Peak nasal inspiratory flow measurement and visual analogue scale in a large adult population

Ottaviano, Giancarlo; Pendolino, Alfonso Luca; Nardello, Ennio; Maculan, Pietro; Martini, Alessandro; Russo, Massimiliano; Lund, Valerie J.

doi:10.1111/coa.13329

Cited by 35 publications

(36 citation statements)

References 31 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%

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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%

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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“…Nasal endoscopy was performed in all subjects using either a rigid, 0° or 30° endoscope to exclude the presence of nasal polyps [ 18 ]. A portable “Youlten” flowmeter (Clement Clark International—Harlow, England) was used for PNIF measurement as previously reported [ 19 , 20 , 21 , 22 , 23 ]. The Screening 12 Test ® , a quick suprathreshold validated smell identification test based on 12 odors, was also performed to investigate any olfactory dysfunction [ 24 , 25 ].…”

Section: Methodsmentioning

confidence: 99%

Upper and Lower Respiratory Signs and Symptoms in Workers Occupationally Exposed to Flour Dust

Crivellaro

Ottaviano

Maculan

et al. 2020

IJERPH

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A group of 142 bakers was studied in order to investigate the relationship between higher/lower respiratory signs/symptoms and inflammation biomarkers and occupational exposure to flour dust. A complete upper and lower respiratory tract evaluation was performed. Seven percent of bakers complained of lower respiratory symptoms, while 22% of them complained of upper respiratory symptoms. Fifty five percent of the bakers were allergic, and 37.1% showed sensitization to occupational allergens. Abnormal spirometries were found in 15% of bakers, while fractional exhaled nitric oxide (FeNO) was above the normal reference in 24.5% of them. Moreover, 23.8% of bakers were found to be hyposmic. Population mean peak nasal inspiratory flow (PNIF) was in the normal range even if almost all the workers suffered from neutrophilic rhinitis at nasal cytology with the number of nasal neutrophils increasing with the increase of the duration of exposure to flour dust (p = 0.03). PNIF and FEV1 (forced expiratory volume in the 1st second) showed a positive correlation (p = 0.03; r = 0.19). The Tiffeneau index decreased with the increase of dust (p = 0.017). A similar result was obtained once we divided our population into smokers and non-smokers (p = 0.021). Long-term exposure to bakery dusts can lead to a status of minimal nasal inflammation and allergy.

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“…PNIF is a valuable instrument for clinicians and PNIF values were associated with subjective nasal obstruction in previous studies 27,28 . We found it was a suitable tool to show maintenance of nasal airflow after foam application.…”

Section: Discussionmentioning

confidence: 73%

Reversible obstruction of the olfactory cleft: impact on olfactory perception and nasal patency

Besser

Liu

Renner

et al. 2020

Int Forum Allergy Rhinol

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Background: Temporary disruption of sensory input can be studied relatively easily for vision or hearing by covering the eyes or ears. In contrast, closing the nostrils affects not only the sense of smell, but also the ability to breathe through the nose and humidify and warm inhaled air. We hypothesized that filling the olfactory cle (OC) with dissolvable nasal dressing (foam) would temporarily block olfaction while respecting nasal airflow. Methods:In 30 healthy volunteers, the OC was unilaterally obstructed in a back-to-front fashion. Orthonasal and retronasal olfactory function were tested before and after foam application. Ratings of odors and subjective nasal patency (SNP) were collected. Peak nasal inspiratory flow (PNIF) was used to measure nasal patency. Results:Foam was safely applied in every case using minimal instruments. No complications were reported. Orthonasal and retronasal test results decreased significantly in overall participants (all p < 0.0008). Indicating temporary anosmia, 3 subjects reached the lowest possible score for odor-threshold testing, with corresponding drops in retronasal test scores. PNIF values before and a er foam application were not significantly different (p = 0.11). SNP ratings decreased slightly, but not significantly (p = 0.052). Odor-intensity ratings dropped significantly (all p < 0.05). Conclusion:The OC can be safely obstructed with dissolvable nasal dressing, resulting in a decrease in odorintensity and orthonasal and retronasal olfactory function test scores. This procedure may serve as a hyposmia model that maintains normal nasal airflow.

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Peak nasal inspiratory flow measurement and visual analogue scale in a large adult population

Cited by 35 publications

References 31 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

Upper and Lower Respiratory Signs and Symptoms in Workers Occupationally Exposed to Flour Dust

Reversible obstruction of the olfactory cleft: impact on olfactory perception and nasal patency

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