Four-phase rhinomanometry: a multicentric retrospective analysis of 36,563 clinical measurements

Vogt, Klaus; Wernecke, Klaus‐Dieter; Behrbohm, Hans; Gubisch, Wolfgang; Argale, Mara

doi:10.1007/s00405-015-3723-5

Cited by 53 publications

(55 citation statements)

References 11 publications

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“…differences in these values appeared after decongestion by xylometazoline spray. This was expected and corresponds with our previous investigations in adults (8,9) . The values for the effective and vertex resistance only differed when the nasal valve influen- The correlation with both characteristics was highly significant at a level of p = 0.01 (two-sided).…”

Section: Step 1: Determination Of Anthropometric Parameterssupporting

confidence: 93%

“…The classification of obstruction as shown in Table 6 is more reliable for the 'green' classes (i.e., the healthy noses after decongestion), while classes 3 to 5 are built from material that is much smaller because of the comparative classification in adults from 36,500 measurements (8) .…”

Section: Step 1: Determination Of Anthropometric Parametersmentioning

confidence: 99%

“…The essentials of four-phase rhinomanometry are the replacement of estimations by correct measurements of pressure and flow, the introduction of new parameters related to the subjective sensing of obstruction, and the acquisition of graphical information about the disturbed function of the nasal valve. Comprehensive clinical material of 36,500 unilateral measurements, a classification of nasal obstruction, and statistically significant data regarding the calculated total nasal resistance were published in 2015 and 2016 (8,9) . The measurement methods and the correctness of the parameters in four-phase rhinomanometry were confirmed at the 2016 ISCOANA conference and now represent the new standard in rhinomanometry (10) .…”

Section: Introductionmentioning

confidence: 99%

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Relationships among nasal resistance, age and anthropometric parameters of the nose during growth

Peksis¹,

Unger²,

Paulauska³

et al. 2018

RHINOL

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Background: Children generally have a higher nasal resistance than adults. Growth changes the size and different anthropometric parameters of the nose. Logarithmic effective resistance and logarithmic vertex resistance were introduced as physically correct parameters for nasal obstruction. The previously published classification of obstruction derived from 36,500 measurements is missing data for patients aged 7 to 19 years. Methodology: Rhinomanometry was performed before and after decongestion with 9 different anthropometric measurements in 225 children and adolescents. Correlations among age, anthropometric measurements, and logarithmic effective and vertex resistance were determined for both sexes, and regressions were calculated. Results: The highest correlations with the resistance values were found between age, lateral nasal length, and logarithmic effective resistance. A highly significant linear regression between age and logarithmic effective resistance was also found. This was used for adaption of the classification of obstruction in adults to growing patients. The resistance of the nasal airways at the age of 7 years was about twice that in adults. Conclusions: The linear regression equations can be used to suborder obstructions measured by four-phase rhinomanometry into classes for estimation of their severity according to age.

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Section: Step 1: Determination Of Anthropometric Parameterssupporting

confidence: 93%

Section: Step 1: Determination Of Anthropometric Parametersmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Relationships among nasal resistance, age and anthropometric parameters of the nose during growth

Peksis¹,

Unger²,

Paulauska³

et al. 2018

RHINOL

View full text Add to dashboard Cite

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“…Two additional new parameters were also introduced in 4PR: Vertex resistance, which is the resistance at the point of maximum flow during inspiration or expiration in a normal breath; and effective resistance, which is equivalent to the average of all the resistances during either inspiratory flow, expiratory flow, or the entire breath. 52,53 The advantages of 4PR as described by Vogt et al 52 include the acquisition of better diagnostic information due to the representation of the entire work of breathing. Moreover, the better correlation of the logarithmic transformation of resistance values with the subjective feeling of obstruction in the visual analog scale (VAS) and the consideration of valve problems and Bernoulli's effect in breathing have been discussed.…”

Section: Four-phase Rhinomanometrymentioning

confidence: 99%

Objective Assessment of Nasal Patency

et al. 2017

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The aim to objectify nasal airflow and patency is ongoing—many methods have been suggested, often lacking clinical relevance or showing weak correlations with patients' symptoms. It is crucial to thoroughly consult our patients presenting with nasal obstruction—and to inform them about realistic possible surgical outcomes. Often, a perfect-looking internal nose with a straight septum and normal-appearing turbinates does not guarantee a happy, symptom-free “owner.” A review of the literature and the current technical market is presented here to facilitate the rhinosurgeon's decision to perform pre- and postoperative objective measurements of nasal airflow. Recommendations by the societies have been included.

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“…Moreover, those methods, such as four-phase rhinomanometry 5 and rhinoresistometry, 6,7 only use upper thresholds to identify impairment of nasal breathing due to high resistance. Therefore, they are not able to address the issue of a too wide nasal cavity with a very low resistance that is connected to the empty nose syndrome.…”

mentioning

confidence: 99%

Numerical Analysis of Nasal Breathing: A Pilot Study

et al. 2017

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Currently, there is no fully sufficient way to differentiate between symptomatic and normal nasal breathing. Using the nose's total resistance is disputed as a valid means to objectify nasal airflow, and the need for a more comprehensive diagnostic method is increasing. This work's aim was to test a novel approach considering intranasal wall shear stress (WSS) as well as static pressure maps obtained by computational fluid dynamics (CFD). X-ray computed tomography (CT) scan data of six symptom-free subjects and seven symptomatic patients were used. Patient-specific geometries of the nasal cavity were segmented from these datasets. Inspiratory and expiratory steady airflow simulations were performed using CFD. Calculated static pressures and WSSs were mapped onto a common template of the nasal septum, allowing for comparison of these parameters between the two patient groups. Significant differences in WSS distributions during the inspiratory phase could be identified between the two groups, whereas no differences were found for the expiratory phase. It is assumed that one essential feature of normal nasal breathing probably consists of distinctively different intranasal flow fields for inspiration and expiration. This is in accordance with previous investigations. The proposed method seems to be a promising tool for developing a new kind of patient-specific assessment of nasal breathing. However, more studies and a greater case number of data with an expanded focus would be ideal.

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Four-phase rhinomanometry: a multicentric retrospective analysis of 36,563 clinical measurements

Cited by 53 publications

References 11 publications

Relationships among nasal resistance, age and anthropometric parameters of the nose during growth

Relationships among nasal resistance, age and anthropometric parameters of the nose during growth

Objective Assessment of Nasal Patency

Numerical Analysis of Nasal Breathing: A Pilot Study

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