Predictive role of nasal functionality tests in the evaluation of patients before nocturnal polysomnographic recording.
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Obstructive sleep apnoea syndrome is a disease characterized by a collapse of the pharyngeal airway resulting in repeated episodes of airflow cessation, oxygen desaturation, and sleep disruption. It is a common disorder affecting at least 2-4% of the adult population. The role of nasal resistance in the pathogenesis of sleep disordered breathing and sleep apnoea has not been completely clarified. Aim of the present study was to establish whether nasal resistance and nasal volumes, measured by means of Active Anterior Rhinomanometry and Acoustic Rhinometry together with Muco-Ciliary Transport time play a positive predictive role in the evaluation of Obstructive sleep apnoea syndrome patients before running a nocturnal polysomnographic recording. A retrospective study was performed analysing 223 patients referred for suspected Obstructive sleep apnoea syndrome. All patients were submitted to complete otorhinolaryngological evaluation and underwent nocturnal polysomnography. On the basis of polysomnographic data analysis, the apnoea-hypopnoea index and snoring index, patients were classified into two groups: Group 1 (110/223 patients) with a diagnosis of mild-moderate Obstructive sleep apnoea syndrome (apnoea-hypopnoea index < 30) and Group 2 (113/223 patients) affected by snoring without associated hypoxaemia/hypercapnia. A control group of 76 subjects, not complaining of sleep disorders and free from nasal symptoms was also selected. The results showed, in all the snoring and Obstructive sleep apnoea syndrome patients, total nasal resistance and increased Muco-Ciliary Transport time compared to standard values. Furthermore, the apnoea-hypopnoea index was significantly higher in patients with higher nasal resistence and significantly different between the groups. These results allow us to propose the simultaneous evaluation of nasal functions by Active Anterior Rhinomanometry, Acoustic Rhinometry, and Muco-Ciliary Transport time in the selection of patients undergoing polysomnography. (+info)
Changes in Peak Flow value during immunotherapy administration.
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Correlation between nasal resistance and different acoustic rhinometry parameters in children and adolescents with and without allergic rhinitis.
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The nasal valve region plays a key role in nasal breathing. In the international literature, a variety of techniques have been described to rectify nasal valve compromise, but based on the present evidence it is impossible to counsel a patient as to which technique is most effective. The aim of this study was to evaluate the results of surgery of the nasal valve through a hemitransfixion incision objectively with nasal endoscopy and rhinomanometry. The study group consisted of 54 males and 15 females with a mean age of 41.8 +/- 14.4 years, (range: 21-72 years). After a mean follow-up of 8 +/- 4.1 months, nasal endoscopy demonstrated the favourable effects of surgical treatment with a normalization of the nasal valve angles. Only 5 patients showed persistent nasal valve stenosis, and were scheduled for revision surgery. Preoperatively, total decongested inspiratory NARs were 0.245 +/- 0.091 Pa/cm3/s and decreased significantly after the operation (p < 0.0005) to 0.154 +/- 0.059 Pa/cm3/s. Similarly, preoperatively total decongested expiratory NARs were 0.188 +/- 0.068 Pa/cm3/s and decreased significantly after the operation (p < 0.0005) to 0.142 +/- 0.059 Pa/cm3/s. Moreover, total dilated inspiratory and expiratory NARs resulted significantly (p < 0.0005) lower than the preoperatively total decongested NARs, with a mean value of 0.120 +/- 0.059 Pa/cm3/s and 0.102 +/- 0.057 Pa/cm3/s, respectively. Statistical analysis did not reveal any influence of sex and age in rhinomanometric measurements. Hemitransfixion incision allowed a wide access to the whole valve area for inspection and correction of the various components. Rhinomanometry, performed in a decongested condition and after dilation test, was thus a useful diagnostic tool for the preoperative diagnosis of nasal valve obstruction and permitted to assess quantitatively the favourable effect of surgical procedures. (+info)