Axial computed tomography evaluation of the internal nasal valve correlates with clinical valve narrowing and patient complaint

Abstract

Using standard axial CT imaging we describe an objective method of radiographically evaluating the nasal valve, demonstrating strong correlation with physical examination and patient complaint. Additionally, radiographic valve areas can be used to screen for clinically narrow nasal valves with good sensitivity and specificity, providing a novel straightforward method for nasal valve assessment.

Imaging of the internal nasal valve using long‐range Fourier domain optical coherence tomography

“…A study using CT scans and endoscopy for the measurement of the INV angle in an Asian population reported values of 21.68, 17 similar to the mean value of 21.88 in our Asian subpopulation. The cross-sectional area here was found to be 0.65 cm 2 , correlating well with values estimated using acoustic rhinometry 4-6 (0.62-0.92 cm 2 , 0.63 cm 2 , and 0.73-0.92 cm 2 ) and CT scans 14,15 (0.51 and 0.8 cm 2 ). Changes in size could be reliably delineated: analogous to previous studies, LR-OCT here demonstrated an increase in valve angle and cross-sectional area after the application of nasal decongestant.…”

“…4,5,13 However, several limitations, including high costs and lack of reliability, have led to limited use. 1,10,11 Computed tomography (CT) has been proposed as an objective tool to provide anatomical information, [14][15][16][17] but currently, there are no data to show that radiographic studies are useful in evaluating the extent of nasal valve collapse. 3,10 CT is not commonly ordered for nasal airway obstruction management alone.…”

In vivo imaging of the internal nasal valve during different conditions using optical coherence tomography

“…The cross-sectional area was also found to be significantly reduced by 0.08 cm 2 at the subjective beginning of nasal airway obstruction (from 0.65 cm 2 during normal conditions to 0.55 cm 2 with nasal obstruction) in the Asian and the Caucasian subpopulation, correlating well with values estimated using acoustic rhinometry 14,16 or CT scans 17,18 . Grymer 14 proposed acoustic rhinometry to evaluate the cross-sectional area of the INV before and after reduction rhinoplasty, showing that values of 0.5 cm 2 or below are predictable of nasal obstruction.…”

“…In CT scans a valve area blow 0.38 cm 2 was suggestive for clinical nasal obstruction. 18 These results could potentially signify that the reduction of the INV cross-sectional area is a better predictor of nasal airway obstruction than the decrease of the INV angle alone. The results of other studies suggest that the shape of the INV area might be more important for nasal airway obstruction than the value of the INV angle alone.…”

Novel outcome measurement tool of the nasal valve surgery: image analysis using endoscopic system for smartphones

“…This methodology for measured nasal valve area correlates with clinical narrowing with a sensitivity of 71.4% and specificity of 88.9%. These results are promising, but the main limitation is the radiation exposure …”