Evaluation of Nasal Resistance by Rhinomanometry before and after Endoscopic Sinus Surgery

Abstract

With the objective of identifying the factors affecting the nasal resistance in patients undergoing sinus surgery, we evaluated the data of 95 patients with chronic sinusitis who underwent endoscopic sinus surgery (ESS) between 2015 and 2018 at our hospital. We determined the nasal resistance by rhinomanometry and also patients' sensation of nasal obstruction before surgery and 3 months after the ESS. In total, 49 bilateral and 46 unilateral ESS procedures were performed, including ESS alone, ESS + septoplasty, and ESS + septoplasty + conchotomy. In addition, the surgical cases were classified into single sinus or polysinus surgery, and groups with or without polyps. We compared the nasal resistance and degree of change in the nasal resistance among the groups. The same comparisons were also conducted separately in cases with nasal resistance levels of >0.25 Pa/cm³/s. Nasal resistance improved following the ESS in both the bilateral and unilateral cases. In almost all the subgroups, the nasal resistance improved following ESS with the exception of the ESS with septoplasty group with nasal resistance levels of >0.25 Pa/cm³/s. The degree of change in the nasal resistance was not significantly different between the ESS alone, ESS + septoplasty, and ESS + septoplasty + conchotomy groups. Similarly, the degree of change in the nasal resistance was also not significantly different between the single sinus and polysinus surgery or between patients with and without polyps. Furthermore, there were no differences among the above groups of patients with >0.25 Pa/cm³/s either. The patients' sensation of nasal obstruction improved following the ESS. The nasal resistance measured by rhinomanometry was weakly correlated with the sensation of nasal obstruction prior to the ESS; however, the nasal resistance following the ESS and the degree of change of the nasal resistance following the ESS were not correlated with the sensation of nasal obstruction or the degree of change in the sensation of nasal obstruction. Future studies are needed for a precise clarification of the factors that affect nasal resistance.

Keywords

nasal obstruction - nasal resistance - rhinomanometry - before and after ESS

• References

• 1 Naito K, Miyazaki S, Nonaka S. Guideline for measuring the nasal resistance by rhinomanometry. Jap J Rhinol 2001; 40: 327-331
• 2 Kase Y, Ohki M. Guideline for acoustic rhinometry. Jap J Rhinol 2001; 40: 322-326
• 3 Takeuchi H. Evaluation of nasal resistance. Jiten 2011; 54: 390-397
• 4 de Paula Santos R, Habermann W, Hofmann T, Stammberger H. Pre and post functional endoscopic sinus surgery nasal cavity volume assessment by acoustic rhinometry. Rev Bras Otorrinolaringol 2006; 72 (04) 549-553
• 5 Yoshida T, Kojima J, Mori E. , et al. Changes in quality of life and subjective symptoms following endoscopic sinus surgery. Jiten 2010; 53: 293-299
• 6 Takeuchi H, Kase Y, Naito K. , et al. Pre- and postoperative objective evaluations using rhinomanometry and acoustic rhinomanometry in patients undergoing paranasal sinus surgery. Jap J Rhinol 2012; 51: 455-461
• 7 Hisamatsu K, Makiyama K, Hirai R. Effect of septoplasty with bilateral submucosal inferior turbinectomy on snoring and sleep-disordered breathing. Jap J Rhinol 2009; 48: 349-354
• 8 Takahashi R, Ohbuchi T, Hohchi N. , et al. Effect of septoplasty and turbinectomy on obstructive sleep apnea syndrome [in Japanese]. Nippon Jibiinkoka Gakkai Kaiho 2013; 116 (07) 789-792
• 9 Numminen J, Dastidar P, Rautiainen M. Influence of sinus surgery in rhinometric measurements. J Otolaryngol 2004; 33 (02) 98-103
• 10 Naito K, Miyata S, Saito S, Sakurai K, Takeuchi K. Comparison of perceptional nasal obstruction with rhinomanometric and acoustic rhinometric assessment. Eur Arch Otorhinolaryngol 2001; 258 (10) 505-508
• 11 Prus-Ostaszewska M, Wysocki J, Niemczyk K, Balcerzak J. The correlation of the results of the survey SNOT-20 of objective studies of nasal obstruction and the geometry of the nasal cavities. Otolaryngol Pol 2017; 71 (02) 1-7