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PubMed1990

Rhinomanometry evaluation of the effects of pre- and post-operative SMR on exercise.

Nasal airway resistance due to uncomplicated DNS was examined in 43 patients, and the results compared with those obtained following corrective surgery. The patients were examined independently by the two authors using a strict examination protocol. Rhinomanometry was carried out pre- and post-operatively at rest and after exercise assessing the worst and the better breathing nostrils separately. The results show that both resting and post-exercise nasal resistance was reduced following septal surgery.

Adult↗
PubMed2001

Study and application of a mathematical model for the provisional assessment of areas and nasal resistance, obtained using acoustic rhinometry and active anterior rhinomanometry.

Nasal resistance (NR) depends on the geometrical features and tortuosity of the nasal airway and on the air flow. Knowing the longitudinal distribution of cross-sectional areas (CSAs) in the nasal cavity (which can be obtained using acoustic rhinometry) and the laminar nasal resistance (obtainable by processing the rhinomanometric results), it is possible to calculate, utilizing a mathematical model elaborated on the basis of fluid dynamics, the differential nasal resistance (NRdiff) and the cumulative nasal resistance (NRcum), thus localizing the position at which the highest resistance is concentrated and the related longitudinal distribution. Using a mathematical model, we integrated the sigmoid curves DeltaP/Q of rhinomanometry with the cross-sectional areas obtained using acoustic rhinometry, thus obtaining the normal distribution of differential and cumulative nasal resistances. Afterwards, we empirically reduced the cross-sectional areas corresponding to the head, body, tail and the whole inferior turbinate, recalculating the differential and cumulative nasal resistance distribution curves. The results show that reduction of up to 50% of cross-sectional areas does not substantially affect the resistivity role of the nasal valve, while greater reductions move the highest resistivity point to an area at the junction of the body and the head of the inferior turbinate. The study of the differential nasal resistance trend curves as a function of the reduction of cross-sectional areas shows that the resistance variation of the body and the whole inferior turbinate prevail with reductions of up to 40%, while the variation of cross-sectional areas of the body bordering the inferior turbinate head is predominant with higher reductions. The cross-sectional areas of the nasal airway cavity with highest resistivity are mainly located in an anterior position, where the differential nasal resistances are higher, but there are substantial variations produced by reducing the cross-sectional area of the posterior nasal airway. A similar model can produce provisional values for the results obtainable with functional nasal surgery.

Acoustics↗
PubMed1993

[Rhinoresistometry--a further development of rhinomanometry].

The methods of rhinological diagnostics available today are not sufficient for every functional aspect in modern therapeutic strategies. We developed active anterior rhinomanometry to rhinoresistometry, in order to improve diagnostic methods. We created a new software for calculation and graphic presentation. The program shows nasal resistance in relation to airflow. It is also possible to see whether the nasal airflow is laminar or turbulent depending from the degree of flow. Rhinoresistometry can measure the hydraulic diameter as a suitable value for nasal patency in nasal airflow and lambda as a parameter for the degree of turbulences. The method allows new views into the physiology and pathophysiology of nasal breathing and has been applied successfully in clinical practice.

Airway Resistance↗
PubMed1998

Evaluation of nasal patency: comparison of patient and clinician assessments with rhinomanometry.

The correlation between the objective measurement of nasal resistance and nasal airflow sensation is usually regarded as poor. The aim of the study was to assess the relation between objective indices of nasal patency, as assessed by the occlusion method (RN) and the Youlten peak nasal inspiratory flow meter (PNIF), with subjective sensations of nasal blockade by either the patient or the clinician in groups of patients with rhinitis, asthma, rhinitis and asthma, nasal septal deformity and ill normal controls. We studied nasal airway patency in 254 subjects (37 women, 217 men), mean age 21 years (range 14-78) by RN and PNIF. Nasal resistance was also measured by the application of Ohm's law for parallel resistors (NRO) by estimating the unilateral resistance separately. Subjective sensation of nasal blockade was assessed either by the patient on a 10-point Borg scale (SUB), or the clinician (CLN) on a 6-point scale (3 for each side of the nose). The latter was done in a controlled fashion with the aid of reference sensations. Adjusting for age, height, smoking status and airway calibre, we found good correlation between RN and CLN (r=0.57, p=10(-4)), whereas the association between RN and SUB was moderate and of borderline significance (r=0.42. p=0.05). By logistic regression analysis, we found that the only independent predictors of abnormal nasal resistance at a cut-off value of 0.30 kPa/l/s were the nasal scores as assessed by the clinician (r-=0.26, odds=2.45). We conclude that PNIF measurement and SUB scores are of limited use as indices of nasal patency, although the latter showed an improved association in comparison to older studies. As there is a necessity for some sort of objective measurement to assess nasal patency, the described clinician evaluation may be clinically useful in place of PNIF, but due to its somewhat subjective nature and its inability to detect milder levels of nasal obstruction it cannot be recommended as an alternative to rhinomanometry.

Adolescent↗
PubMed1988

On rhinomanometry in rhinoplasty.

Changes in nasal obstruction, nasal airway resistance, and postoperative nose appearance were evaluated in 92 rhinoplasty patients. Fifty-six patients had a deviation of their nose from the midline preoperatively. They were improved according to rhinomanometry whether the rhinoplasty was combined with a functional septoplasty or with a submucous resection. Among the other 36 patients who did not have a deviation of the nose from the midline, 23 had a rhinoplasty combined with a functional septoplasty and 13 had no surgery on the septum at all. Rhinomanometrically, only patients operated on with the combined operation were improved; the rest became worse, even in terms of nasal obstruction. Among 58 patients from both groups with preoperative nasal obstruction, there was agreement for 76 percent between the subjective and rhinomanometric changes. The advantages of giving the rhinomanometric results in a polar coordinate system are discussed.

Adolescent↗
PubMed1990

A comparison of response characteristics of airflow and pressure transducers commonly used in rhinomanometry.

Although the ranges in which pneumotachographs evidence linear output to static flows are documented in the literature, measures of output reliability or the stability of calibration functions resulting from the input of dynamic nonsinusoidal flows (such as those which occur during nasal breathing) have not been investigated. Furthermore, it is not known whether the type of requisite pressure transducer used in conjunction with the pneumotachograph influences the pneumotachograph's linearity, output reliability, or dynamic response. To provide information on these points, we determined the dynamic and static responsiveness of three pneumotachographs commonly used in rhinomanometry, in combination with three requisite pressure transducers. In general, a) output reliability depended on the pneumotachograph/pressure transducer combination and was not readily predictable from the reliabilities of the individual components, b) heating increased pneumotachograph reliability, and c) differences in accuracy existed among transducer combinations at high, but not low, flow frequencies. In addition, results from the calibration syringe study (in which the pneumotachograph is calibrated with dynamic non-sinusoidal flows) suggested that: a) a single calibration factor, as supplied by most pneumotachograph manufacturers, is inadequate for accurately measuring the full range of flows produced in sniffing and breathing tasks; b) the measurement of complex waveforms, even when the dominate frequencies of such waveforms are low, requires pneumotachographs that accurately respond to relatively high frequencies; and c) the use of dynamic nonsinusoidal flows (as opposed to static flows) to calibrate pneumotachographs results in a calibration function with higher reliability.

Calibration↗
PubMed1987

Histamine and allergen induced changes in nasal airways resistance measured by anterior rhinomanometry: reproducibility of the technique and the effect of topically administered antihistaminic and anti-allergic drugs.

1. Changes in nasal airways resistance (NAR) following the topical application of histamine and allergen solutions were measured by passive anterior rhinomanometry. 2. The repeatability of five consecutive measurements of resting NAR prior to provocation with histamine or allergen (expressed as the coefficient of variation) was 32.8% and following instillation of saline control solution 37.2%. 3. The repeatability of five consecutive measurements of NAR during the nasal obstruction produced by histamine and allergen was similar to that recorded prior to provocation; the coefficients of variation (median values) being 39.6% and 33.1% respectively. The degree of variability was not related to the dose of agonist or the degree of nasal obstruction. 4. The reproducibility of histamine or allergen induced changes in NAR on four separate weekly occasions showed no significant intra-subject differences. 5. The effects of sodium cromoglycate (SCG), clemastine and ketotifen administered to the nasal mucosa 30 min before provocation with histamine and allergen were compared in a random order, double-blind, placebo controlled study. 6. Clemastine and SCG, but not ketotifen, significantly inhibited the nasal response to increasing concentrations of histamine. None of the drugs administered in the concentrations used in this study significantly inhibited the nasal response to allergen.

Administration, Topical↗
PubMed1981

Nasal provocation and passive anterior rhinomanometry (PAR).

A rapid and convenient method of nasal provocation (aerosol provocation combined with passive anterior rhinomanometry) is described. A comparative study between skin tests, bronchial provocations and nasal provocations highlights the usefulness of this method.

Adolescent↗
PubMed1980

The lateralization percentage as a measure of nasal flow asymmetry in active anterior rhinomanometry.

A new parameter is introduced in active anterior rhinomanometry: the lateralization percentage, calculated as (right flow--left flow)/(right flow + left flow) x 100%. The flow was measured at 15 mm H2O pressure difference after induced shrinkage of the nasal mucosa. Two groups of subjects were studied. One group consisting of 28 male and 40 female volunteers was used to establish normal values in both sexes for flow, absolute flow difference and lateralization percentage. The second group consisting of 20 men who were to undergo submucous septal reconstruction for nasal obstruction was used to test the detection of abnormal cases when applying the normal values derived from the control group. It appeared that the absolute flow difference is a less effective measure than either the total flow or the lateralization percentage. Optimum detection (75-85% of the abnormal cases) was achieved by applying a criterion combining total flow and lateralization percentage.

Airway Obstruction↗
PubMed1992

Evaluation of nasal resistance data in active anterior rhinomanometry with special reference to clinical usefulness and test-retest analysis.

A systematic evaluation of the most common parameters used in active anterior rhinomanometry was made with artificial tube and cadaver models and patient recordings. The clinical suitability of the parameters was judged on their calculability, reproducibility and power to separate the recordings into meaningful degrees of patency. It was shown that resistance at 150 Pa was not calculable in 30% of the measurements because such a high pressure gradient was not achieved during quiet breathing. The power to separate the grades of obstruction was good with all the models but in the test-retest analysis, it was shown that the power to detect +/- 20% variation in repeated measurement in the same person with a decongested nose was not sufficient with the resistance at 150 ml/s and at radius 100. The coefficient of resistance W = P/V2 at peak flow and resistance at radius 200 showed good capability to separate the grades of obstruction, they are measurable in all recordings, their reproducibility is good and thus, they are recommended for clinical practice.

Adolescent↗
PubMed1992

Evaluation of active anterior and posterior rhinomanometry in normal subjects.

In this study active anterior (AAR) and active posterior (APR) rhinomanometry were performed by 100 normal subjects with a Mercury rhinomanometer according to the recommendations of the International Standardization Committee. There was no significant difference between total nasal airway resistance (Rna) values obtained with APR by direct measurement and those calculated from AAR. Mean total Rna was 0.31 Pa/cm3/s (range 0.13-0.84) at a reference pressure of 75 Pa. Measurements by AAR were more reproducible than those by APR, mean intrasubject coefficients of variation were 12 and 16% respectively. This reproducibility was similar to that of lower airways' resistance measurements. Rna values from this population did not conform to a normal Gaussian distribution. Rna was higher during expiration than inspiration and values were higher in women than in men.

Adult↗
PubMed1996

A comparison of the sensitivity of manometric rhinometry, acoustic rhinometry, rhinomanometry and nasal peak flow to detect the decongestant effect of xylometazoline.

A study has been undertaken to compare the sensitivity of manometric rhinometry, rhinomanometry, nasal peak flow and acoustic rhinometry to detect the decongestant effect of xylometazoline. Twenty healthy volunteers were investigated before and after decongestion. The sensitivity of all four methods varied from 80 to 95%. These differences were not significant. Manometric rhinometry, a new method of investigating nasal physiology, is as sensitive as more established methods.

Adrenergic alpha-Agonists↗
PubMed1987

A preliminary evaluation of the effect of N-acetyl-aspartyl-glutamate on pollen nasal challenge as measured by rhinomanometry and symptomatology.

The preventive effect of a nasally administered single dose of the dipeptide N-acetyl-aspartyl-glutamate (NAAGA) on pollen-induced early nasal reaction as measured by rhinomanometry and symptomatology was investigated in a double-blind cross-over placebo controlled study in 18 patients with nasal sensitization to grass pollen. Mean nasal airways resistance at 20, 40, and 60 min post challenge was, respectively, 33%, 37% (P = 0.03) and 27% less after NAAGA than after placebo administration in the same patients. In contrast, no significant effect on sneeze count and rhinorrhoea was found.

Adolescent↗
PubMed1989

Histamine nasal provocation test. An evaluation of active anterior rhinomanometry and of threshold criteria of provocative dose.

This study is a methodological approach to histamine nasal provocation. The test uses active anterior rhinomanometry and a histamine titration method, challenging both nasal cavities with a metered dose pump. It has been confirmed that the histamine nasal provocation test can differentiate between controls and non-allergic rhinitis patients. This study shows, moreover, that the method is more sensitive in assessing response to histamine provocation when a 25% increase of post-saline nasal airway resistance (PD25) is considered than a PD50 or PD100 criterion. The histamine response, was found to be independent of the baseline nasal airway resistance value. Pronounced unilateral responsiveness was frequently noticed. Both nasal cavities should be challenged and the most reactive side considered.

Airway Resistance↗
PubMed1997

Rhinomanometry.

The importance of nasal obstruction is stressed as one of the cardinal symptoms in allergic rhinitis and the major symptom of the late phase reaction; therefore the objective measurement of this symptom is of the utmost importance. The international committee on objective assessment of the nasal airway advocated rhinomanometry as a reliable method for measuring this symptom. The author's experience with this method after nasal challenge during the early and late phase, in 18 patients and 10 normal volunteers, is discussed. If total nasal resistance is considered then 41% of the patients showed a late phase. When considering unilateral nasal resistance a late phase was observed in 82% of the patients.

Humans↗
PubMed1993

Sources of variability in posterior rhinomanometry.

Sources of variability in nasal airway resistance measured by posterior rhinomanometry were studied in 5 subjects tested on 5 different days and 56 subjects tested on 2 different days. On each day, a questionnaire on upper airway health and nasal symptoms was completed. The mean individual difference in nasal airway resistance between the 2 test days in the group of 56 subjects was 5.3% (SD 52.7%). Between-subject variability accounted for 74.9% and 72.5% of the total variability in the group of 5 and the group of 56 subjects, respectively. For the 5 subjects, by accounting for a change in upper airway symptoms or upper respiratory tract infection that occurred over the 5 test days, there was a significant decrease in the between-subject variability. The difference in sources of variation due to a change in upper airway symptoms was not seen in the group of 56 subjects. We conclude that the largest source of variability in nasal airway resistance is due to between-subject differences.

Adult↗
PubMedDate not supplied

Acoustic rhinometry and rhinomanometry in the evaluation of nasal patency of patients with nasal septal deviation.

The aim of the present study was to assess the clinical utility of acoustic rhinometry (AR) compared with active anterior rhinomanometry (AAR) in the evaluation of nasal patency in subjects with nasal septal deviation. Fifty patients were divided into three groups based upon the part of the nasal cavity where the septal deviation was situated (anterior: up to 2.5 cm; middle: between 2.5 and 4.5 cm; posterior: between 4.5 and 8 cm measured from the columella). The control group consisted of 15 subjects with no nasal complaints and no history of nasal disease. Inspiratory and expiratory nasal airway resistance (NAR) at 75 Pa and at 150 Pa before and after decongestion were measured by AAR. Minimal Cross-sectional Area (MCA), distance of MCA, and nasal volume (Vol) were measured before and after decongestion by AR (Rhino 2000). Subjective nasal patency was assessed by Visual Analogue Score (VAS). In the statistical analysis the deviated unilateral nasal cavities were compared with the randomly chosen unilateral nasal cavities of normal subjects. Both techniques AR and AAR were sufficiently sensitive to reveal severe deviations in the anterior nasal cavity (MCA, Volant, NAR75, NAR150, p < 0.05). The techniques were less sensitive in cases of middle and posterior deviations (MCA, Volmid, Volpost, MCAmid, MCApost, NAR75, p > 0.05). The nondecongested inspiratory and expiratory NAR at 150 Pa were the only parameter that differed from normal in cases of posterior deviations. The VAS correlated better with NAR than with MCA. MCA correlated more frequently with expiratory than with inspiratory NAR.

Acoustics↗
PubMed1979

Hyposensitization in allergic seasonal rhinitis as evaluated by rhinomanometry.

Hyposensitization with Allpyral extracts was performed in 38 patients suffering from seasonal allergic rhinitis. An objective evaluation of the clinical course was obtained by rhinomanometry. After one year of hyposensitization therapy, 55% of the patients (21 out of 38) showed an improvement, and after the 3-year follow-up this figure had increased to 76% (19 out of 25 patients continuing with the treatment for this period). For the patients' subjective appraisal of the therapy the respective figures were 76 and 92%.

Adolescent↗