Components of the Nasal Examination

Murrell, George L.

doi:10.1177/1090820x12469626

Cited by 20 publications

(22 citation statements)

References 12 publications

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“…4 The results from that survey are broadly in keeping with our data. Almost all of the respondents used anterior rhinoscopy (which in this survey was part of physical examination).…”

Section: Comparison With Other Studiessupporting

confidence: 72%

“…There is a patient dissatisfaction rate of 30% following surgery for nasal obstruction, and hence a growing need to improve our assessment of nasal patency. 3 Murrell performed a survey of USA practice in functional nasal airway assessment in 2013 4 and concluded that clinical history and nasal examination with anterior rhinoscopy were the two most universal parts of a functional assessment of nasal blockage. However, it was noted that they both proved challenging to measure as an outcome owing to their subjective interpretation.…”

Section: Introductionmentioning

confidence: 99%

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A UK survey of current ENT practice in the assessment of nasal patency

Andrews

Joseph

et al. 2017

J. Laryngol. Otol.

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ObjectivesNasal obstruction is a common presentation in ENT practice, and yet decisions on its management are challenging, with high rates of patient and clinician dissatisfaction following surgery. The aim of the study was to investigate the practice of UK ENT clinicians in the subjective and objective evaluation of nasal patency. DesignVoluntary, written questionnaire. SettingBritish Academic Conference in Otolaryngology 2015, Liverpool, UK. Participants UK-based ENT professionals. Results UK based rhinologists were surveyed at the 2015 British Academic Conference inOtorhinolaryngology (BACO) from a cohort of 250 delegates attending two symposia on rhinology with a response rate of 78/250. Clinical history and examination were found to be almost universally used in the evaluation of nasal blockage. The most commonly used clinical test was the nasal misting pattern demonstration on a metal spatula (73%), followed by the peak nasal inspiratory flow rate (19%). The most commonly used subjective measure was the sinonasal outcome test (SNOT-22/23), with a 29% uptake.63% of the responders reported that non-availability of suitable equipment was the main reason for not using objective measures, followed by time consumption, and the lack of correlation with subjective symptom scores. ConclusionsOur study demonstrated that British clinicians rely largely on clinical skills to evaluate nasal blockage. There is a desire for a simple, practical, non-invasive device which a) objectively measures airflow during physiological resting nasal breathing, b) correlates with subjective symptom scores, and c) is capable of simultaneous measurement of each nostril.

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“…4 The results from that survey are broadly in keeping with our data. Almost all of the respondents used anterior rhinoscopy (which in this survey was part of physical examination).…”

Section: Comparison With Other Studiessupporting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

A UK survey of current ENT practice in the assessment of nasal patency

Andrews

Joseph

et al. 2017

J. Laryngol. Otol.

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“…where V r and V l , both expressed in cm 3 , represent the volumes of the right and left VOIs defined previously.…”

Section: Methodsmentioning

confidence: 99%

“…1,2 Diagnostic investigations currently used for this pathology are anterior rhinoscopy, endoscopy, multislice CT and MR, which allow a good evaluation of the entity and position of NSD. [3][4][5][6][7][8] In particular, pre-operative CT scan of the paranasal sinuses is often performed before septoplasty, in order to evaluate nasal anatomy, to find concomitant sinonasal pathologies and to reduce surgical failure. [8][9][10] Despite the fact that pre-operative CT scan of the paranasal sinuses can be recommended in case of obstructive middle turbinate hypertrophy, impossibility to evaluate the middle meatus and the posterior nasal cavity or in patients with chronic sinusitis, the high radiation dose and costs do not allow its usage routinely in patients undergoing septoplasty.…”

Section: Introductionmentioning

confidence: 99%

The nasal septum deviation index (NSDI) based on CBCT data

Codari¹,

Zago²,

Guidugli³

et al. 2016

Dentomaxillofacial Radiology

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Objective: To assess whether three-dimensional morphometric parameters could be useful in nasal septal deviation (NSD) diagnosis and, secondarily, whether CBCT could be considered an adequate imaging technique for the proposed task. Methods: We analysed images of 46 subjects who underwent CBCT for reasons not related to this study. Two experienced operators divided all the images into healthy and NSD subjects. Subsequently, the images were segmented using ITK Snap in order to obtain the three-dimensional model of the nasal airways and compute four morphological parameters: septal deviation angle (SDA), percentage of volume difference between right and left side of the nasal airways, nasal airway total volume and a new synthetic septal deviation index (SDI). Principal component analysis (PCA) was used to unveil relationships between each variable and the global nasal airway variability. Results: Differences between the groups were found in SDA (p , 0.001), in volume percentage difference (p , 0.05) and in SDI (p , 0.001). PCA showed high correlation between the SDI and the first principal component (0.97, p , 0.001). Conclusions: Among the analysed parameters, SDI seemed to be the most suitable for the quantitative assessment of NSD, and CBCT allowed accurate assessment of airway morphology.

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“…1 A detailed examination of the nasal valves is a crucial part of the airway assessment prior to any procedure that is planned in the region of the nose. [1][2][3]6,8,9 Many methods and techniques have been proposed for the assessment of the nasal valve, including rhinomanometry, 7 acoustic rhinometry, 5 and computed tomography (CT). 4 Most of these methods require special equipment and skills, and nearly all of them are focused on the internal nasal valve.…”

mentioning

confidence: 99%