Rui Xavier, MD, PhD
Nasal airway obstruction is a frequent complaint of patients from both facial plastic
and rhinology clinics. If in most cases establishing the cause or causes for this
complaint is relatively straightforward, not infrequently the etiology of this symptom
is a challenge, as the symptoms of nasal obstruction may not always match the clinical
examination.
It is, therefore, crucial that the facial plastic surgeon is able to adequately evaluate
the nasal airway to properly address nasal airway obstruction. Several methods are
available for functional evaluation of the nasal airway, each one analyzing nasal
breathing from a different perspective. These distinct methods do not overlap each
other; instead data produced by any specific method will complement data obtained
by other methods. Nasal airflow level may be determined, as may its velocity or the
different paths of the nasal airstream inside the nasal cavity. The resistance of
the nasal airway to the airflow may be measured, as may the temperature or the pressure
inside the nasal cavity. The dimensions and angles of the nasal cavity may be analyzed,
as may the geometry of the nasal airway. And, rather importantly, nasal breathing
sensation may be quantified, as may the impairment caused by nasal obstruction on
routine daily activities of the patient.
Only after an adequate assessment of the nasal airway can the facial plastic surgeon
establish a treatment plan to correctly address each individual case of nasal airway
obstruction.
This issue of Facial Plastic Surgery is intended to provide an overview of the diverse methods currently available for
analyzing the nasal airway and nasal breathing, to provide the state-of-the-art knowledge
for selecting the evaluation method or combination of methods that afford the most
relevant information in each clinical scenario, and to provide critical judgment of
data produced by each method of nasal airway evaluation.
