“Nasal dyspnea” describes the common symptom of nasal airway obstruction, which usually is assessed subjectively. Objective, quantitative methods are needed to assess the nasal airway adequately.
Methods
Rhinomanometry, in use for >30 years, was reviewed.
Results
No other symptom of rhinitis can be measured as objectively and accurately as that of nasal obstruction. Determinations by rhinomanometry are precise, usually better than 5%. Most rhinomanometers meet the published requirements of standardization by the International Rhinologic Society. An improved system for scoring symptoms of nasal dyspnea is suggested. Rhinomanometry, potentially a gold standard for the objective measurement of obstructed nasal airflow, has a proven place in the selection of patients for septal and nasal valve reconstruction.
Conclusion
Recommendations are given for extension of the standards to account for the near universal computerization of equipment. Miniaturization of equipment will increase its application to trials of drugs for rhinitis.
Get full access to this article
View all access options for this article.
References
1.
VinerA.S., and JackmanN.Retrospective survey of 1271 patients diagnosed as perennial rhinitis.Clin Allergy6: 251–259, 1976.
2.
NaitoK., ColeP., ChabanR., and OpryskD.Nasal resistance, sensation of obstruction and rhinoscopic findings compared.Am J Rhinol2: 65–69, 1988.
3.
SipilaJ., SuonpaaJ., and LaippalaP.Sensation of nasal obstruction compared to rhinomanometric results in patients referred for septoplasty.Rhinology32: 141–144, 1994.
4.
ConstantinidesM.S., AdamsonP.A., and ColeP.The long-term effects of open cosmetic septorhinoplasty on nasal air flow.Arch Otolaryngol Head Neck Surg122: 41–45, 1996.
5.
NaitoK., ColeP., and HumphreyD.Comparison of subjective and objective nasal patency before and after decongestion of the nasal mucosa.Am J Rhinol5: 113–115, 1991.
6.
D'SouzaM.F., EmanuelM.B., GreggJ.A method for evaluating therapy for hay fever. A comparison of four treatments.Clin Allergy13: 329–35, 1983.
7.
LinderA.Symptom scores as measures of the severity of rhinitis.Clin Allergy18: 29–37, 1988.
8.
Annesi-MaesanoI., DidierA., KlossekM.The score for allergic rhinitis (SFAR): A simple and valid assessment method for population studies.Allergy57: 107–114, 2002.
9.
JuniperE.F., ThompsonA.K., FerrieP.J.Validation of the standardized version of the rhinoconjunctivitis quality of life questionnaire.J Allergy Clin Immunol104: 364–369, 1999.
10.
JuniperE.F., ThompsonA.K., FerrieP.J.Development and validation of the mini rhinoconjunctivitis quality of life questionnaire.Clin Exp Allergy30: 132–140, 2000.
11.
JuniperE.F., ThompsonA.K., and RobertsJ.N.Can the standard gamble and rating scale be used to measure the quality of life in rhinoconjunctivitis? Comparison with the RQLQ and SF-36.Allergy57: 201–206, 2002.
12.
SipilaJ., and SuonpaaJ.A prospective study using rhinomanometry and patient clinical satisfaction to determine if objective measurements of nasal airway resistance can improve the quality of septoplasty.Eur Arch Oto-Rhino-Laryngol254: 387–390, 1997.
13.
RicciE., PalontaF., PretiG.Role of nasal valve in the surgically corrected nasal respiratory obstruction: Evaluation through rhinomanometry.Am J Rhinol15: 307–310, 2001.
14.
VogtK., HasseW., JalowayskiA.A.The clinical impact of high resolution rhinomanometry. In Abstract, 17th World Congress Int Fed Oto-Rhino-Laryngol Soc, Cairo, Egypt, 2002.
15.
ClarkeR.W., and JonesA.S.The limitations of peak nasal flow measurement.Clin Otolaryngol Allied Sci19: 502–504, 1994.
16.
SchumacherM.J., and PainM.C.F.Nasal challenge testing in grass pollen hay fever.J Allergy Clin Immunol64: 202–208, 1979.
17.
ColeP.Acoustic rhinometry and rhinomanometry.Rhinol Suppl16: 29–34, 2000.
SchumacherM.J., and GainesJ.A.Mathematical modeling of pressure flow curves from posterior rhinomanometry.J Allergy Clin Immunol77: 241, 1986.
20.
ClementP.A.R.Committee report on standardization of rhinomanometry.Rhinology22: 151–155, 1984.
21.
BromsP., JonsonB., and LammC.J.A universal way to evaluate the curve in rhinomanometry.Acta Otolaryngol Suppl360: 22–23, 1979.
22.
LundV.J.Objective assessment of nasal obstruction.Otolaryngol Clin N Am22: 279–90, 1989.
23.
NaitoK., and IwataS.Current advances in rhinomanometry.Eur Arch Oto-Rhino-Laryngol254: 309–312, 1997.
24.
ColeP.Nasal patency and its assessment.Am J Rhinol1: 135–139, 1987.
25.
SchumacherM.J.Nasal congestion and airway obstruction: The validity of available objective and subjective measures.Curr Allergy Asthma Rep2: 245–251, 2002.
26.
ColeP.Nasal airflow resistance: A survey of 2500 assessments.Am J Rhinol11: 415–420, 1997.
27.
SzucsE., KaufmanL., and ClementP.A.Nasal resistance—a reliable assessment of nasal patency?Clin Otolaryngol Allied Sci20: 390–395, 1995.
28.
SheltonD.M., and EiserN.M.Evaluation of active anterior and posterior rhinomanometry in normal subjects.Clin Otolaryngol Allied Sci17: 178–182, 1992.
29.
CanbayE.I., and BhatiaS.N.A comparison of nasal resistance in white caucasians and blacks.Am J Rhinol11: 73–75, 1997.
StokstedP.Rhinometric measurements for the determination of the nasal cycle.Acta Otolaryngol Suppl109: 159, 1953.
32.
RundcrantzH.Postural variations and nasal patency.Acta Otolaryngol68: 435–443, 1969.
33.
PiriläT.Acoustic rhinometry, rhinomanometry and the amount of nasal secretion in the clinical monitoring of the nasal provocation test.Clin Exp Allergy28: 468–477, 1998.
34.
EcclesR., JawadM.S., and MorrisS.The effects of oral administration of (-)-menthol on nasal resistance to airflow and sensation of airflow in subjects suffering from nasal congestion associated with the common cold.J Pharmacy Pharmacol42: 652–654, 1990.
35.
OrgelH.A., MeltzerE.O., KempJ.P.Clinical, rhinomanometric, and cytologic evaluation of seasonal allergic rhinitis treated with beclomethasone dipropionate as aqueous nasal spray or pressurized aerosol.J Allergy Clin Immunol77: 858–864, 1986.
36.
KohanD., JacobsJ.B., NassR.L.Rhinomanometric evaluation of two nasal steroid sprays in rhinitis.Otolaryngol Head Neck Surg101: 429–433, 1989.
37.
MalmL., Gerth van WijkR., and BachertC.Guidelines for nasal provocations with aspects on nasal patency, airflow, and airflow resistance. International Committee on Objective Assessment of the Nasal Airways, International Rhinologic Society.Rhinology38: 1–6, 2000.
