances were measured in the decongested nose of an experienced subject by traditional anterior (sealed anterior catheter) and posterior (perorally by mouthpiece) rhinomanometry and also by a fine catheter inserted pernasally to the nasopharynx. No significant differences in magnitude (N = 25, p = 73, mean Rn = 0.345 Pa/cm3/sec) were found. Dimensions of an #8F catheter were adequate for conduction of transnasal pressures and the catheter placed along the floor of a decongested nasal cavity was found not to increase resistance to airflow significantly. Posterior pernasal catheter measurements were less variable than either traditional posterior (peroral) or anterior rhinomanometry. In 35 consecutive patients untreated by decongestant there were no significant differences in magnitude or variation between resistances of the combined nasal cavities immediately following insertion of the catheter and those obtained 5 minutes later (initial mean Rn = 1.66 + 0.49, 5 min mean Rn = 1.70 + 0.50) and in these naive subjects posterior rhinomanometric resistances averaged 9% greater than those in whom resistances were measured pernasally.

Humans↗
PubMedDate not supplied

Nasal provocation test (NPT) through previously active rhinomanometry: physical and mathematical reasons.

Rhinomanometry is a technique which studies the resistance of the nasal airways. It also permits us to measure their variations during NPT. This work has analysed the different methods of rhinomanometry (previously active, previously passive and late), commenting on its advantages and disadvantages. Bearing in mind that the European Committee for the standardizing of rhinomanometry has suggested the use of AAR, we have analysed it's physical and mathematical principles, as well as the bases of NPT through AAR. On these principles we present our technique, highly standardized, showing the comparative data with other diagnostic methods, as well as it's diagnostic value and we compare it with other proposed systems. We have also considered it useful to include a mathematical development of TPN which informs us of the equations of regression for the dose and nasal responses.

Airway Resistance↗
PubMed1989

Nasal provocation with histamine: a comparison of the determination of the threshold of reactivity by three methods of rhinomanometry.

Three methods of rhinomanometry were compared with each other with respect to their ability to determine the histamine threshold (histamine concentration for a 100% increase of the initial total nasal resistance): the active anterior rhinomanometry (P.A.R.). Nasal challenge and consecutive measurement by the three methods of rhinomanometry were conducted in a group of 11 volunteers. The three methods gave significantly different histamine concentration thresholds (p = 0.002). Unilateral histamine thresholds as available from A.A.R. and P.A.R. (at a flow of 250 cm3/sec) did not differ significantly (p = 0.299). For A.A.R. and A.P.R., histamine thresholds were assessed at five different pressure values as well as at five different flow values. The thresholds did not appear to be significantly different at any one of those pressure gradients (p = 0.690) or flow values (p = 0.357).

Clinical Trials as Topic↗
PubMed1981

[Clinical rhinomanometry].

Between 1971 and 1978 the author did 575 rhinomanometric examinations, using the Cottle rhinomanometer, Model FP-102. It was always a unilateral passive rhinomanometry. Results obtained on the rhinomanometer were compared with the patient's history and the clinical examination. For 423 cases (74%) the rhinomanometry confirmed the clinical data, and for 152 cases (26%) there was no relation between the two. It is concluded that for evaluation and choice of treatment the clinical history and examination are the only valuable criteria. Defects of the rhinomanometer are discussed. In medical rhinitis an effect was noticed which was exactly the contrary to that expected with a local decongestant. We believe that this equipment is not sufficiently developed to be currently useful in clinical work although rhinomanometry may have a role in research.

Equipment Failure↗
PubMedDate not supplied

Rhinomanometry. IV. A pre- and postoperative evaluation in functional septoplasty.

One hundred patients, subjected to functional septoplasty, were examined pre- and postoperatively with anterior rhinomanometry, questionnaire and rhinoscopy. Nasal airway resistance was described as a resistance (R2) for clinical, and as an angle of the pressure-flow curve (v2) for statistical use. Before operation uni- or bilateral R2 after mucosal decongestion was abnormally high in 72 of the patients. Regression analysis showed that patients with a preoperative R2 greater than 4.5 cmH2O/(l/sec) in at least one cavity were improved after surgery, as shown by rhinomanometry. Patients with such postoperative improvement were significantly more often satisfied and free from nasal obstruction than patients with decreased nasal patency. It is concluded that rhinomanometry is an indispensable aid in the selection of patients for functional septoplasty and for assessing the results of operation.

Adolescent↗