Comparison between unilateral PNIF and rhinomanometry in the evaluation of nasal cycle

Pendolino, Alfonso Luca; Nardello, Ennio; Lund, Valerie J.; Maculan, Pietro; Scarpa, Bruno; Ottaviano, Giancarlo

doi:10.4193/rhin17.168

Cited by 32 publications

(35 citation statements)

References 23 publications

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“…More recently, using acoustic rhinometry (AR), Alnselmo-Lima and Lund tried to define more precisely four types of NCs (27) NC patterns may transform from one to another in the same subject (27) , with patterns' shifts that could be influenced by environmental or physical factors (28) . Although it was reported that the reciprocal changes in unilateral airflow are present in the majority of subjects (29) , in a recent work a parallel pattern was observed in half of the subjects, while the other half showed a reciprocal pattern (30) .…”

Section: Patternsmentioning

confidence: 82%

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The nasal cycle: a comprehensive review

Pendolino¹,

Lund²,

Nardello³

et al. 2018

RHINOL

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Background: The nasal cycle is the spontaneous, reciprocal congestion and decongestion of the nasal mucosa during the day and it is present in almost 70-80% of healthy adults. The German physician Richard Kayser first described it in 1895. Since then, the number of papers focused on this fascinating issue has continued to flourish. Main body: Even though there are a high number of publications on this topic, the understanding of nasal cycle is still very poor. The present review tries to offer a comprehensive analysis of this issue investigating all the physiologic and pathologic conditions able to modify the nasal cycle. A section of methods used for its evaluation has been also included in this review. Conclusion: The influence of the nasal cycle on nasal airflow must be considered during any rhinologic evaluation, especially if investigating the need for septal/turbinates surgery, rather than nasal medical therapy alone. The nasal cycle is a normal phenomenon and must be recognized in order to differentiate it from the pathologic causes of nasal obstruction.

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Section: Patternsmentioning

confidence: 82%

“…The evaluation of the NC requires multiple measurements of nasal flow/patency over many hours. Several methods have been used including, among others (4,(129)(130) , rhinomanometry (RM) (6) , peak nasal inspiratory flow (PNIF) (30) , AR (131) and, more recently, MRI (2) .…”

Section: Evaluation Of the Nc (Table 3)mentioning

confidence: 99%

The nasal cycle: a comprehensive review

Pendolino¹,

Lund²,

Nardello³

et al. 2018

RHINOL

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“…Nasal decongestion provides evidence about the reversibility of nasal airflow limitation after intranasal vasoconstrictor drug use measured by rhinomanometry and how the grade of decreased reversibility is associated with the severity of allergic inflammation . Peak nasal flow is more suitable as a screening method for evaluating nasal patency in clinical practice as it is simple, rapid, reproducible, and correlates with the absolute value of nasal rhinomanometry . On this basis, the limitation of reversibility of peak nasal flows after decongestion should also be associated with the degree of underlying mucosal inflammation.…”

Section: Discussionmentioning

confidence: 99%

“…This method includes measurement of peak nasal expiratory flow (PNEF) and peak nasal inspiratory flow (PNIF) . Both PNEF and PNIF have shown good correlations with rhinomanometry and have been demonstrated to be valid for the assessment of an absolute value of nasal airflow . It is likely that the reversibility of both nasal peak flow techniques after decongestion could be used as a simple method for indirectly assessing the degree of underlying mucosal inflammation.…”

Section: Introductionmentioning

confidence: 99%

Correlation Between Peak Nasal Flow Reversibility and Mucociliary Clearance in Allergic Rhinitis

2019

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Objectives/Hypothesis: Reversibility of nasal airflow after decongestion measured by rhinomanometry is associated with the severity of allergic inflammation. Peak nasal flow is a simpler alternative method for assessing nasal patency. The aim of this study was to evaluate the correlation between changes in peak nasal expiratory and inspiratory flows (PNEFs and PNIFs) after decongestion and nasal mucociliary clearance times (NMCCTs).Study Design: Single-center, prospective cross-sectional study. Methods: One hundred one allergic rhinitis patients were enrolled. Nasal symptoms and NMCCTs were assessed. PNEF and PNIF were performed before and after decongestion. Correlations between changes in PNEF and PNIF after decongestion and NMCCTs were analyzed. One-half the standard deviation of baseline peak nasal flows was used to estimate the minimal clinically important differences (MCIDs) and discriminate between patients with reversible mucosa and with irreversible mucosa.Results: PNEF showed more peak flow improvements after decongestion compared to PNIF. Changes in PNEF had better negative correlations with NMCCTs than PNIF (ρ = −0.49, P < .001 and ρ = −0.34, P < .001, respectively). The MCID values of the PNEF and PNIF were 27.93 and 19.74, respectively. In comparisons of NMCCTs between patients with or without MCID of peak nasal flow after decongestion, PNEF had better discrimination ability compared to PNIF (P = .003 and P = .026, respectively).Conclusions: The limitation of reversibility as measured by peak nasal flows could indirectly point to the affection of mucosal inflammation as indicated by NMCCTs. PNEF is more sensitive to assess peak flow changes after decongestion than PNIF.

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“…In addition, a recent study has shown a reasonable correlation between unilateral NIPF and unilateral AAR in the measurement of unilateral nasal airflow and hence in the ENT secondary care setting NIPF would be considered more cost effective. 16 In order to look at nasal blockage in more detail, we incorporated the validated NOSE scale. This is a symptom specific PROM which only looks at nasal blockage sequelae and not QOL.…”

Section: Keypointsmentioning

confidence: 99%

The role of unilateral nasal inspiratory peak flow in nasal obstruction—A study of 70 patients undergoing septorhinoplasty surgery

Kaura

Virk

Joseph

et al. 2019

Clinical Otolaryngology

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Comparison between unilateral PNIF and rhinomanometry in the evaluation of nasal cycle

Abstract: Nasal cycle can be easily assessed by means of PNIF. In fact, AAR and PNIF showed a reasonable correlation in the measurement of nasal cycle, although PNIF offered a lower variability. Reciprocal and in-phase patterns of the nasal cycle were equally distributed in our population.

Cited by 32 publications

References 23 publications

The nasal cycle: a comprehensive review

The nasal cycle: a comprehensive review

Correlation Between Peak Nasal Flow Reversibility and Mucociliary Clearance in Allergic Rhinitis

The role of unilateral nasal inspiratory peak flow in nasal obstruction—A study of 70 patients undergoing septorhinoplasty surgery

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