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PubMed1977

Rhinomanometry in myocardial infarction.

In the curves obtained from rhinomanometry a mid-cycle rest (M.C.R.) is sometimes found to occur. The aim of this study was then to analyse the frequency of the M.C.R both in normal subjects and in subjects who had had a myocardial infarction. Rhinomanometry was therefore performed on 3 different groups of people, viz. 1 .32 normal subjects without any respiratory, cardial or any pathological problems. 2. 44 subjects who had had a myocardial infarction. 3. 34 subjects without any cardial problems. Rhinomanometry revealed that 50-60% of the second and third group had a poor nasal respiration. In the first group no M.C.R. was found in any of the subjects. In the second group over 50% of the subjects had a M.C.R. In the third group less than 50% of the subjects had a M.C.R. The x2 test was used to analyse these results as to their statistical significance. The x2 parameter was 3,84 with a significance of 95%, and 6,64 with a significance of 99%. Our result was x2=5,34 which seems to justify further study.

Acute Disease↗
PubMed1997

[Rhinomanometry: a method of objective study of nasal patency].

Rhinomanometry is the most applied method of evaluation of nasal patency in the world. In the study the authors present application of rhinomanometry in the diagnosis of the nose disease. On own material the authors introduce the technique of rhinomanometry and interpretation of its results.

Manometry↗
PubMed2002

Nasal airflow and resistance measured by active anterior rhinomanometry in healthy children and adolescents.

Rhinomanometry allows objective assessment of nasal patency in pediatric patients with nasal and other respiratory problems. However, no reliable reference values are available in the pediatric age group. We measured nasal inspiratory airflow and nasal inspiratory resistance of the right and left nostrils (V'nar, V'nal, Rnar, and Rnal) and total nasal inspiratory flow and resistance (V'na and Rna) at a transnasal pressure of 150 Pa during quiet breathing in healthy children with a closed mouth by using active anterior rhinomanometry. Cross-sectional measurements were done in 192 healthy Caucasian children and adolescents free of nasal or other respiratory diseases (age, 2-19 years; body height, 94-190 cm; 95 boys and 97 girls). The values of V'na, V'nar, and V'nal increased significantly with an increase of body height or age (P<0.0001). Rna, Rnar, and Rnal significantly decreased with an increase of body height and age (P<0.0001). No significant statistical differences were found between boys and girls (P=0.11) or between right and left nostrils (P=0.07). V'nar and Rnar comprised 50.1%, and V'nal and Rnal 49.9%, of total V'na and Rna, respectively. Best-fit regression equations relating rhinomanometric parameters and body height or age were power functions. We obtained reference regression equations with upper and lower limits, and prepared tables listing reference (normal) values of rhinomanometric parameters in healthy pediatric Caucasian patients, against which patients with nasal obstruction can be compared.

Adolescent↗
PubMed2003

Assessment of nasal cycle by acoustic rhinometry and rhinomanometry.

OBJECTIVE: We sought to investigate the pattern, duration, and amplitude of nasal cycle and its response to nasal decongestant. STUDY DESIGN AND SETTING: Ten adult volunteers attended 2 sessions (with and without nasal spray of 0.1% xylometazoline) for consecutive examinations by rhinomanometry and acoustic rhinometry every 10 minutes over 6 hours. RESULTS: A spontaneous fluctuation in nasal minimum cross-sectional area, volume, and nasal resistances (inspiration and expiration) could be observed in every consecutive measurement. A significant negative correlation (r = -0.33 to -0.70, P < 0.05) between both nasal passages was shown in 5 subjects by rhinomanometry and in 2 subjects by acoustic rhinometry but was not detectable after nasal spray with 0.1% xylometazoline. CONCLUSION: A spontaneous fluctuation in nasal patency can be documented every 10 minutes with irregular pattern, frequency, and amplitude. Classic nasal cycle is not a universal phenomenon, which can be abolished by the application of decongestant.

Adolescent↗
PubMedDate not supplied

[Anterior rhinomanometry as a diagnostic test in occupational allergy caused by Liliaceae].

UNLABELLED: The Liliacea family has been implicated as a cause of occupational rhinoconjunctivitis and bronchial asthma. We report a patient who presented symptoms when he manipulated spices including garlic and onion dusts. Nasal challenge test with active anterior rhinomanometry was used for the diagnosis. MATERIAL AND METHODS: Skin-prick tests with common inhalants, commercial spices, fresh Liliaceae and powdered spices diluted in saline solution (10 mg/ml) were performed. Immunoblot and specific IgE (CAP-Pharmacia) were determined. Control peak expiratory flow was monitored during a period at work in an area where spices were manipulated and in an area where they were transported. Nasal challenge test with garlic and onion powder was performed. The resulting nasal obstruction was measured as nasal airway resistance and was determined by rhinomanometry. RESULTS: Skin-prick tests were positive for onion, garlic powder and fresh Liliacea. Specific IgE were positive for garlic and onion. IgE immunoblotting showed very strong bands at 14 and 40 kD with garlic extract. Nasal challenge showed an increase in inspiratory nasal resistance which was higher than 100 % of the basal value for both onion extract and garlic.

Adult↗
PubMedDate not supplied

Role of nasal valve in the surgically corrected nasal respiratory obstruction: evaluation through rhinomanometry.

The aim of this study was to evaluate the improvement of nasal flow and the fall of nasal resistance in 50 patients that underwent rhinoseptoplasty in our department and discuss the relative importance of valvular and septal deformities in nasal airway obstruction. Fifty consecutive patients underwent rhinoseptoplasty to improve nasal obstruction caused by severe septal deviation, external or internal valvular incompetence, or any combination of the three. We excluded patients with minor septal curvatures, septal perforations, or turbinate hypertrophy. Preoperative and postoperative rhinomanometry was performed on all 50 patients. In all 50 patients, septal and/or valvular surgery lowered nasal resistance in 90% of cases. Septoplasty alone with medial and basal osteotomies did not improve nasal flow (p < 0.4), whereas the correction of valvular obstruction alone increased nasal airflow in a statistically significant way (p < 0.0001). Moreover, patients with both valvular incompetence and septal deviation represented the group in which the greatest preoperative obstruction and the greatest postoperative improvement occurred. Nasal valvular function should be assessed with rhinomanometry in all preoperative rhinoplasty patients with airway obstruction. In many cases, valvular effects may surpass septal deviation as the primary cause of nasal airflow obstruction.

Female↗
PubMedDate not supplied

[Importance of active anterior rhinomanometry].

The establishing of an objective method of measuring nasal flow has long been a desire of rhinologists. Many methods have been developed by individual physicians as means of measuring nasal function, indicating which treatments, both surgical and medical, should be employed. The aim of this study is to assess anterior active computer rhinomanometry, and to determine its role and importance in objectivisation of patients condition who have inflammation and tumour of nose and paranasal sinuses. Examinations have been done before and after surgical procedure. Regarding measurements of pressure (at kPa), values of nasal resistance are indicated as normal, increased, distinct and total. Anterior active rhinomanometry is a fast, effective, comfortable, relatively simple diagnostic method for objective presentation of nasal airflow and evaluation of patients capability of breathing through the nose.

Humans↗
PubMed2002

Rhinomanometry in patients with a cleft deformity of the nose.

A typical cleft deformity of the central facial area is very frequently associated with impaired patency of the nose. Rhinomanometry makes it possible to assess objectively and quantitatively the patency of these airways. For objective assessment of the disorder this examination was made closely before secondary rhinoplasty in 36 patients with complete unilateral (81%) or bilateral cleft (19%). Using the method of active anterior rhinomanometry, values of nasal flow and nasal resistance were assessed. Subsequently the degree of obstruction of the nasal airways and the lateral ratio of the nasal flow were evaluated. The mean value of the total nasal flow was 239.9 cm3/s, and the mean value of nasal resistance for individual nasal vents was 3.55. The results were compared with normal values according to Bachmann. It was revealed that patients with clefts suffer in 88% of casesfrom significant obstruction of the nasal airways and In the remaining 12% of cases from mild obstruction. The lateral ratio can be evaluated as normal only in 19% and 14% of patients with unilateral and bilateral clefts respectively. Although the great majority of patients ask for secondary correction because they want to improve their appearance, It is an advantage to express objectively the functional disorder of nasal patency before surgery--thus defining the indication more accurately--and to explain to the patient the possible benefit of the operation.

Adolescent↗
PubMed1985

Comparison of sequential anterior and posterior rhinomanometry.

This study was conducted to test the validity in adult subjects of the commonly used technique of summing anterior nasal measurements to describe the patency of the total nose. We measured the total nasal conductance in 36 nonallergic, nonsmoking subjects by use of posterior rhinomanometry (PRM) and compared the results with sequential summed unilateral conductances in the same subjects based on anterior rhinomanometry (ARM). Linear regression of the relationship between the two measures demonstrated significant differences. Variation between these two measures is composed of two parts: random time variation and a component attributable to the difference between methods. Random time variation was estimated from five serial posterior nasal conductances in nine of the subjects in a second experiment. We observed significantly greater variations between ARM and PRM than between PRM measures separated by similar time intervals (F 36.36 = 2.30, p less than 0.01). We conclude that PRM is significantly more accurate than summed ARM when the goal is to quantitate precisely the patency of the nose as a whole at a given instant in time, and yet summed ARM measurements may be acceptable in clinical studies wherein large changes in nasal patency occur.

Adolescent↗
PubMed1989

Rhinomanometry in the selection for adenoidectomy and its relation to preoperative radiology.

Recent work has shown that resolution of otitis media with effusion (OME) following adenoidectomy may be related to certain preoperative radiographic parameters. This study was performed to investigate the relationship between the total nasal resistance (TNR), adenoid volume and the radiographic palatal airway and adenoid depth in children with OME. Fifty-six children underwent anterior active rhinomanometry and 40 completed the investigation. There was a significant association between the Palatal Airway and the TNR, and in the 27 who subsequently underwent adenoidectomy this was nearly so with respect to adenoid volume and TNR. The relationship demonstrated was not strong enough for TNR to be of use in selection of children for adenoidectomy based on radiographic parameters. Rhinomanometry can be difficult and time-consuming to perform in children. In its present form it is unlikely to be of routine clinical use in this context.

Adenoidectomy↗
PubMed1984

Clinical use of rhinomanometry in children.

To investigate Passive Anterior Rhinomanometry (PAR), several clinical experiments were set up to explore in children aged 3-6 years the nasal resistance in various normal and pathological situations, in order to determine the role of rhinomanometry in clinical situations in young children. It was shown that the nasal cycle in children differs greatly from that in adults, showing a regular undulating pattern of nasal resistance, but without alternating phenomena. There are also quite regular fluctuations with a short period of about 90 s. Physical exercise and changes in body position have also, in children, a definite influence on nasal resistance. PAR in various pathological situations of the nasal cavity gave a wide range of individual results. It was, however, found that children with a nasal septum deviation, with a pronounced nasal edema, and with serous and purulent nasal secretions had a higher nasal resistance than children without nasal pathology. Because of the spontaneous and evoked changes in nasal resistance in children and because of the large standard deviations of nasal resistance values in pathological situations, clinicians should interpret the results of a one-time rhinomanometrical measurement very carefully.

Airway Resistance↗
PubMed1990

[Accuracy of measurement and comparability of anterior rhinomanometry and whole body plethysmography in determination of nasal resistance. Studies with a mechanical model].

The degree of accuracy of anterior rhinomanometry and the plethysmographic method in determining nasal resistance was examined in a mechanical model. The plethysmographic method allows a precise estimation of nasal resistance. It was found that the absolute variation of the plethysmographically measured values is not greater than 5%. Anterior rhinomanometry as described by Bachmann (2) allows a valid estimation of the pressure-flow relation. Here, too, inaccuracy remains within a range of 5% if the values are recorded with an X-Y-plotter. With the system developed by EVG, a microprocessor-controlled analysis is also possible. The flow rate is measured at pressure rates of 75, 150, and 300 Pa. Inconstancies in respiratory flow cause deviations from the correct pressure-flow graph. Should these deviations accidentally coincide with the predefined points of evaluation these erroneously achieved results will be assumed to be representative for the whole graph. This analytical fault has meanwhile been corrected by interpolating the points at the predefined pressure rates. Due to the differences in analytic techniques the methods of determining nasal resistance are not comparable in practice. The authors therefore recommend that, in addition to the usual results of analysis, average value of nasal resistance be determined for each measuring procedure. Today, this can be done without any problem by using microprocessors.

Airway Resistance↗
PubMed1996

Evaluation of acoustic rhinometry and posterior rhinomanometry as tools for inhalation challenge studies.

Objective measures of upper respiratory function are needed to understand the effects of inhaled toxicants on the nasal passages. Acoustic rhinometry (AR) is a simple new technique that determines nasal volume by measuring the cross-sectional area of the upper airway as a function of the distance along the nasal passage. This study compares acoustic rhinometry with the more traditional posterior rhinomanometry (NAR) and correlates these objective measures with the symptom of nasal congestion. Healthy young adults (n = 29) were studied on 4 days, each separated by at least 1 wk, in a climate-controlled environmental chamber for 6 h, with exposure to clean air or sidestream tobacco smoke (SS) (2 h, 1, 5, and 15 ppm CO). The coefficient of variation for single measurements was 8-15% (AR) and 4% (NAR); for across-day measurements it was 15-25% (AR) and 13-15% (NAR); and for between days it was 19-27% AR and 17-21% (NAR). These coefficients were similar in subjects with a history of environmental tobacco smoke sensitivity (ETS-S) and those with no history of ETS sensitivity (ETS-NS). At baseline, the perception of unilateral nasal congestion was significantly correlated with unilateral nasal dimensions or nasal resistance; the symptom of baseline bilateral nasal congestion (estimated for both nasal passages simultaneously) correlated less well with objective measures of nasal patency. Under challenge conditions (SS at 1-15 ppm CO), there were typically significant correlations between changes in unilateral congestion and both unilateral rhinomanometry and acoustic rhinometry, but correlations of bilateral congestion and measurable dimensions were much lower. ETS-S and ETS-NS subjects differed in correlations between bilateral subjective and objective measures: ETS-S subjects showed significant correlation between baseline congestion and NAR; in contrast, ETS-NS subjects showed significant correlation between baseline congestion and acoustic rhinometry. These results indicate that NAR and AR are complementary tests for use in inhalation challenge studies and have different correlations with nasal congestion under baseline and challenge conditions.

Acoustics↗
PubMedDate not supplied

Rhinomanometry: an update.

Rhinomanometry has been widely accepted and used as an objective method to assess nasal patency for more than two decades. Much knowledge was obtained with its application in nasal pathophysiology and measuring techniques are still an issue for continuous improvement. Background, concept and current techniques, past, present and future, reliability, indications and contraindications are discussed in details. Special attention is paid to problems of definition, correlation between rhinomanometric data and subjective sensation of nasal patency and calibration. It is concluded that rhinomanometry applied together with acoustic rhinometry gives the most reliable objective information on nasal patency in an authentic rhinologic laboratory.

Acoustics↗
PubMedDate not supplied

Correlations between subjective sensation of nasal patency and rhinomanometry in both unilateral and total nasal assessment.

The correlation between rhinomanometry and subjective sensation of nasal obstruction was studied. Patients assessed their nasal airway patency using a visual analogue scale (VAS). The VAS results and rhinomanometry correlated better when unilateral nasal obstruction was evaluated compared to total nasal evaluation. When rhinomanometric data were divided into four clinically relevant grades of obstruction (very patent, normal, obstructed and very obstructed) and the quartiles of the VAS results were compared to these, the agreement was good or fairly good in 75-85% of cases. A similar result was also encountered when, in an experimental study, 30 individuals were asked to breathe through four artificial nose models with a varying inner diameter of 9-3 mm. Again, most subjects assessed these models logically, but in 11% of the cases the subject assessed the narrowest tube as patent or the widest tube as very obstructed. Our results prove the necessity of having some sort of objective method to evaluate nasal patency; if we rely only on the patient's sensation, we may get a misleading picture of his nasal function.

Adolescent↗
PubMed1989

Rhinomanometry 1988: practice and trends.

This report discusses characteristics and measurement of transnasal pressures and flow of respiratory air, indices of nasal airway patency, and components of contemporary rhinomanometric systems. Sources of error that can result from mucovascular fluctuation and from the use of face masks and nasal nozzles are delineated. Useful adjuncts to rhinomanometry include microcomputation and plethysmography. State-of-the-art transducers and microcircuitry and reliability and economy. Aerodynamic parameters closely correlated with chronic obstructive nasal symptoms have yet to be determined. Nevertheless, resistance calculated from concomitant measurements of transnasal pressure and flow, as recommended by the International Committee on Standardization of Rhinomanometry, provides a practical index of nasal patency and aids the exchange of rhinological information.

Airway Obstruction↗
PubMedDate not supplied

Reproducibility of acoustic rhinometry and rhinomanometry in normal subjects.

The reproducibility of nasal patency measurements was assessed by acoustic rhinometry and active rhinomanometry using previously described Toronto methodologies. Six subjects with normal upper airways were tested with both procedures on six separate occasions within a 2-month period. Topical decongestant was applied to minimize the effects of mucosal variation on the nasal airway. The mean coefficients of variation (mean +/- s.d; %) over time of the measurements were 8.1 +/- 4.1 and 9.7 +/- 5.2 for minimal unilateral cross-sectional area and 4.8 +/- 1.8 and 5.5 +/- 3.5 for nasal volume (0-5 cm) of the right and left sides, respectively. For active rhinomanometry, the mean coefficients of variation (mean +/- s.d.; %) over time of the measurements were 15.9 +/- 7.3, 12.9 +/- 4.6, and 8.5 +/- 2.8 for right, left and combined nasal airflow resistance. The intraclass correlation coefficient was 0.76, 0.70, and 0.96 for right, left, and combined nasal resistance, 0.91 and 0.87 for right and left minimal cross sectional area, and 0.86 and 0.69 for right and left nasal volumes, respectively, also confirming a high level of reproducibility for both methods. In conclusion, performed by an experienced operator under controlled circumstances, the reproducibility of both methods of nasal patency assessment compared favorably with many widely accepted clinical tests.

Acoustics↗