Which Nasal Airway Dimensions Correlate with Nasal Airflow and with Nasal Breathing Sensation?

Xavier, Rui; Azeredo‐Lopes, Sofia; Menger, Dirk Jan; Carvalho, Henrique; Spratley, Jorge

doi:10.1089/fpsam.2021.0148

Cited by 8 publications

(12 citation statements)

References 35 publications

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“…43 In a previous study our group investigated possible correlations between several nasal airway dimensions and nasal airflow and have found nasal valve area to statistically correlate with PNIF value. 44 Interestingly, the results of the present investigation further corroborate the findings of that study and reinforce existing data supporting the functional role of spreader grafts. Therefore, the current trend for using spreader flaps instead of grafts in primary rhinoplasty may not be advised when a functional improvement is required.…”

Section: Discussionsupporting

confidence: 91%

Comparative Functional Effect of Alternative Surgical Techniques Used in Rhinoplasty

Xavier

Azeredo‐Lopes

Menger

et al. 2022

Ann Otol Rhinol Laryngol

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Rhinoplasty makes use of a combination of surgical techniques selected to address the specific requirements of each individual nose. Several different surgical techniques may be used for addressing each section of the nose, with possible different functional effects. Objective: The purpose of this investigation is to compare the functional effect of the different surgical techniques used for addressing each section of the nose. Methods: Prospective study of 57 consecutive rhinoplasty patients. Patients were evaluated with peak nasal inspiratory flow (PNIF), Nasal Obstruction Symptom Evaluation (NOSE), and Visual Analog Scale (VAS) for nasal obstruction before and 1 year after rhinoplasty. Additionally, esthetic evaluation of the nose was obtained with Rhinoplasty Outcomes Evaluation (ROE). According to the surgical technique used to address each portion of the nose, groups of patients were created and the functional improvement of these groups was compared. Results: Using the TukeyHSD multiple pairwise-comparison test, the estimated difference of the increase of PNIF between using spreader grafts and using spreader flaps was 94.9 (95% CI 24.3, 165.5, P = .004) between spreader grafts and neither grafts or flaps was 79.2 (95% CI 5.8, 152.6, P = .03), between spreader grafts and bilateral spreader flaps plus a unilateral spreader graft was 90.2 (95% CI 22.1, 158.2, P = .005). In all other portions of the nose, no significant difference was found in the functional improvement between different surgical techniques. Conclusions: Spreader grafts increase PNIF more significantly than other surgical techniques used for dorsal mid-vault reconstruction. Spreader grafts should be preferred over other techniques whenever an improvement of nasal airflow is required. No significant differences were found between the functional effect of alternative techniques used in other sections of the nose. Additional cohort studies will be necessary to further confirm data from this investigation.

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Section: Discussionsupporting

confidence: 91%

Comparative Functional Effect of Alternative Surgical Techniques Used in Rhinoplasty

Xavier

Azeredo‐Lopes

Menger

et al. 2022

Ann Otol Rhinol Laryngol

Self Cite

View full text Add to dashboard Cite

show abstract

“…Interestingly, the correlation between several airway measurements and nasal airflow has been documented elsewhere 12 . The nasal valve area is statistically associated with peak nasal inspiratory flow, and is more relevant when the sum of the two valve areas or the area of the smaller nasal valve are considered, regardless of the nasal valve angle.…”

Section: Accepted Manuscriptmentioning

confidence: 70%

Imaging Nasal Obstruction: An Objective Evaluation for a Subjective Complaint

Abreu,

Xavier

2023

Facial Plast Surg

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Nasal obstruction (NO) is a common clinical symptom characterized by a subjective sensation of insufficient airflow through the nasal cavity and may result from various factors, including changes in nasal anatomy, inflammatory conditions, tumoral lesions and other etiologies. While a thorough medical history and physical examination can often identify its cause, imaging is usually necessary in order to fully understand the problem. Computed tomography (CT) is the primary imaging modality used to evaluate the nasal cavity and paranasal sinuses, allowing for the identification of potential causes and structural abnormalities. However, when soft tissue characterization is required, magnetic resonance imaging (MRI) is also useful. Understanding the anatomical and pathological basis of NO is crucial for accurate diagnosis and appropriate management. Imaging techniques provide valuable information for identifying the underlying causes of NO and guiding treatment decisions. This article reviews the normal anatomy of the nasal cavity and adjacent paranasal sinuses, as well as the several conditions that may affect breathing comfort (tumors, inflammatory diseases, bony and cartilaginous anatomical variants, and "non-obstructive" mucosal thickenings), showing their normal presentation on CT and MRI.

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“…Computational fluid dynamics (CFD) studies have shown that the perception of nasal patency is related to the distribution of nasal airflow and mucosal cooling in NAO. 12 -17 Some studies have also emphasized the positive effect of airflow in the middle of the nasal airway on the perception of nasal patency. 12 -14 Computational fluid dynamics studies have confirmed that sinus surgery increases airflow in the middle of the nasal cavity, 18 -21 and Xiong et al found that functional endoscopic surgery increased flux through the area connecting the middle meatus and surgically opened ethmoid sinuses by more than 13%.…”

Section: Introductionmentioning

confidence: 99%

“…12 -17 Some studies have also emphasized the positive effect of airflow in the middle of the nasal airway on the perception of nasal patency. 12 -14 Computational fluid dynamics studies have confirmed that sinus surgery increases airflow in the middle of the nasal cavity, 18 -21 and Xiong et al found that functional endoscopic surgery increased flux through the area connecting the middle meatus and surgically opened ethmoid sinuses by more than 13%. 18 Nasal and sinus surgery has also been used to improve subjective symptoms in patients with obstructive sleep apnea (OSA), and symmetric opening of the sinuses was found to reduce nasal resistance, increase nasal ventilation, and alleviate upper airway obstruction.…”

Section: Introductionmentioning

confidence: 99%

Value of Opening the Middle Meatus in Patients With Nasal Airway Obstruction

et al. 2023

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Objectives While surgeries to correct the anatomical malformations that cause nasal airway obstruction (NAO) are generally successful, the outcomes of such procedures are often unsatisfactory. The aim of the present study was to assess the value of opening the middle meatus in patients with NAO. Methods Thirty-four patients with nasal obstruction due to nasal septal deviation were included in this study. After randomization, the middle meatus was either opened or not opened during septoplasty. The patients were evaluated through pre- and postoperative rhinomanometry and acoustic rhinometry. The Visual Analog Scale (VAS) scores of subjective symptoms along with responses to the 20-item Sinonasal Outcome Test (SNOT-20) were obtained before surgery and three months after surgery. Results The VAS scores and SNOT-20 responses improved significantly in both groups after surgery. The effective treatment rate based on the nasal congestion score (NCS) was 64.7% in the single group (septoplasty alone) and 100% in the combined group (septoplasty in conjunction with opening the middle meatus), and the difference was statistically significant ( P = .018). In both groups, surgery significantly improved nasal flow, resistance, minimal cross-sectional area, cross-sectional area 6 cm (CA6) from the anterior nostril and nasal volume. Nasal volume and CA6 after surgery were statistically different between the 2 groups ( P = .004 and .019, respectively). Conclusions Opening the middle meatus may further improve the subjective perception of patency on the basis of septoplasty.

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Which Nasal Airway Dimensions Correlate with Nasal Airflow and with Nasal Breathing Sensation?

Cited by 8 publications

References 35 publications

Comparative Functional Effect of Alternative Surgical Techniques Used in Rhinoplasty

Comparative Functional Effect of Alternative Surgical Techniques Used in Rhinoplasty

Imaging Nasal Obstruction: An Objective Evaluation for a Subjective Complaint

Value of Opening the Middle Meatus in Patients With Nasal Airway Obstruction

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