The Use of Acoustic Rhinometry in Predicting Outcomes after Sinonasal Surgery

Abstract

Today's healthcare environment demands objective assessment of surgical outcomes. The recent otolaryngologic literature has established acoustic rhinometry (AR) as a valid instrument to objectively document nasal patency. The purpose of this article is to evaluate the utility of AR in predicting outcomes after sinonasal surgery. All patients scheduled for sinonasal surgery at the Tulane University and University of Mainz Departments of Otolaryngology between 10/1/98 and 12/15/98 were enrolled. All subjects underwent AR and completed a sinonasal outcome survey (SNOT-20) one day before and two months after their surgical procedure. Thirty-one patients were enrolled. The SNOT-20 raw scores improved from a mean of 7.93 (+/- 3.78) preoperatively to 3.35 (+/- 2.33) postoperatively (p < 0.05). The I-notch revealed no significant change postoperatively. The mean bilateral predecongestion C-notch increased from 1.257 cm2 to 1.451 cm2 (p < 0.05). Patients with a bilateral C-notch > 1 cm2 were 1.96 times more likely to have a five-point improvement in the SNOT-20 raw score (95% CI = 1.17, 3.27). The mean value of the C-notch is significantly altered (increased) as a result of sinonasal surgery. Patients with a preoperative cross-sectional area < 1 cm2 are less likely to report large postoperative subjective improvement. These results indicate that patients with poor geometry at the area of the C-notch do not fare as well surgically as those with better preoperative measurements.

Measures of health-related quality of life for adults with acute sinusitis

“…Four studies did not clearly state the patient diagnosis. Three of these studies were in patients undergoing sinus surgery, 30,36,42 and 1 study included patients with “rhinosinusitis or rhinitis.” 29 Two studies had a mix of patients with chronic sinusitis and acute sinusitis 28,41 . Only 2 studies included exclusively patients with acute sinusitis 40,45 …”

“…47 Studies included a variety of interventions. Thirteen studies included surgical interventions, 22,25,26,30,32,34,36,37,39,42,44,46,48 9 studies included primarily medical interventions, 21,24,27,31,40,41,43,45,47 1 study included both medical and surgical interventions, 23 and 6 were observational. 28,29,33,35,38,49 Among the randomized interventions, 4 were placebo controlled.…”

Nasal Provocation Testing as an International Standard for Evaluation of Allergic and Nonallergic Rhinitis

“…It is designed to analyze the transnasal airflow in one nostril at a time depending on transnasal pressure, which is assessed contralaterally during tidal breathing. For complete and state of the art evaluation of nasal patency, this method is combined with acoustic rhinometry, which documents nasal geometry as cross‐sectional area within the nasal cavity 11–15 …”

“…For complete and state of the art evaluation of nasal patency, this method is combined with acoustic rhinometry, which documents nasal geometry as cross-sectional area within the nasal cavity. [11][12][13][14][15] Results of both methods, anterior rhinomanometry and acoustic rhinometry, are visualized graphically to facilitate analysis and documentation. Measurements before and after NPT can be easily compared and accurately assessed using these graphs in combination with the exact numbers for nasal airflow (cm 3 /s) and cross-sectional area (cm 2 ), which are computed by the respective analyzers.…”

Effect of an intra-oral nasal dilation appliance on 3-D nasal airway morphology in adults

“…Recent literature has established AR as a valid instrument for objectively documenting nasal patency [15]. For example, Mamikoglu et al [16] found that the diagnosis of nasal septal deviation can be supported by AR.…”