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Automated rhinomanometry.

In order to facilitate measurements and calculations in rhinomanometry a microprocessor is used. Pressure and flow signals, obtained from microtransducers, are automatically calibrated by drawing known volumes of air through a standardized test-nose, while the signals are read by the computer. When the patient is connected, the pressure-flow curves are displayed on a screen. At adequate breathing, the computer reads the pressure and flow 200 times per second for a few breaths. It performs all calculations and presents data describing the pressure-flow relationship, e.g. in terms of the resistance, where the curve crosses a circle with a certain radius in a polar coordinate system. Automatically calculated data were compared to manually derived ones in six healthy subjects and twenty patients with symptoms of nasal obstruction. There was a close correlation between the two sets of data. It is concluded that the described automated rhinomanometer facilitates the rhinomanometric procedure and gives accurate data on nasal airway resistance.

Airway Resistance↗

[Statistical data concerning passive anterior rhinomanometry (PAR)].

The authors measured the values of the passive anterior rhinomanometry (PAR) obtained from 30 normal subjects and studied the influence of the different variables involved in PAR. This influence was calculated by using of statistical analysis (ANOVA). By measuring "p" with successively changing flows, it was possible to determine that the airstream was mainly laminair.

Adolescent↗

The use of a mathematical model in rhinomanometry.

The authors consider the mathematical model proposed by the Swedish Group (Broms et al.). This model permits the pressure gradient-flow recording as obtained from anterior or posterior rhinomanometry to be converted into a mathematical formula. The model was tested for its mathematical, statistical, and clinical utility with 32 normal test subjects. It is the conviction of the authors, although not totally without reservation, that this is the best mathematical model in existence.

Adolescent↗

Some physical data about passive anterior rhinomanometry (P.A.R.).

The authors studied the physical data of the passive anterior rhinomanometry (P.A.R). The values obtained from thirty normal test subjects made it possible to make a statistical analysis (ANOVA) of the different variables involved with the P.A.R. By measuring "delta p" with successively changing flows, it was possible to determine that the airstream was mainly laminar.

Adolescent↗

[The intranasal provocative test with use of "passive anterior rhinomanometry" in the specific diagnosis of allergic rhinitis].

77 patients with suspected allergic rhinitis to inhalative allergens were studied. Skin tests, RAST determinations and nasal provocation tests, performed by placing a cotton-pledge with aqueous allergen and by "passive anterior rhinomanometry" (PAR), were carried out. This latter test was evaluated by determining nasal resistance and by measuring the temperature variations before and after allergen aerosol inhalation with use of a Heyer-PAR rhinomanometer-sprayer by the method of van Dishoeck. Among 30 hay-fever patients with positive prick tests to grasses or to birch pollens, the overall agreement of PAR with the other allergological diagnostic methods was 90 +/- 5%. Evaluation of a further 47 patients with perennial rhinopathy and suspected allergy to house dust, housedust mite and different molds showed that PAR serves to clarify the allergy diagnosis more reliably than the other methods. The advantages and the negative aspects of PAR are briefly discussed.

Adolescent↗

[Anterior rhinomanometry and intranasal challenge tests. Technique and results in 270 cases. Usefulness for the aetiological diagnosis of vasomotor rhinitis (author's transl)].

Nasal response to a large number of stimuli is almost invariably the same, with sneezing, watery rhinorrhoea and nasal obstruction constituting the three major conventional symptoms of the so-called vasomotor (autonomic) rhinitis. These symptoms are not specific to allergic reactions but can be seen in viral infections, sudden changes in temperature, inhalation of irritant fumes or of certain smells. The aetiological diagnosis of vasomotor rhinitis therefore is sometimes very difficult but seems to be greatly facilitated by intranasal challenge tests associated with anterior rhinomanometry.

Allergens↗

[The importance of nasal provocation and rhinomanometry (author's transl)].

The diagnostic investigation of allergic rhinitis requires nasal provocation. Subjective signs of such an allergy are secretion, irritation (itching and sneezing), and swelling of the nasal mucosa. Mainly the latter can be determined objectively, by measuring the change in nasal airway resistance using rhinomanometry. We shall discuss the current method which is especially suitable for determining nasal allergies in children. The results of 69 allergic and 22 healthy subjects investigated with the oscillation method will be presented.

Adult↗

Hyposensitization in allergic rhinitis--a comparison of aqueous extracts and Allpyral by means of rhinomanometry.

Fifty-six patients with seasonal allergic rhinitis were hyposensitized with aqueous extracts (23 patients) and Allpyral extracts (33 patients). The clinical course was appraised objectively on the basis of rhinomanometry findings at examinations performed before hyposensitization and one year later. There was no essential difference between the two groups of patients as regards the relief of symptoms. A reduction of nasal congestion was recorded in 54 and 58% of the patients, respectively. Complications were less severe and less frequent in the Allpyral group.

Adolescent↗

Our technique of partial inferior turbinoplasty: long-term results evaluated by rhinomanometry.

Conservative surgical technique (Partial inferior turbinoplasty) for enlarged inferior turbinates, not responding to adequate local and systemic therapy is described. Short and long term results are evaluated. Relief of nasal obstruction is reported in 94.7% of the patients. There is a good correlation between this success-rate and the objective measurements of the nasal resistance by active anterior rhinomanometry. Rhinorrhea or postnasal drip was still present in 34.2%. Atrophic changes in the nasal mucosa were not observed. Early post-operative epistaxis was found in 5.3% of the patients. Late post-operative epistaxis did not occur.

Adolescent↗

Diagnostic value of nasal provocation testing and rhinomanometry in allergic rhinitis.

We studied 32 patients, aged 7 to 17 years, with clinical symptoms of perennial allergic rhinitis, isolated (n = 21) or associated with asthma (n = 11), all of them with positive skin test and specific serum IgE for Dermatophagoides pteronyssinus (Dpt). The control group consisted of 10 children aged 7 to 16 years, with no personal or family history of allergy and with negative skin tests and negative specific serum IgE for mites. Total and specific IgE measurements in nasal secretion and nasal provocation testing (NPT) were also performed with increasing concentrations of Dermatophagoides pteronyssinus (Dpt) extracts. The nasal response was evaluated using a clinical score and active anterior rhinomanometry. The levels of total and specific IgE in nasal secretion were higher in patients with allergic rhinitis than in individuals from the control group. The NPT presented a significant correlation with clinical symptoms, skin tests and specific serum IgE. None of the individuals from the control group presented a positive NPT. No generalized reactions or bronchial response at the immediate phase of NPT were observed. The NPT constitutes a safe, dependable investigative procedure of nasal reactivity to a specific allergen, presenting a good sensitivity and specificity when compared to the other methods classically used in allergy studies.

Adolescent↗

A clinical evaluation of the Cottle rhinomanometry "flow" nozzle.

A clinical study was undertaken to establish what changes in values were caused by the nozzle used in the Cottle flow-pressure technique of rhinomanometry. Cottle rhino-sphygmo-manometry was performed over seven hundred times, half with the nozzle and half without and the results analyzed using pattern, rate, amplitude, work co-efficient and four breath factor as outlined by Cottle. In many instances marked changes did occur but were unpredictable by examination prior to testing. It is suggested that Cottle rhino-sphygmo-manometry be carried out routinely with and without this nozzle in order to better evaluate results of flow-pressure relationship in which this nozzle is used.

Adolescent↗

[The evaluation of Rhinocort in patients with allergic rhinitis by rhinomanometry].

The authors present the results of the rhinomanometry examinations before and after Rhinocort-Nasal Aerosol or Rhinocort-Nasal Turbuhaler inhalations. 79 patients with allergic rhinitis were observed. 56 out of them were treated by Aerosol and 23 by Turbuhaler. The improvement was found in 78.6% of the patients in the first group and 86.9% in the second one. Rhinocort-Nasal Turbuhaler was generally better tolerated by patients.

Administration, Inhalation↗

Rhinomanometry, sinus CT-scan and allergy testing in the diagnostic assessment of chronic nasal obstruction.

In order to assess how effective a combination of diagnostic methods, each addressing specific aetiopathogenic aspects, would be in uncovering the cause of common chronic nasal obstruction, we evaluated 45 consecutive adult subjects. They were submitted to rhinomanometry testing, sinus CT-scans and RASTs to prevalent allergens. Most, but not all, patients ended up showing abnormal results in at least one of the diagnostic procedures. Sinus pathology was, by far, the most frequent diagnosis, while allergy took second place, with a number of atopic subjects displaying sinusitis as well. On the other hand, septal deviations with a significant effect on nasal resistance were only seldom found to be the cause of chronic nasal obstruction.

Adolescent↗

[Comparison of anterior rhinomanometry and impulse oscillometry in nasal provocation with histamine].

UNLABELLED: Anterior rhinomanometry (aR) is the standard method for measurement of nasal resistance, but it has some drawbacks because it requires full co-operation of the patient and the results are disturbed by forced ventilation due to stenosis. The patient must generate flow by active ventilation. Resistance results from the flow/pressure ratio. Forced oscillation technique (IOS) does not affect spontaneous breathing. Flow/pressure ratio is generated externally by a loudspeaker. IOS measures not only resistance but also reactance. Whereas former methods used only a single frequency IOS is capable of applying and analysing frequencies between 0 and 100 Hz. The range from 5 to 35 Hz is useful for diagnostic issues. We compared IOS with aR in nasal provocation tests with histamine and checked the sensitivity of resistance (R) and reactance (X) at different frequencies. METHOD: 20 patients (13 m, 7 f) underwent nasal challenge test using increasing doses of histamine (max. 3.2 mg). Resistance (aR, IOS) and reactance (IOS) were measured parallel. To compare the two methods, we calculated the dose of histamine which is required to double nasal resistance. RESULTS: 1. IOS demonstrates the increase of R at all frequencies. 2. The highest increase of R is measured at a frequency of 5 Hz (5 Hz: NaCl 0.41 +/- 0.25; Hist. 1.26 +/- 0.57; 35 Hz: NaCl 0.36 +/- 0.172; Hist. 0.60 +/- 0.1 kPa/l/s, p < 0.001). 3. The critical dose is significantly lower in IOS than in aR (2.29 +/- 2.59 vs. 1.06 +/- 1.16 mg/ml, p < 0.02). 4. Basal values of R do not differ significantly between aR and IOS (0.37 +/- 0.12 vs. 0.41 +/- 0.25 kPa/l/s, p < 0.001). CONCLUSIONS: We conclude from our results that IOS is at least equivalent to aR in measuring nasal resistance. R at 5 Hz is the most important parameter in IOS. IOS is less dependent on the cooperation of the patient. In case of stenosis it does not require forced ventilation to achieve the required flow-pressure ratio.

Adult↗

[Anthropometric assessment of the nose and nasal patency by means of anterior rhinomanometry method in children with complete primary and secondary cleft palate].

This study was carried out as an attempt to evaluate the relationship between the results of nasal patency examinations and selected anthropometric measurements of nasal cavities in children with complete primary and secondary cleft palate. The examined group consisted of 130 children with cleft palate treated by means of surgery in early childhood owing to their clefts. Concerning the diagnostic methods the study group was divided into two subgroups. Group I consisted of 75 children in whom face photographs in frontal and axial projections towards the external nasal aperture were analysed. Group II consisted of 55 children in whom by means of P-A teleradiography projection the total area, the maximum height and width of nasal cavity were measured separately for the side with cleft and without cleft. The assessment of nasal patency tests using the objective method--active anterior rhinomanometry was carried out.

Adolescent↗

Filtration efficiency of the ramathibodi nasal filter evaluated by rhinomanometry in high concentration level of laser smoke particle.

Under conditions with a high concentration level of laser smoke particles, the filtration efficiency of the Ramathibodi nasal filter was studied. Different kinds of filter material in the Ramathibodi nasal filter were evaluated in human adults with an anterior standard rhinomanometric method. The Ramathibodi nasal filter with three-layers of a half-face mask filter and a 4 mm thickness polyurethane foam put inside was applied in a simulated human airway. The experiment was conducted in the Otolaryngology Department, Ramathibodi Hospital from October to December 2001. The amount and size of laser smoke particles were measured by a laser diode portable dust monitor. The amount of residual laser smoke particles in the simulated human airway without the Ramathibodi nasal filter of PM2.5, PM10 and PM15 were 100.91 +/- 7.65, 109.10 +/- 7.87 and 120.18 +/- 14.28 mcg/m3 respectively. The amount of residual laser smoke particles in the simulated human airway with the Ramathibodi nasal filter of PM2.5, PM10 and PM15 were 85.55 +/- 3.42, 92.18 +/- 4.40 and 99.72 +/- 5.02 mcg/m3 respectively. The filtration efficacy of the Ramathibodi nasal filter showed a high statistically significant difference with a p-value of <0.001 for three particle sizes. High concentration of laser smoke particles in an operative room represented suspended particulate matters which are very dangerous for human healths. The Ramathibodi nasal filter as a personal respiratory protective device applied in human nasal vestibules could protect the human airway from atmospheric suspended particulate matter.

Adult↗

Nasal lavage fluid examination and rhinomanometry in the diagnostics of occupational airway allergy to laboratory animals.

OBJECTIVES: The purpose of this studywas to compare the cellular and biochemical findings in the nasal lavage fluid (NALF) and nasal resistance changes due to a challenge with laboratory animal allergens in 25 patients with occupational asthma and rhinitis, in 22 patients with atopic asthma and rhinitis sensitized to house dust mite, and in 15 healthy subjects. METHODS: Skin prick tests with common and occupational allergens, total serum IgE level, specific anti-allergens IgE, spirometry and nasal lavages were performed. RESULTS: In patients with occupational airway allergy, nasal symptoms of varying severity developed directly after specific nasal challenge. The total symptom score immediately and 24 h after specific challenge was significantly correlated with expiratory nasal resistance (ENR). The percentage of eosinophils and basophils in NALF increased significantly 5 and 24 h after specific challenge in patients with occupational asthma and it was correlated with ENR. The authors did not observe any significant increase in the percentage of eosinophils, basophils and in the level of albumin in NALF of patients with non-occupational allergy and healthy subjects at any time-point after specific challenge. None of the healthy subjects and patients with non-occupational allergy developed either allergic symptoms or increased ENR after the challenge with laboratory animal allergens and placebo. CONCLUSIONS: The prolonged increase in the percentage of eosinophils, basophils and in the level of albumin seems to reflect allergic inflammation. The intensity of inflammation during the specific reaction is related to the symptom score and to ENR in occupational allergics.

Adult↗