Correlation between subjective and objective nasal breathing assessments in examinees with nasal septum deformities

Savovic, Slobodan; Smajic, Miroslav; Molnár, Szabolcs; Jovančević, Ljiljana; Buljcik-Cupic, Maja; Kljajić, Vladimir; Pilija, Vladimir

doi:10.2298/vsp1304380s

Cited by 5 publications

(8 citation statements)

References 13 publications

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“…For nasal obstruction, the most commonly studied PROM was the visual analogue scale (VAS) for nasal obstruction which was used in 45% of the included studies 17,36,40,41,44,48–50,52–60 . Only 25% of the included papers used the validated NOSE questionnaire for nasal obstruction 30,31,35,46,48,50,61,62 .…”

Section: Resultsmentioning

confidence: 99%

“…Because the NOSE questionnaire was only validated as a PROM for nasal obstruction due to a deviated septum for patients undergoing septoplasty in 2004, 63 studies conducted prior to 2004 would not have been able to use the questionnaire. Nevertheless, a large number of studies conducted after 2004 opted not to utilize the NOSE questionnaire 17,19,29,35,40–42,44,48,50,53–60 …”

Section: Resultsmentioning

confidence: 99%

“…There were 36 included studies evaluating the correlation for nasal obstruction in CRS, AR, and DNS, covering 3 main objective measures: rhinomanometry, 19,30,31,35,48,49,52–55,57,61 AcR, 19,28,29,35,36,46,54,56,58 and PNIF 17,42,44,50,58,62 (12, 9, and 8 studies, respectively). A small number of publications (19%) utilized various uncommon and non‐validated measures for nasal obstruction 17,36,40–43,46,58 …”

Section: Resultsmentioning

confidence: 99%

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A systematic review to examine the relationship between objective and patient‐reported outcome measures in sinonasal disorders: recommendations for use in research and clinical practice

Philpott

2021

Int Forum Allergy Rhinol

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Background Common sinonasal disorders include chronic rhinosinusitis (CRS), allergic rhinitis (AR), and a deviated nasal septum (DNS), which often coexist with shared common symptoms including nasal obstruction, olfactory dysfunction, and rhinorrhea. Various objective outcome measures and patient‐reported outcome measures (PROMs) are used to assess disease severity; however, there is limited evidence in the literature on the correlation between them. This systematic review aims to examine the relationship between them and provide recommendations. Methods A search of MEDLINE and EMBASE identified studies quantifying correlations between objective outcome measures and PROMs for the sinonasal conditions using a narrative synthesis. Results In total, 59 studies met inclusion criteria. For nasal obstruction, rhinomanometry shows a lack of correlation whereas peak nasal inspiratory flow (PNIF) shows the strongest correlation with PROMs (r > 0.5). The Sniffin’ Stick test shows a stronger correlation with PROMs (r > 0.5) than the University of Pennsylvania Smell Identification Test (UPSIT) (r < 0.5). Computed tomography (CT) sinus scores show little evidence of correlation with PROMs and nasal endoscopic ratings (weak correlation, r < 0.5). Conclusion Overall, objective outcome measures and PROMs assessing sinonasal symptoms are poorly correlated, and we recommend that objective outcome measures be used with validated PROMs depending on the setting. PNIF should be used in routine clinical practice for nasal obstruction; rhinomanometry and acoustic rhinometry may be useful in research. The Sniffin’ Sticks test is recommended for olfactory dysfunction with UPSIT as an alternative. CT scores should be excluded as a routine CRS outcome measure, and endoscopic scores should be used in combination with PROMs until further research is conducted.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

A systematic review to examine the relationship between objective and patient‐reported outcome measures in sinonasal disorders: recommendations for use in research and clinical practice

Philpott

2021

Int Forum Allergy Rhinol

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“…8 in 2009 could not refer to 4-phase-rhinomanometry because at this time statistically relevant logarithmic data have not been available. Savovic et al 9 found recently a correlation between subjective obstruction and rhinomanometric results if the degree of obstruction increases -one more hint for the relation to the logarithmic scale of sensing. In summary, misleading and unfounded statements as they have been recently given by Clement et al 10 and Wong and Eccles 11 have to be rejected because they barricade the way of a meaningful development of nasal airway function tests.…”

Section: Discussionmentioning

confidence: 96%

Classification of total nasal obstruction in 10,033 cases by 4-phase –rhinomanometry

Vogt

Wernecke

Argale

et al. 2016

Romanian Journal of Rhinology

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BACKGROUND. The measurement of the total nasal resistance by rhinomanometry is of special interest in the functional diagnosis of the nasopharynx and retropalatal space. It can be measured by posterior rhinomanometry or estimated by calculating the total resistance from measurements of both sides. Because the standard parameters of the classic rhinomanometry have to be considered as obsolete, Vertex Resistance and Effective Resistance and their logarithmic derivations have been introduced with 4-phase-rhinomanometry. MATERIAL AND METHODS. In the first part, posterior and anterior rhinomanometry have been compared in a study of 32 volunteers. The disadvantages of posterior rhinomanometry have been apparent because of inconsistent statistic results. To compare both methods is useful in cooperative patients for the diagnosis of postnasal pathological alterations. By analyzing the rhinomanometric databases of 5 hospitals in 10,033 untreated patients and in 8,246 patients after decongestion, the total nasal resistance could be determined. RESULTS. Because only the logarithmic values for effective and vertex resistances are correlated with the sensing of obstruction, these values have been used to classify the total obstruction in 5 classes. The descriptive data of every class are given. The here-described classes are valid for Caucasian noses. The calculated data can be delivered on request by the authors. CONCLUSION. The here-presented parameters for measuring the resistance of the nasal airway and the classification of the obstruction from a statistically representative material can be recommended for the daily practice in rhinology and rhinosurgery.

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“…The purpose of this study was to demonstrate the changes of the mucociliary clearance in particular diseases, or to highlight the possible risk factors for its prolonged duration [6][7][8][9] . Rhinitis and chronic rhinosinusitis have an undeniable role in the mucociliary clearance decreased performance, according to a US In a study on patients with deviated septum, who underwent septoplasty intervention, it has been shown that this pathology has a direct effect on the mucociliary clearance and that surgery has good effects in restoration of the mucociliary function in affected patients 10 .…”

Section: Discussionmentioning

confidence: 99%

Outcomes of mucociliary clearance and rhinomanometrical changes in nasal pathology

Neagoş

Cirticioiu²,

Stanciu³

et al. 2017

Romanian Journal of Rhinology

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OBJECTIVE. The aim of the study was to determine the impact of the nasal pathologies over nasal mucociliary clearance and rhinomanometric parameters. MATERIAL AND METHODS. This is a retrospective analytical observational clinical study during a period of 6 months, between 2014 and 2015. 123 subjects, 63 of whom had nasal pathology and 60 of whom were healthy controls, were enrolled in this study. The diagnosis of nasal pathology was made based on clinical examination, nasal endoscopy and anterior rhinomanometry. A methylene blue test was used to evaluate the mucociliary clearance. RESULTS. The subjects with nasal pathology had nasal septum deviation (No=50), chronic rhinitis (No=42), rhinosinusitis (No=15) and nasal polyposis (No=17). The mean total air flow in inspiration in nasal pathology patients group was 546.7 ml/s (millilitre/second), with a median of 594 ml/s, comparing with the control group who had the mean air flow of 865.5 ml/s, with a median of 866.5 ml/s. In expiration, the mean air flow in those with nasal pathology was 603.9 ml/s and a median of 611 ml/s, comparing with the control group who had the mean air flow of 871.1 ml/s and a median around 872 ml/s. The mean time from the application of methylene blue liquid to first seeing it in patients with nasal pathology was 23.41 minutes for the right nostril and 23.32 minutes for the left nostril, comparing with the control group who had the mean of mucociliary clearance of 6.76 minutes for the right nostril and 6.93 minutes for the left one. CONCLUSION. The results obtained in anterior rhinomanometry and methylene blue liquid test showed that nasal pathology does affect nasal physiology and it is an important factor to evaluate the mucociliary clearance.

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Correlation between subjective and objective nasal breathing assessments in examinees with nasal septum deformities

Cited by 5 publications

References 13 publications

A systematic review to examine the relationship between objective and patient‐reported outcome measures in sinonasal disorders: recommendations for use in research and clinical practice

A systematic review to examine the relationship between objective and patient‐reported outcome measures in sinonasal disorders: recommendations for use in research and clinical practice

Classification of total nasal obstruction in 10,033 cases by 4-phase –rhinomanometry

Outcomes of mucociliary clearance and rhinomanometrical changes in nasal pathology

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